Nurse Case Manager
Med-Care Management
West Palm Beach, FL
2003 - 2011
- Provided education to patients and their families on disease management, medications and other treatments.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Maintained accurate documentation of all case management activities in accordance with regulatory standards.
- Assessed patient needs, identified health problems and provided appropriate interventions to improve outcomes.
- Coordinated with healthcare team to establish, enact and evaluate patient care plans.
- Facilitated referrals between primary care providers and specialists when needed.
- Collaborated with payers to obtain authorization for requested services when applicable.
- Provided emotional support to patients and their families during difficult times.
- Facilitated access to specialty services by identifying providers who accept Medicaid and Medicare insurance programs.
- Coordinated discharge planning to ensure continuity of care post-hospitalization.
- Analyzed data from various sources including claims information, laboratory results and medication histories to identify potential risks or gaps in care.
- Reviewed test results and lab reports for accuracy before sending them back out for further action by physician or other practitioners.
- Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
- Communicated regularly with patients via phone calls or emails to check on their progress and answer any questions they may have.
- Coordinated with other healthcare professionals to provide comprehensive medical care to patients.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Evaluated referrals from physicians, hospitals, clinics and other sources for appropriateness of services requested.
- Advised physicians regarding alternative levels of care when indicated such as skilled nursing facilities or hospice settings.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Worked effectively in team environments to make the workplace more productive.
- Recognized by management for providing exceptional customer service.
- Updated and maintained databases with current information.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Approached customers and engaged in conversation through use of effective interpersonal and people skills.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
