A Nurse Case Manager is tasked with the duty of providing individualized care plans at hospitals. The essential duties listed on the Nurse Case Manager Resume include the following – developing, implementing and evaluating patient care plans; advocating patient welfare; liaising between patients and families; working with new admissions, assessing conditions and needs of the patient, educating patients and their families; and following patient care plans. The job description also entails providing nursing care to patients if needed.
The most sought-after qualifications for the role include – excellent knowledge of case management principles, reimbursements and healthcare management, familiarity with psychological aspects of care, and updated knowledge of technically emerging new concepts. Nurse Case Managers should possess a Nursing degree and pass the National Council Licensure Examination in order to get qualified for this post.
Summary : Nurse Case Manager Case Management & Clinical Nursing Qualifications. Dedicated healthcare professional with an extensive background of nursing and case manager experience working in clinical, supervisory, and managed care. Relevant strengths: Case Management: Managing large volume patient caseloads and optimizing the health care services in a cost effective manner without compromising the integrity of patient care standards.
Skills : AHA BLS, electronic medical records, patient safety, advocacy, teamwork, critical thinking, assessment, case management.
Description :
Manage the daily operations of Homecare Nurses in a long-term home healthcare setting.
Oversee the overall care provided to LTHHC patients to ensure safety and quality skilled services.
Serve as a liaison between the agency and patients/family members.
Complete PRI assessments for SNF placements.
Assist the Nursing Director in utilizing marketing and business acumen to grow patient census with knowledge of Medicare and Medicaid regulations.
Proficient in McKesson Homecare computer program and OASIS and ICD coding regulations.
Review physician orders and patient charts for documentation deficiencies to ensure quality, while providing coaching to RNs to improve documentation.
Experience
10+ Years
Level
Senior
Education
Nursing
Registered Nurse Case Manager Resume
Summary : Certified Nurse Case Manager with over seven years of case management experience and utilization review in workers compensation and inpatient settings. Four years' experience performing both roles specifically for injured workers employed by Lowe's Home Improvement, managing caseloads of 55-65 employees over multiple states. Strong understanding of URAC guidelines as well as certain state specific guidelines.
Skills : Case Management.
Description :
Coordinate return to work plans and perform utilization review for injured workers.
Facilitate coordination of care between medical providers, insurance adjuster as well as the injured worker.
Provide preoperative teaching for workers requiring surgery.
Arrange for transportation for appointments as needed.
Facilitate approval and scheduling of necessary diagnostics and therapies within guideline standards.
Clearly and concisely document all contacts and information of the patient case management process.
Use independent judgment and discretion, identifies and plans strategies to promote return to work.
Experience
7-10 Years
Level
Management
Education
Diploma In Nursing
Primary Nurse Case Manager Resume
Headline : To obtain a position as a Licensed Vocational Nurse in a healthcare setting, where I can utilize my nursing education and training, as well as my interpersonal skills to provide the highest level of care.
Skills : Patient Care, Microsoft Office, NextGen.
Description :
Coordinate and monitor Soldier care plans using proper ICD-9 & ICD -10 coding utilizing online electronic health record databases.
Periodic Health Assessment and physical profile case management using military policies and regulations.
Case management for high risk behavioral health cases and medical board review.
Board member for the ILARNG suicide prevention program.
Develops and implements Soldier case management plans.
Measures effectiveness of Soldier's medical and psychiatric treatment interventions to determine case management outcomes.
Frequently interacts with senior military staff in determining case outcomes.
Assists senior military leaders and military healthcare providers to determine appropriate Soldier duty restrictions and limitations.
Experience
5-7 Years
Level
Executive
Education
Bachelors In Nursing
Clinical Nurse Case Manager Resume
Headline : Managing large volume patient caseloads and optimizing the health care services in a cost effective manner without compromising the integrity of patient care standards.
Skills : Skills NORTEL, KRONOS, CCMS, GRA, Microsoft Outlook,.
Description :
Served in a RN Case Manager role to manage plans of care for any issues related to the case load of 66 patients.
Met with physicians and interdisciplinary team members on a regular basis to discuss patient conditions, evaluated patient disease progression, and modified plans of care.
Created new patient admission form checklists that streamlined the patient charting process.
Earned Employee of the Month Award for outstanding nursing performance.
