Clinical Care Coordinator Resume
Summary : Over 20 years of diverse experience in clinical environments. Responsibilities include motivating staff to implement policy modifications through collaboration, building sensible financial management solutions and providing compassionate care to patients. Experience has led to a thorough knowledge of HIPPA regulations, effectiveness of treatments, operational cost control, assessing staffing needs, clinical medical technology and regulatory requirements.
Skills : Maintenance, Implementation of new policies/plan of correction.
- Responsible for same-store growth within your market, as well as working as a team to help other team members accomplish this goal.
- Maintained ongoing communication with case managers, discharge planners, and physician office staff; conducting frequent presentations, both formally and informally, in order to build a strong network of referrals.
- Attended hospital case manager/discharge planner meetings/case conferences to discuss the agency's patients and also to provide education related to any changes in-home health care guidelines Compiled information needed to establish definitive patient home care plans, including assessment of the appropriateness of requested services.
- Communicated information regarding the patient to the clinical supervisor and/or primary care nurse; making agency administrative staff aware of additional patient needs and arranging for medical supplies as necessary.
- Documented all supporting records in accordance with regulations of applicable regulatory agencies Consistently met established sales call objectives and completing all required account data, call logs, and Quarterly Sales Plan forms as directed by the Sales Manager.
- Actively participated in the agency's business growth meetings, strategic planning meetings, company in-services, and required activities as determined by the Sales Manager.
- Assisted the Sales Manager and Sales Trainer in the orientation and mentoring of other staff related to business growth.
Health Care Management
Sr. Clinical Care Coordinator Resume
Summary : To obtain a leadership position in the Human Services area where effectively utilize professional Social Work, Case Management, Program Development, Contract Monitoring, Program Licensing and regulatory experiences to produce measurable outcomes for families.
Skills : Medical Coordinator, Medical Assistant.
- Made home visits and conducted an assessment for health care needs, service delivery, and provided comprehensive care coordination that reduced barriers to full community integration, optimal health, and choices for independence.
- Developed, reviewed, and revised Plan of Care and Case Management Goals according to the client's acuity level (LOC).
- Telephonically contacted service recipients monthly and completed health status updates and followed through with service needs.
- Maintained continuous contacts and communication with other service providers such as Doctors, Nursing Care Agencies, Pharmacies, Medical Equipment suppliers, Personal Care Aides (PCAs), and other Resource Coordinating agencies.
- Conducted quarterly Cost Utilization Data reviews (CUD) to ensure that the service and equipment used are cost-effective and within program guidelines.
- Conducted Private Duty Nursing (PDN) assessments and recommended increase or decrease in Private Duty Nursing (PDN) hours to the Dept.
- Conduct daily reviews with inpatient psychiatric units in Lake and Cook County Supervised care coordinators Facilitated weekly staffings with attending psychiatrist about care management Completed intakes for new members.
Jr. Clinical Care Coordinator Resume
Summary : Over 20 years' experience in customer service and working with a diverse population. Phlebotomist with over 11 years' experience in performing a range of blood drawing procedures. Exceptional in interpreting the best method for drawing blood depending on each specific patient, friendly, courteous and sympathetic Security clearance for the DOC.
Skills : Recruiting, Human Resources, Network Administration, Supervising, Scheduling, Clinical Care.
- Represents the best interest of the patients, pateint advocate.
- Coordinates and manages nursing tasks and interventions among team members based on the needs of the patient.
- Ensures effective communication and flow of information to all appropriate care providers.
- Anticipates and evaluates clients' risks to prevent errors in care delivery-work with quality improvement teams in implementing a process to maintain and promote patient safety.
- Delivers care in a timely, safe, cost-effective manner utilizing clinical and theoretical nursing concepts, hospital protocols and policies and evidence-based practice.
- Oversees the management of patient care through assessment of the assigned patient population daily to achieve optimal patient outcomes.
- Educates and informs patients and family members regarding available care options, advance directives and supports their rights and decisions about care and treatment.
Clinical Care Coordinator III Resume
Summary : To obtain a position in a healthcare setting that allows to utilize experience, knowledge, and skills to meet organizational goals while continuing to grow professionally and personally.
