Teressa Davis
Tualatin
Summary
A dedicated and compassionate Nurse Case Manager with an extensive career history in providing care coordination, offering services to patients with complex health care needs, acute and chronic disease patient education, as well as transition of care planning. Long term experience in ambulatory and acute care facilities, as well providing utilization management services for Oregon Health Plan members.
Overview
27
27
years of professional experience
Work History
Utilization Management Nurse
Yamhill Community Care Organization
09.2023 - Current
- Reduced hospital readmissions through effective discharge planning and coordination of post-discharge care.
- Increased efficiency in case management documentation by maintaining organized records and utilizing electronic medical record systems.
- Ensured compliance with regulatory guidelines by staying current on industry standards and participating in ongoing education opportunities.
- Promoted positive work environment by mentoring new nurses and serving as a resource for clinical questions and concerns.
- Strengthened relationships with community resources by networking, attending meetings, and establishing collaborative partnerships.
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
RN Case Manager
Legacy Medical Group Tualatin
10.2017 - Current
- Effectively communicates with physicians regarding patient needs, and shared the patient's progress.
- Completed initial assessments of patients and family to determine and address individual home care and potential for a higher level of care.
- Advocated for patients by communicating care preferences to providers.
- Takes an active role in patient and family planning process, detailing instructions and responding appropriately and effectively to questions and concerns.
- Provided diabetes and weight loss support and education.
- Collaborates with other primary clinic multidisciplinary team members.
RN Ambulatory Case Manager
Legacy Medical Group West Linn
01.2023 - 09.2024
- Developed and implemented comprehensive case management plans to address client needs and goals.
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
- Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
- Monitored clients' progress and tracked client services to provide crisis interventions.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Collaborated with an interdisciplinary team to determine timely delivery of services.
- Utilized trauma-informed approach to promote healing and empowerment for clients.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
RN Case Manager
Legacy Meridian Park Medical Center
09.2014 - 10.2017
- Coordinated a safe discharge plans from the acute care setting.
- Submitted requests for prior authorization requests for DME, Home Health, Home infusion,etc by utilizing the Interqual and the Centers for Medicare and Medicaid Services criteria.
- Utilized rapid quality improvement cycles to continuously monitor, evaluate, measure and report progress of interventions and outcomes.
- Coordination of community resources and referrals.
Nurse Case Manager
Tuality Health Alliance
12.2011 - 01.2014
- Educated health plan members and caregivers on healthcare protocols and processes.
- Gathered and recorded patient health information and data to assess, identify and manage characteristics that affect care outcome.
- Utilized McKesson Interqual and CMS criteria to determine appropriate hospital admissions,prior authorizations for medicaid members as well as determining if the request meets Oregon Health Plan criteria.
- Performed concurrent review for hospital ,skilled nursing facility length of stay.
- Followed and supported complicated and complex needs health plan members.
- Collaborated with healthcare leaders and physicians to support and offer resources to maintain high-quality and health care to the health plan members .
Medical Nurse Case Manager
WVP Health Authority
10.2009 - 12.2011
- Identified care needs of individual health plan members coordinated resources based on the need of the members and the per insurance limitations and procedural costs.
- Processed prior authorization requests for diagnostic imaging procedures.
- Processed prior authorization requests for rehabilitation therapies,DME ,home health care and surgical procedures.
- Completed referrals to specialist providers for Oregon Health Plan members.
Registered Nurse Case Manager
Oregon Health Sciences University
08.2006 - 09.2009
- Developed and modified patient care plans and assisted interdisciplinary team in identifying patient needs and goals to determine a safe discharge/transition to a lower level of care ie: skilled nursing facility,long term care, adult foster home.
- Fostered communication among social workers, therapists, hospital staff and patients.
- Collaborated with healthcare providers and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Completed utilization reviews to determine the appropriateness of acute care admissions.
Patient Care Manager
Portland Veterans Administration Hospital
11.2002 - 07.2006
- Utilized the nursing process in clinical practice and telephone triage to assess the urgency of patient care needs and to formulate an appropriate plan of care.
- Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing and other enabling services for veterans.
- Collaborated with professional peers,primary clinic multidisciplinary teams to provide health care needs to veteran patients.
RN Charge Dialysis Nurse
St. Vincent's Kidney Dialysis
04.1998 - 11.2002
- Oversaw the administration of hemodialysis treatments to treat patient's acute and chronic kidney disease.
- Documented patient care plans and evaluated patient's lab results.
- Educated family members and caregivers on a renal diet.
- Administered specific ordered patient medications.
Education
Bachelor of Science of Nursing - Nursing
Linfield Good Samaritan School Of Nursing
Portland, OR05.1990
Skills
- Experience working with Excel,Microsoft Word,McKesson, Interqual and Epic
- Utilization managment
- Strong communication and advocation skills
- Functions as a strong team player
- Extensive Case Management experience
- Clinical judgment
- Chronic Disease Management
- Care Planning
- Case Management
- Health Promotion
- Discharge Planning
- Diabetes management
- Appointment Scheduling
- EMR Systems
- Preventive health
- Patient education and counseling
Timeline
Utilization Management Nurse
Yamhill Community Care Organization
09.2023 - Current
RN Ambulatory Case Manager
Legacy Medical Group West Linn
01.2023 - 09.2024
RN Case Manager
Legacy Medical Group Tualatin
10.2017 - Current
RN Case Manager
Legacy Meridian Park Medical Center
09.2014 - 10.2017
Nurse Case Manager
Tuality Health Alliance
12.2011 - 01.2014
Medical Nurse Case Manager
WVP Health Authority
10.2009 - 12.2011
Registered Nurse Case Manager
Oregon Health Sciences University
08.2006 - 09.2009
Patient Care Manager
Portland Veterans Administration Hospital
11.2002 - 07.2006
RN Charge Dialysis Nurse
St. Vincent's Kidney Dialysis
04.1998 - 11.2002
Bachelor of Science of Nursing - Nursing
Linfield Good Samaritan School Of Nursing
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