Served as new hire employee orientation educator.
Worked closely with the hospice social work, chaplain, and volunteers to coordinate physical, emotional, and spiritual care of the patient and family.
Assured the highest quality of care was provided and documented in accordance with the plan of care.
Experience
5-7 Years
Level
Executive
Education
Nursing
Behavioral Health Nurse Case Manager Resume
Summary : Self-motivator and self-starter. A team player and leader; Adaptable under stressful situations while maintaining keen attention to detail.
Directed completion of in-patient authorizations, and oversaw operating room procedures in compliance with two-day rule regarding extending out patients.
Managed caseload of 98 patients and handled inpatient observations.
Tracked upgraded inpatient observations of ER patients, maintaining accurate inpatient assignments.
Managed entire Med/Surg unit, performing IV insertions for antibiotics and DME.
Completed discharge planning, ensuring patients had ongoing resource support in-home as needed.
Referred patients to third party support groups as needed.
Managed two social workers, and partnered with social services agencies to ensure timely care.
Experience
7-10 Years
Level
Management
Education
BS In Nursing
Charge Nurse Case Manager Resume
Objective : Registered Nurse with over 14 years of nursing experience working with geriatrics, intellectually disabled, and terminally ill clients. skills Successfully directs staff meetings Adept at prioritizing/managing deadlines High level of autonomy Palliative care awareness Patient/family focused Problem resolution capability.
Skills : CPR certified; IV certified.
Description :
Processed Traumatic-Injury insurance claims (TSGLI) for Wounded Warriors.
Utilized team approach to promote communication, collaboration and coordination to provide Warrior focused care when working with various entities including the Warrior, Family members, Providers, Social Worker, and Command Team.
Facilitated all medical care for Warrior Transition Brigade (Wounded Warriors).
Ensured the Warrior received appropriate care related to identify medical conditions.
Provided Warrior Education on timeliness of care and treatment of injury, and provided general guidance to the Warrior.
Assisted with coordination of ongoing follow-up.
Prepared, reviewed and served as resource to Warrior with appeals for all Traumatic-Insurance Claims for Wounded Warriors.
Experience
2-5 Years
Level
Executive
Education
Associate In Nursing
Primary Nurse Case Manager Resume
Objective : Highly motivated, goal-oriented professional nurse with two year experience as a Licensed Practical Nurse and six years as a Registered Nurse, which includes the field of Geriatric Nursing, Medical/Surgical and Acute Rehab Setting.
Skills : Attention to Detail, Supervisor, Customer Service, Training, Educator.
Description :
Managed 130-case caseload in strict compliance with corporate guidelines and outlined criteria.
Interact with physicians and other providers to determine current medical status and future needs including alternative treatment plans.
Negotiate level of care, intensity and duration with providers.
Work independently while handling complex injuries.
Identify creative and cost-effective solutions using problem solving and decision-making skills to advance workers compensation cases.
Maintain high level of claim quality and adhere to quality standards.
Visit employers, underwriters, and risk managers on a quarterly basis to identify and discuss the most cost-effective and patient-oriented goals for injured workers return to functional employment.
Review all lost-time injuries for appropriateness of treatment.
Experience
0-2 Years
Level
Entry Level
Education
Nursing
Junior Nurse Case Manager Resume
Objective : Twelve years of experience in an array of nursing fields. Included working in Telemetry, Float Pool, Hospice, Charge Nurse on a Pulmonary Medicine unit, and a School Nurse. My most recent experience is in Case Management for the past 4 years in the doctor's medical office, an insurance company, an inpatient rehabilitation facility and emergency care center.
Skills : MDS, ICD-9, Lab Draws, IV Treatments, Injections, ECGs, Spirometry, Pulse Ox Testing, Care Plans, Phlebotomy, Geriatric Care, and Nurse Case Management.
Description :
Screens assigned population against established criteria during pre-admission/visit.
Collaborates with other members of the case management and health care teams.
Assist the patient in achieving optimal health.
Assure appropriate use of health care resources in accordance with utilization management standards and medical necessity review.
Facilitate/coordinate timely care along the continuum.
Decrease unnecessary variances in care through proactive case management.
Develop a safe and timely discharge plan to meet the patient's needs.