Skills : Healthcare Adminstration, Education, Research, Recruiting.
- Serves as facility authority and case manager for pediatric patients with asthma and RAD directing the integration of care within BAMC and/or with other community agencies.
- Develops case management patient care plans; conducts case management discussions with a variety of stakeholders; and evaluates appropriateness, quality, and/or cost effectiveness of care.
- Coordinates and monitors the administration of medication by protocol and documents effectiveness.
- Responsible for developing patient education programs to teach inpatients/family members self-management techniques for the successful daily management of asthma and RAD.
- Ensures the care provided in the Pediatric Disease Management Clinic is in compliance with all regulatory agencies and NHLBI guidelines.
- Performs healthcare systems delivery analysis and provides recommendations to healthcare providers and/or case managers regarding diagnosis and clinical events to facilitate efficient, effective, and high quality patient care.
- Serves as a member of the Clinical Practice Guidelines working group on Asthma.
Health Care Administration
Clinical Care Coordinator II Resume
Objective : Works collaboratively with physicians and other health care professionals. Confident decision maker with the ability to demonstrate excellent leadership skills and offer outstanding patient care.
Skills : Manager, Microsoft Office.
- Perform functional assessments of members using clinical skills and appropriate measurement tools.
- Provide outcomes targets to appropriate audience.
- Utilizes naviHealth proprietary technology for consideration of the level of care.
- Maintains UM/CM tool Collaborate effectively with the member's health care team to establish an optimal, transition plan to the most appropriate PAC setting.
- Assist the member in meeting short and long-term goals with regards to their overall well-being.
- Consult with Medical Directors and/or management to resolve any barriers in the patient's movement along the continuum of care.
- Assess and monitor patient's appropriateness for care setting (as indicated) according to LiveSafe and InterQual criteria for approvals and refer to licensed physicians for the next level of care determinations that do not meet criteria to be approved.
Masters Of Science
Clinical Care Coordinator I Resume
Objective : Enhancing the quality of care and the outcomes of patient care and achieving patient satisfaction. Being part of a team in the provision/advising of care, leading a team, coordinating, and providing oversight of care, especially wound care.
Skills : CAFAS Certified, PECFAS Certified.
- Applies utilization management criteria in determining the appropriateness of a requested level of care that considers the severity of illness and intensity of service.
- Coordinates with physicians on causes requiring a higher level of care for initial or stay reviews.
- Collects and reviews clinical information for concurrent and retrospective reviews for the purpose of extending the length of stays for all levels of care.
- Reviews and makes recommendations as needed on initial and subsequent stay reviews.
- Promoting decreased lengths of stay and assuring the appropriate level of care recommendations.
- Present educational lectures, and do Blood Pressure and screening for these.
- Coordinate care with physicians and follow plans of care set out by the physician.
Clinical Care Coordinator/Supervisor Resume
Summary : A Licensed Vocational Nursing position within your organization that will utilize recent education, experience, and unique abilities.
Skills : Essette, Sunrise, Nextgen, Microsoft Office, As400, Emds, Cerner.
- Ensures facility's compliance with Medicare regulations, Managed Care/Insurance contracts and company guidelines, policies and procedures.
- Advocates on behalf of the patient and Facility for needed patient resources and services within the reimbursement continuum.
- Provides education (including orientation of new employees) to other health care providers, the facility's care team and the patient/family on Medicare, Managed Medi-Cal /Medicaid or Managed Care/Insurance.
- Conducts weekly care management meetings to review and update plan of care and ensure contractual compliance for patients.
- Collaborates with Business Office to ensure Medicare Part A services are appropriately billed and meet Medicare documentation guidelines.
- Oversees the resource utilization of services covered under consolidated billing as well as ancillary costs.
- Directs the completion of claims requests and appeals for denied Medicare, Managed Medical/Medicaid and Managed Care/Insurance claims.
Clinical Care Coordinator/Executive Resume
Summary : Experience working in assisted living facilities as well as experience with the memory care unit at previous employee.
Skills : Excellent verbal and written communication Multicultural Counseling, Adlerian and other Theories.
- Conducted referrals and managed data to ensure patient and provider continuity of services.
