Wendi Jones
Keokuk
Summary
RN Case Manager with Aetna, specializing in care coordination and patient assessment. Demonstrated success in optimizing discharge planning and fostering interdisciplinary collaboration. Led initiatives that enhanced communication and team morale, ensuring adherence to medical record standards. Focused on empowering patients through education and advocacy.
Overview
24
24
years of professional experience
Work History
DSNP RN Case Manager
Aetna
Work From Home
07.2021 - Current
- Advocate for Dual Special Needs Plans (DSNP) members with a wide range of health and social challenges.
- Assist members with navigating confusing language and procedures, and provide education and motivation for self-care and self-advocacy.
- Assist members in optimizing the use of medical and social services.
- Collaborate with members of the Interdisciplinary Care Team on how to best support our most vulnerable members.
- Led team huddle meetings, reviewing workflows and identifying obstacles to improve communication, coordination, and team morale.
RN Case Manager/Utilization Review Nurse
Keokuk Area Hospital
Keokuk
06.2019 - 06.2021
- Performed patient assessments for social health, extended hospital stay, and readmission risks.
- Coordinated with the physician, nurses, and therapists to develop an inpatient plan of care.
- Arranged care conferences with patients, family members, providers, and facilities or agencies to ensure a safe discharge plan, and to meet post-acute care needs.
- Created relationships with community agencies and facilities, including Department of Human Services social workers.
- Medical record data abstraction for CMS conditions of participation, and Joint Commission Standards.
- Collaboration with hospital coding and billing departments.
Director of Home Health Care Services
Keokuk Area Hospital
Keokuk
06.2016 - 06.2019
- The Director of the Home Health Agency was named to the Home Care Elite Top 100.
- Medical record review to ensure appropriate documentation and diagnoses coding.
- Collaborate with facilities, agencies, and professional advisory committees.
- Organization and scheduling of multi-discipline staff members according to patient treatment plan and need.
- Created agency policies and performance improvement plans.
RN Home Health, Labor and Delivery, Medical Surgic
Keokuk Area Hospital
Keokuk
08.2001 - 06.2016
- Provided direct nursing care to patients, including administering medications, wound care, and IV therapy.
- Collaborated with physicians in developing patient-specific treatment plans.
- Provided patient and family health education focusing on self-management, prevention and wellness.
- Delivered information regarding care and medications to patients and caregivers in comprehendible terminology.
- Updated charts throughout shifts with current, accurate information to maintain strict recordkeeping standards.
- Maintained thorough, accurate and confidential documentation in electronic medical records.
- Trained and mentored new RNs on best practices, hospital policies and standards of care.
- Developed education materials to help explain various conditions and treatments to patients.
- Maintained accurate documentation of patient records in accordance with HIPAA regulations.
Education
Associate Degree in Nursing -
Southeastern Community College
Keokuk, IA05-2020
Bachelor of Science in Nursing -
Chamberlain College of Nursing
10-2013
Skills
- Care coordination
- Patient assessment
- Interdisciplinary collaboration
- Discharge planning
- Medical record review
- Data abstraction
Timeline
DSNP RN Case Manager
Aetna
07.2021 - Current
RN Case Manager/Utilization Review Nurse
Keokuk Area Hospital
06.2019 - 06.2021
Director of Home Health Care Services
Keokuk Area Hospital
06.2016 - 06.2019
RN Home Health, Labor and Delivery, Medical Surgic
Keokuk Area Hospital
08.2001 - 06.2016
Associate Degree in Nursing -
Southeastern Community College
Bachelor of Science in Nursing -
Chamberlain College of Nursing
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