Registered Nurse with nearly two decades of experience, including over 10 years in internal and external Case Management. Demonstrated strong work ethic, attention to detail, and dedication to providing quality patient care. Proven track record as a clinical navigator, liaison, and manager in a fast-paced healthcare environment. Seeking long-term career opportunity in a reputable healthcare organization to continue making a positive impact.
Overview
13
13
years of professional experience
Work History
Central Intake Coordinator
StoneGate Senior Living LLC
01.2023 - 02.2025
Received referrals through Electronic Medical Records (Epic/AllScripts), E-Fax, and Email from acute care facilities within the community to evaluate the required level of care for skilled nursing placement.
Evaluated clients' medical conditions for nursing placement suitability.
Served as the liaison between external marketing and sales teams and internal insurance personnel to obtain insurance authorization for skilled nursing placement.
Evaluated potential clients' medical records to assess their eligibility for long-term care placement in a skilled nursing facility in accordance with CMS guidelines.
Reviewed between 10 to more than 20 cases daily to assess patient needs for skilled or long-term care.
Market Director of Case Management
Post Acute Medical Rehabilitation Hospital
01.2021 - 06.2021
Oversaw departmental operations of two acute care rehab hospitals— case management, staffing, IT use, onboarding, and staff competencies, to meet performance and quality goals of both PAM's hospitals in Allen and Richardson (TX.)
Focused primarily on census management, patient care outcomes and key care indicators.
Worked closely with the hospitals' CEO, CNO, Medical Director and other central stakeholders to achieve established goals and expectations.
Ensured compliance with care coordination and discharge planning procedures by maintaining timeliness, quality standards, and accurate documentation.
Conducted the interdisciplinary team meeting bi-weekly to ensure a safe and effective discharge plan for all patients.
Advocated for patients and families to ensure services met their needs and resources were used appropriately.
Clinical Navigator
Post Acute Medical Rehabilitation Hospital
10.2019 - 01.2021
Cultivated referral relationships, effectively managed the assigned territory, and completed comprehensive patient assessments.
Established sales contacts and conducted an analysis of referral and admission data within the designated territory.
Worked collaboratively with business development team members regularly including the admissions manager and admissions staff as well as nursing and other internal and external staff to facilitate the referral conversion.
Promoted patient satisfaction through compassionate communication and attentive listening to concerns and needs.
Offered feedback and recommendations to improve customer service, the referral and admission process, and patient and referral source satisfaction.
Comprehensive Care Management/Care Coordinator
BSWH - Centennial Medical Center
03.2017 - 09.2019
Worked as an RN case manager on a medical/surgical unit.
Extensive experience with making post-acute care arrangements including outpatient hemodialysis, skilled nursing placement, LTAC placement, home health, hospice care, and home IV infusion.
Ability to determine the appropriate patient status: inpatient vs. observation and criteria to meet each.
Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
Used company software and databases to maintain records of services performed and patient conditions.
Proficient in utilization review.
Registered Nurse Case Manager
Washington Regional Medical Center
05.2012 - 12.2016
Served as a case manager on the medical/surgical, dialysis, and intensive care units.
Evaluated patients' discharge needs to ensure the development of safe and effective discharge plans.
Coordinated with admissions case managers using InterQual to verify that patients were assigned the appropriate admission status.
Evaluated patient progress and adjusted care plans accordingly, ensuring continuity of care across all healthcare settings.
Collaborated with physicians and other healthcare providers to ensure appropriate resource utilization for complex cases.
Provided education and support to patients and families, empowering them to make informed decisions regarding their healthcare needs.
Education
Registered Nurse Licensure -
Baptist Health School of Nursing
Little Rock, Arkansas
Licensed Practical Nurse Licensure -
Southeast Arkansas College
Pine Bluff, Arkansas
Skills
Expertise in macOS and Windows environments
Skilled in Microsoft Office software
Proficiency in multiple electronic medical records platforms
Skilled in utilizing CRM platforms
Advanced knowledge of medical terminology
Effective task management
Prioritization and organization skills
Meticulous quality assurance
Thorough in analyses
Client advocacy
Polished correspondence skills
Documentation management
Extensive knowledge in utilization management/review
Medical Billing and Collections Specialist/Accounts Payable Clerk at Stonegate Senior Living LLCMedical Billing and Collections Specialist/Accounts Payable Clerk at Stonegate Senior Living LLC