- Provided guidance and handle complicated inquiries related to case initiation to internal and external customers.
- Investigated and resolve complaints regarding claims issues or case initiation.
- Educated providers in the certification process and helped reconcile inconsistencies and procedural difficulties.
- Initiated cases by taking data over the phone from providers and contracted companies.
- Helped to resolve issues and complaints from providers needing care management services related to: referrals for treatment, authorizations for services and verification of eligibility information.
- Oversee the administration of discharges, aftercare follow-up, and administrative waivers.
- Evaluated clinical appropriateness of treatment using professional knowledge within Ageless Home Care clinical guidelines.
Master Of Management
Clinical Care Coordinator/Specialist Resume
Headline : To obtain a position where interpersonal, medical, and behavioral health training will be utilized and expanded upon. To continue to grow within an organization and help improve the environment in which using previously acquired skills to learn and succeed in position. To empower both co-workers and the public by providing guidance that nurtures success and confidence.
Skills : Financial Analysis.
- Determined and assessed clients' needs to determine the appropriate services to fulfill the therapeutic requirements of the family and client.
- Advocated for the clients and their families within the agency and outside agencies, such as Magellan, to ensure that proper services were being provided and that all team members were provided appropriate information to provide services.
- Arranged and facilitated meetings with clients, families, and clinicians to promote accurate and proper testing and evaluations.
- Communicated with staff regularly to maintain an optimal level of service and cohesion.
- Developed organizational documents and methods to allow all team members to maintain an up to date treatment protocol.
- Trained new employees for their roles as therapeutic staff support personnel.
- Recruited new employees, reviewed resumes, and conducted interviews with new candidates.
BA In Psychology
Clinical Care Coordinator/Supervisor Resume
Summary : Organized, self-motivated and people-oriented professional with knowledge in Healthcare and Management. Has knowledge and skills beneficial to any organization that is seeking to create a productive work environment and maintain positive rapport with clients, patients and/or customers.
Skills : Emotional Intelligence, Customer Service, Critical Thinking, Problem Solving, Compassion.
- Assessed Medicaid client's needs and coordination of services.
- Developed and maintained a plan of care in consultation with primary care and specialty providers, the enrollee, caregivers or guardians, and family members.
- Assist clients in mitigating issues and removing barriers to care.
- Assist with coordination of clinical tests, images, and specialty consults as deemed appropriate by Healthcare providers and Medicaid benefits.
- Assessed for efficacy and drug interaction/side effects.
- Conducted medication education sessions, assuring client compliance and adherence to prescribed therapies.
- Develop communication and referral mechanisms to assure seamless communication between Medicaid, the healthcare provider, and the Care Coordination Team.
Associate In Nursing
Associate Clinical Care Coordinator Resume
Headline : Experience working in assisted living facilities as well as experience with the memory care unit at previous employement.
Skills : MS Office, MS Excel.
- Management of day to day care of residents and managing changes in conditions.
- Supervision of team on delivery of care and medication administration.
- Communication with physicians regarding changes in condition, medication management and management of resident plan of care.
- Development, review, verification of all resident's plan of care, and updating as resident condition changes.
- Assessment of residents to manage ongoing care.
- Participation in quality control team to improve quality measures that affect resident care.
- Responsible for assuring policies and procedures are adhered to by team members and provide coaching or disciplinary action to assure adherence by all team members.
- Skills Used Communication between all levels of staff members.
Associates Of Science
Clinical Care Coordinator Resume
Headline : Enthusiastic, experienced, energetic person in search of a career in the registered nursing arena contributing skills knowledge, training, and education.
Skills : Medical Assistant, Technician.
- Supervised 16 bed-detoxification unit contributing education, conflict resolution skills, and experience.
- Enforce state regulations of the Department of Mental Health, Mental Retardation, and Substance Abuse.
- Manage staff training, schedules, and coordination of care for clients.
- Utilize the nursing process for client assessment, TB testing, EKGs, and urine drug screens.
- Triage clients for medical clinic: immunizations, venipunctures, finger sticks, review lab results.
- Coordinated referrals, follow-ups within the community and respond appropriately.
- Responsible for monitoring of patients, medication administration, and providing client education.
A.A.S In Nursing