Director Of Case Management Resume
Summary : Registered Nurse with 20+ years of experience in inpatient and outpatient health care, specializing in Oncology. 11 out of 21 years have been in a management role, supervising staff and the clinical care provided for primarily Oncology patients. Adjunct faculty experience since 2012, clinical and online.
Skills : Fluent English and Spanish. Computer proficient, Microsoft Word, Power Point, Excel.
- Developed and oversaw the Case Management Department.
- Hired, trained and oversaw a line staff providing Ryan White Medical Case Management, DRS Home Services Program Case Management, Senor Case Specialist and Manager of Clinical Services.
- Provided clinical and administrative supervisor to Ryan White Medical Case Mangers .
- Monitored and oversaw the completion of annual performance evaluation of staff.
- Developed, implanted and revised the Ryan White Medical Case Management.
- Co-Developed and implement program for co-location of Ryan White Medical Case Management Services in medical facilities for the engagement and retention of patients into medical care.
- Oversaw and managed Chicago House's Residential Housing programs.
M.DIv In Theology
Sr. Director Of Case Management Resume
Summary : Professional Health Care Manager with over 29 years experience in a variety of hospital settings. A diversified knowledge of health care system. A skilled problem solver and self-starter with an orientation towards goal achievement and outcomes assessment. Demonstrate success in project completion, team building and organizational design.
Skills : Excellent Communication, Collaboration, Professionalism, Detail-Oriented, Responsible.
- Worked closely with physicians, ancillary team, patients and families to promote the best possible outcomes.
- Worked with local recourses for discharge planning and placement.
- Oversighted Case Management Department.
- Directly responsible for the continuing education and enhancement knowledge base for Case Management Department.
- Supervised Case Management staff.
- Focused on quality and appropriateness admission determination, including close coordination with medical staff toward that end.
- Implemented all current and upcoming CMS regulations.
MS In Health Services
Jr. Director Of Case Management Resume
Summary : Experienced licensed Nurse in Case Management with strong clinical and people skills. Professionally trained Case Manager with experience ensuring high standards of culturally competent care for wide variety of patients with diverse needs. Responsible Case Manager with excellent communication skills.
Skills : Case Management and discharge planning for acute care patients.
- Made decisions based on documented facts and findings to explain outcomes.
- Understood and utilized CQI principles, methods and tools.
- Served as advisor for current denials, as well delineation of as system improvements for future revenue preservation.
- Responsible for complete day to day operations within the Department.
- Oversaw and managed clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.
- Organized and led support groups per in subjects related to physical and emotional health to ensure long-term patient well-being.
- Assessed need for, ordered, obtained and interpreted appropriate lab tests.
Asst. Director Of Case Management Resume
Objective : In the last 30 years, have worked as a staff nurse, in hospital nursing management, in commercial insurance in utilization review and case management, assisted in the implementation of a Medicare/Medicaid case management program for a commercial insurance carrier, and developed inpatient departmental quality improvement programs.
Skills : Customer Service, Social Services, Management And Leadership.
- Measured results by using indicators of quality of working life and the socio-environmental contexts such as improvement of health, employment, .
- Implemented and provided ongoing assessments to the population.
- Responsible for Case Management department.
- Responsible for collaboration between employer and worker's compensation patients Liaison between local hospital and corporate Case Management .
- Recruited by CFO to lead and manager the case management department's care coordination and utilization management staff and functions.
- Improved retention by developing a career ladder that resulted in a Supervisor and two Case Manager II positions.
- Kindred Healthcare is the largest diversified provider of post-acute care services.
Science In Nursing
Associate Director Of Case Management Resume
Headline : Collaborative and Forward-thinking healthcare service management professional with 18 years' progressive experience in the non-profit and for-profit healthcare industry. Ability to prepare staffing plans and schedules, conduct performance appraisals and make hiring decisions.
Skills : Office Computer Applications, Self Motivated, Educator, Case Management.
- Developed and implemented the philosophies, policies, procedures and goals for the Case Management Department.
- Managed a team responsible for case management and underwriting new business life insurance applications.
- Worked with insurance sales agents to ensure all details are accurate with quotes, proposals, and illustrations making sure retail consumers.
- Included establishing department financial goals (daily, weekly, monthly), implementation of policies and procedures manuals, interviewing & hiring, .
- Represented applicants with extensive medical conditions to insurance carriers ensuring the best risk class rating and lowest premiums possible, .
- Responsible for strategic plan for PPS implementation and oversight Insurance contract negotiations and precerting new admissions Oversaw Utilization .
