Wendy Lamb
Cottondale
Summary
Nurse leader with 26 years of healthcare experience, specializing in acute and managed care settings. Proven track record as a high-performing manager with over 15 years in hospitals and medical offices. Expertise in culturally competent patient care, clinical operations, and utilization management, complemented by a baccalaureate degree and ongoing Master’s studies. Strong skills in communication, problem-solving, and team leadership, seeking a role in an integrated delivery system focused on exceptional patient and staff support.
Overview
9
9
years of professional experience
Work History
Interim Executive Director of Case Management, Social Service, Utilization Review, Transitions of Care, Transfer Center
University of California Medical Center- Orange County
02.2022 - 03.2023
- Directed strategic initiatives to enhance patient care and operational efficiency.
- Managed interdisciplinary teams to ensure compliance with healthcare regulations.
- Oversaw budget planning and resource allocation across departments.
- Collaborated with stakeholders to develop community health programs and outreach efforts.
- Implemented best practices in clinical governance and quality assurance processes.
- Evaluated existing programs for improvement opportunities based on market analysis.
- Maintained accountability for operational and fiscal integrity by managing designated budgets.
- Strengthened organizational effectiveness through hiring, training, and mentoring staff members.
Director of Case Management, Social Services and Utilization Review
Washington Hospital Healthcare System
Fremont
06.2020 - 12.2021
- Directed case management teams to ensure efficient delivery of patient care.
- Implemented policies aligning with healthcare standards and regulations.
- Collaborated with interdisciplinary teams to enhance care coordination practices.
- Oversaw staff training and development for case management protocols.
- Evaluated processes to identify areas for improvement in case management.
- Established communication channels between patients, families, and healthcare providers.
- Managed budgetary resources for case management operations efficiently.
- Created and implemented case management programs based on analysis of patient data.
Interim Director of Case Management, Social Services & Utilization Review
Washington Hospital Healthcare System
Fremont
10.2019 - 06.2020
- Directed case management strategies to enhance patient care at Washington Hospital.
- Implemented compliance policies to meet industry standards in healthcare operations.
- Facilitated communication among patients, families, and providers to strengthen support.
- Collaborated with multidisciplinary teams to develop comprehensive care plans.
- Streamlined discharge planning processes to promote efficient, patient-centered strategies.
- Conducted staff training sessions to elevate case management practices.
- Evaluated services to identify performance improvement initiatives in case management.
- Maintained a thorough database for tracking patient progress and evaluating outcomes.
Nurse Case Manager/Utilization Management Contract/Consultant Position
Meleeo St Anthony’s Hospital
Lakewood
03.2019 - 06.2019
- Coordinated patient care plans with multidisciplinary teams to enhance treatment outcomes.
- Assessed patient needs, developing individualized strategies for effective management.
- Collaborated with healthcare providers to monitor progress and adjust care plans accordingly.
- Conducted daily utilization reviews per MCG guidelines for various admissions.
- Facilitated discharge planning, coordinating services like DME and home health support.
- Issued HINN and IM letters, ensuring safe discharge options for patients no longer qualifying for inpatient care.
- Participated in physician-assisted rounding to evaluate length of stay and establish discharge timelines.
- Analyzed data from claims, lab results, and medication histories to identify care gaps.
Nurse Case Manager/Utilization Management Contract/Consultant Position
Denver Health Managed Plan
Denver
10.2018 - 03.2019
- Conducted medical necessity reviews on procedure authorizations, admissions, and concurrent hospital stays.
- Managed notifications to medical providers and patients regarding service authorizations or denied requests.
- Completed 50 initial reviews daily or 20 concurrent reviews based on assignments.
- Informed medical facilities of denied authorizations for current hospital admissions.
- Prepared decision letters for members of Denver Health Plan.
- Developed personalized health plans addressing diverse client needs and goals.
- Educated clients on nutrition, exercise, and wellness practices to promote healthier lifestyles.
- Collaborated with healthcare professionals to ensure comprehensive care delivery.
Nurse Case Manager/Nurse Supervisor-Contract/Consultant Position
United HealthCare Group
Cottondale
02.2018 - 10.2018
- Coordinated interdisciplinary teams to develop patient care plans for optimal outcomes.
- Led complex training programs on Medicare and Medicaid compliance.
- Developed timely care plans for 65 to 125 members, including comprehensive medication reviews.
- Conducted monthly meetings with nursing home residents to enhance quality interactions.
- Engaged community members through regular phone check-ins for ongoing support.
- Arranged transitional care placements for members needing higher levels of care.
- Initiated home services like personal care assistance and meal deliveries.
- Trained and hired nursing staff for community and long-term care environments.
Adjunct Clinical Instructor-Part Time
Charter College
Anchorage
07.2016 - 03.2018
- Assessed need for lab tests, ordered and interpreted results efficiently.