Experience
2-5 Years
Level
Junior
Education
Nursing
Nurse Case Manager/Primary Care Manager Resume
Summary : Twelve years of experience in an array of nursing fields. My experience has included working in Telemetry, Float Pool, Hospice, Charge Nurse on a Pulmonary Medicine unit, and a School Nurse. My most recent experience is in Case Management for the past 4 years in the doctor's medical office, an insurance company, an inpatient rehabilitation facility and emergency care center.
Skills : Microsoft Office, QuickBooks.
Description :
Completed initial assessment of patient and family and determined home care needs.
Provided medical and health services to patients at their places of residence.
Provided a complete and thorough physical assessment and history of current and previous illnesses.
Administered medications and treatments plans as prescribed by the physician.
Identified discharge planning needs as part of the care plan development and implemented prior to discharge of the patient.
Design, implement and evaluate patient's plan of care and revise as patient status and needs change.
Responsible for health of the patient through observation of blood pressure, body temperature, patient history and symptoms.
Worked with both patients and their families to assess the home environment and determined the needs of patients.
Experience
10+ Years
Level
Senior
Education
Master's In Nursing
Nurse Case Manager/Nurse Coordinator Resume
Objective : Occupational Health On-site clinical health services Regional Manager overseeing multiple on-site Health Centers across the U.S.
Skills : <div>Critical thinking and creative problem solving, Professionalism, Empathy.</div>
Description :
Serve to provide proactive case management that coordinates health care services in order to expedite a safe return to work; promote worker restoration of health and reduction of disability; monitor lost time claims.
Conduct on-site functional job analysis to make recommendations for job accommodations or modifications, Perform client assessments to determine appropriateness of medical care and make recommendations as needed.
Attend doctor appointments as needed to ensure proper care is given and serve as the client advocate.
Conduct on going assessments of client's progress in a return to work for both non-occupational and occupational health claims.
Possess knowledge of job hazard analysis and control, and how to apply the ergonomic principles to work place design.
Provide strong contributions as key member the nurse case management team designed to identify and evaluate problems, manage and reduce lost time claims, and assist in setting up transitional work programs to employers who request assist in reducing their lost time claims.
Exhibit motivation and dedication by providing the highest quality of care to each claim referred for nurse case management.
Experience
0-2 Years
Level
Entry Level
Education
Bachelor Of Science In Nursing
Nurse Case Manager II Resume
Objective : Thirty years experience in the health care industry Organized, with a positive attitude Good analytic, problem solving, and presentation skills Work well in highly pressured situation Self motivated and directed Working knowledge of Medicare, Medicaid, and state regulations for a skilled nursing facility and inpatient rehabilitation facility Proficient at MDS completion Experience in rehabilitation program management and coordination of referrals Proficient in Microsoft Office, keyboarding and 10-key operations.
Skills : EPIC and McKesson EMR training, Super-user at GRMC. KCI wound vac therapy certification.
Description :
Insure appropriate utilization of health care services and resources and facilitate the continuum of care including discharge to appropriate setting.
Effective communication, both orally and in writing.
Gather data, compile information, and prepare reports.
Assist in development of plan of care for the delivery of appropriate services for patients/ caregivers in conjunction with patient, family, patient's physician and other providers.
Assist with patient progression along continuum of care using a case management approach.
Collaborate with other providers (physicians, home care agencies, etc.) to discuss patient/caregiver needs services.
Collaborate with the multidisciplinary team serving as a resource to insure appropriate utilization of resources.
Complete comprehensive case management assessment of patient/caregiver.
Experience
0-2 Years
Level
Entry Level
Education
BS In Nursing
Nurse Case Manager Resume
Summary : Deadline oriented and capable of multi-tasking. Accustomed to working in high stress environments, while paying attention to detail and the task at hand. Dedicated team player with excellent communication skills.
Skills : <div>Decision-making and problem-solving, Organizational, Autonomy.</div>
Description :
Maintained a caseload of up to 30 wounded warriors in transition.
Liaised between patients and physicians to ensure patient comprehension of treatment plans.
Developed and implemented nursing care plans.
Developed patient care plans, including assessments, evaluations and nursing diagnoses.
Documented patient information obtained from interviews.
Ensured efficacy of treatments through monitoring of treatment regimens.
Maintained all confidential personnel files, license and CPR compliance records.
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