- Responsible for 10 FTEs Financial viability of the department.
Director Of Case Management III Resume
Objective : Experienced Nurse Case Manager with strong clinical abilities and successful career in both health care facilities and the payor industry. Proactive, organized with passionate commitment to quality patient care. Focused on utilizing the health care system to improve a patient's episode of care and education for self-advocacy within that system.
Skills : Customer service. Leadership.
- Coordinated the care delivered to a group of patients Facilitate communications between care providers and hierarchies.
- Oversaw the follow up of consultations and that they were linked to other follow-up services.
- Eliminated task and intervention duplications to the plan of care along with implementation of the plan of care to ensure proper follow up.
- Held an executive leadership position that required clinical experience, comprehensive knowledge of the healthcare industry.
- Developed case management program for hospital.
- Position eliminated due to financial cutbacks.
- Responsible for senior management position included the coordination of the agency's internal case management system.
Bachelor Of Science In Criminology
Director Of Case Management II Resume
Headline : High-performing healthcare senior leader with expertise in building and/optimizing organizational processes to achieve positive results, customer satisfaction, and employee retention. Relationship-based personality - authentic, trustworthy, with quick wit and good sense of humor. Skilled strategist who transforms strategic plans into workable solutions.
Skills : Current Training For RYT, Certified Health Coach Through ACE.
- Coordinated, implements, and monitor the Consumer Service Plan.
- Provided mediation between the consumer and the providers, guardians, family members, or the agency relative to the needs and desires identified by the consumer.
- Set up and maintain client files.
- Completed all required documentation in individual case files in a timely manner.
- Assisted consumers in receiving services which have been identified in the planning process.
- Initiated the transfer of an individual to other services or terminate services when the client determines they are no longer required or desired.
- Assisted consumers, guardians, and families in maximizing their abilities for self-determination by enabling them and empowering them in decision-making to the greatest extent possible.
Director Of Case Management I Resume
Summary : To work with a dynamic company where excellent customer service skills, management experience, financial acumen, problem solving skills, and outstanding communication skills will be appreciated and enhanced.
Skills : MS Office, Data Entry, Typing, Customer Service, Customer Service, Administrative.
- Supervised staff of 6 Ftes.
- Supervised discharge planning and social work for the department.
- Developd programs for denial management, discharge planning, and cost benefit analysis.
- Utilized Allscrips program to document on patients and ensure they meet InterQual criteria for admission.
- Facilitated total using electronic charting with Cerner.
- Facilitated weekly interdisciplinary rounds and quarterly utilization review meetings.
- Coordinated all billing and payments from expert review to deposition to trial.
Bachelor Of Science In Nursing
Director Of Case Management/Executive Resume
Summary : Senior administrator with over 10 years of experience in program management, development and operations in multiple healthcare settings which include private, public, for profit, and not-for-profit.
Skills : Microsoft Office, Multi-Line Phone System, Administrative.
- Facilitated a monthly support group to families and caregivers through certification from the Alzheimer's Association.
- Distributed to staff quarterly HIPPA compliance and education.
- Responsible for case management and utilization review program including hiring and training of staff and ensuring that key competencies .
- Utilized broad scope of dynamic nursing talents to direct forward-thinking development, planning, coordination, and administration of activities.
- Ensured agency compliance with state and federal guidelines, along with conducting internal utilization and quality assurance reviews, assisting.
- Established, promoted, and monitored innovative methods to enhance patient safety while adhering to core JCAHO goals.
- Associated the coordination of patient hospital stays along with their discharge needs, but also was able to coordinate.
Director Of Case Management Resume
Summary : Professional individual offering comprehensive experience in elder care with expertise in program development, management and implementation, staff training and supervision. Excellent interpersonal communication skills. Able to effectively interact with people of diverse backgrounds at all levels of responsibility.
Skills : Microsoft Office, Process Improvement, Leadership Development, Organizational Development, Project Management.
- Conducted admission review and oversight of inpatient stay .
- Responsible for the day to day operations of 5 Case managers and 1 DC Coordinator in the function of their duties as it relates to .
- Interfaced with and education of medical staff regarding regulatory guidelines and documentation r/t medical necessity.
- Developed and maintained clinical records, assessments, care plans, progress notes and discharge observations.
- Completed detailed intake and assessment with data collection and developed treatment plans.
- Executed outstanding case management (case load of up to 40).
- Tracked patient outcomes via follow up call, data collected and reported daily to administration.
B.S. In Social Work