- Conducted mandated health screenings and physicals for students in multiple schools.
- Managed chronic patient care in med-surg unit, providing treatment for numerous patients each shift.
- Organized support groups focused on physical and emotional health to promote patient well-being.
- Oversaw clinical staff in patient care activities while fostering high morale and professionalism.
- Examined patients and prescribed contraceptives and necessary medications.
- Implemented pharmacological and non-pharmacological treatments for various disorders.
- Evaluated student performance through assessments and practical evaluations.
RN Case Manager Director & Assistant CNO
St Elias Specialty Hospital
Anchorage
01.2014 - 03.2018
- Managed clinical oversight for 64-bed unit, ensuring optimal patient health outcomes.
- Coordinated multidisciplinary patient care plans with teams and families.
- Assessed patient needs, developing individualized treatment strategies.
- Monitored patient progress, adjusting care plans as necessary.
- Led clinical team in delivering comprehensive services promoting patient wellness.
- Oversaw nursing operations, including financial management and quality assurance.
- Conducted utilization reviews, prior authorizations, and appeals processes efficiently.
- Educated staff on compliance with state and federal home care regulations.
Nurse Case Manager/Nurse Supervisor- Part TIME while employed with St. Elias
CorVel Corporation
Anchorage
10.2016 - 02.2018
- Led high-performing healthcare teams to achieve optimal patient outcomes.
- Assessed patient needs and crafted personalized care plans.
- Coordinated with providers to ensure comprehensive support for patients.
- Monitored patient progress and adjusted care strategies accordingly.
- Educated patients and families on treatment options and health management.
- Collaborated with interdisciplinary teams to enhance overall patient care.
- Conducted claimant interviews to collect essential medical information.
- Documented patient data for workers' compensation injuries and maintained accurate records.
Education
Master of Science - Nursing
Sentential College of Nursing
Denver, CO01.2026
Bachelor of Science - Nursing
Chamberlain College of Nursing
Grover, IL01.2016
Associate of Arts - General Education
Chipola College
Marianna, FL01.2013
Associate of Science - Nursing
Chipola College
Marianna, FL01.2012
LPN Program - Nursing
George C. Wallace
Dothan, AL01.1998
Certified Nursing Assistant - Nursing
Washington-Holmes Vocational School
Chipley, FL01.1997
High School Diploma -
Cottondale High School
Cottondale, FL01.1996
Skills
- JIVA and Interqual
- Data analysis
- Budget management
- Staff training
- Interdisciplinary collaboration
- Case management
- Healthcare compliance
- Patient care coordination
- Budgeting and financial management
- Strategic planning
- Team bonding
- Operational planning
- Crisis management
- EPIC and CPSI
- Quality improvement strategies
- Risk management
- DRG and MCG
- Prior authorization processes
- Utilization review
- Appeals management
- Policy development and compliance
- Medicaid regulations knowledge
- Resource allocation
- Project management skills
- Commercial and private insurance expertise
- Communications strategy
- Leadership development
- Human resources management
- Grant writing
- Education
- Staff management
References
- Jenifer Turner (850) 693-6433
- Hannah Batista (850) 486-8000
- Tracy Hood (404) 655-6682
- Romeo Harris (832) 302-5295
Timeline
Interim Executive Director of Case Management, Social Service, Utilization Review, Transitions of Care, Transfer Center
University of California Medical Center- Orange County
02.2022 - 03.2023
Director of Case Management, Social Services and Utilization Review
Washington Hospital Healthcare System
06.2020 - 12.2021
Interim Director of Case Management, Social Services & Utilization Review
Washington Hospital Healthcare System
10.2019 - 06.2020
Nurse Case Manager/Utilization Management Contract/Consultant Position
Meleeo St Anthony’s Hospital
03.2019 - 06.2019
Nurse Case Manager/Utilization Management Contract/Consultant Position
Denver Health Managed Plan
10.2018 - 03.2019
Nurse Case Manager/Nurse Supervisor-Contract/Consultant Position
United HealthCare Group
02.2018 - 10.2018
Nurse Case Manager/Nurse Supervisor- Part TIME while employed with St. Elias
CorVel Corporation
10.2016 - 02.2018
Adjunct Clinical Instructor-Part Time
Charter College
07.2016 - 03.2018
RN Case Manager Director & Assistant CNO
St Elias Specialty Hospital
01.2014 - 03.2018
Master of Science - Nursing
Sentential College of Nursing
Bachelor of Science - Nursing
Chamberlain College of Nursing
Associate of Arts - General Education
Chipola College
Associate of Science - Nursing
Chipola College
LPN Program - Nursing
George C. Wallace
Certified Nursing Assistant - Nursing
Washington-Holmes Vocational School
High School Diploma -
Cottondale High School