Care Manager resume examples

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Skillful Care Manager resume

DENISE TATE
Professional Summary
Licensed nurse with 16+ years experience in sub-acute rehab facilities. I bring extensive experience as a Nurse Case Manager/MDS Coordinator/Admissions with solid clinical background.  Current and active LPN license in Arizona and Washington state.  I am currently enrolled with Maricopa Community Colleges in order to pursue my BSN degree in nursing.
Skills

Supervisory experience

  • Advanced knowledge of Medicare/Medicaid regulations
  • Independent judgment and decision making producing accurate work



  • Excellent organizational skills
  • Multi-tasking
  • Excellent written and verbal communication
Work History
Case manager/MDS Coordinator Arizona Dept of Veterans Services - Phoenix, AZ 08/2017
  • Coordination of Care Conferences with clients and families to establish care needs and discharge barriers and need for coordination of care with transitions to the community
  • Participated in Quality Assurance Program/ Performance Improvement Committee.
  • Management of the RAI process in order to complete the MDS including Care area triggers and assessment and careplans for 170+ veterans.
  • Coordination of discharge planning process to ensure clients have required DME, referrals, and medications to transition back to the community with a safe discharge plan
  • Concurrent reviews for determination of coverage for Medicare, Med Advantage and Managed Care plans.
Admissions Coordinator Anderson House - Shoreline, WA 06/2016 - 05/2017
  • Coordinate the admission process utilizing referrals from community hospitals to secure new customers.
  • Build and maintain excellent relationships with local hospitals, DC Planners and SW personnel.
  • Verify benefits and eligibility for Skilled Nursing Facility (SNF) benefits, initiate pre-authorizations and obtain authorization for admission.
  • Coordinate with key personnel to ensure a smooth transition from the hospital to the SNF.
  • Excellent verbal and written communication skills.
  • Utilize clinical skills in review and determination of eligible admissions.
  • Utilization of  ICD-10 and DRG coding.
  • Estimating Insurance/Medicare reimbursement rates vs. cost of care and determining skilled needs for the patient. 
  • Maintain referral log for disposition of admissions, cancellations, and denials.


MDS Coordinator Life Care of Scottsdale - Scottsdale, AZ 03/2016 - 12/2016
  • Maintained and developed on-going MDS schedules for all residents Completion of the MDS, CAAs and care planning for all assessments Monitored completion of MDSs by other disciplines and provided on-going training as needed Monitoring and auditing for daily skilled nursing notes Transmission of assessments to the state and monitoring and reporting of monthly reports Participate in triple check process Assistance with discharge planning/ equipment needs/ community referrals.
  • Coordinate with the Interdisciplinary Team to determine continued eligibility of benefits in conjunction with Insurance Case Mgmt. for notices of Non-coverage and/or continued skilled needs.
  • Training of staff for skilled needs of patients and documentation requirements for Medicare guidelines.
  • Weekly reviews and updates related to  Medicare replacement plans and continued determination of skilled needs
MDS Coordinator Anderson House - Shoreline, WA 01/2015 - 01/2016
  • Maintained and developed on-going MDS schedules for all residents Completion of the MDS, CAAs and care planning for all assessments Monitored completion of MDSs by other disciplines and provided on-going training as needed Case management for all Medicare and Managed Care residents Monitoring and auditing for daily skilled nursing notes Transmission of assessments to the state and monitoring and reporting of monthly reports Participate in triple check process Coordination with Business Office Manager for accurate billing.
  • Review of medical claims under review with Medicare IDR process for accuracy of billed services and determination of skilled services
  • Coordinate with the Interdisciplinary Team/MD/Insurance Case Mgmt. for determination of benefits.
  • Provide education to staff and patients' on skilled care vs. custodial care.
  • Execute and deliver of Notice of Medical Non-Coverage letters to patients and informing them of their options as needed.
MDS Coordinator Life Care of Skagit Valley - Woolley, WA 01/2013 - 01/2015
  • Completion of the MDS, CAAs and care planning for Medicare/Medicaid/Managed Care/Private pay population.
  • Communicate clients' progress by conducting weekly interdisciplinary meetings  and submitting results to the proper insurance CM for continuation of coverage as applicable.
MDS Coordinator/RCM Careage of Whidbey - Coupeville, WA 01/2012 - 01/2013
  • Completion of the MDS, CAAs and care planning for Medicare/Medicaid/Managed Care/Private pay population Managing care of 40 residents and staff on unit for a mixed Medicare/LTC population including oversight of admissions and discharges and providing support and training of staff.
Staff Development Coordinator Life Care of Port Townsend - Port Townsend, WA 01/2012 - 01/2012
  • Creating and enacting training programs for employees Employee health including pre-employment screenings and immunization record management Interview and hiring process Employee hiring process including general orientation and job specific orientation Infection control including monthly reports and management of records for the annual survey process Injured workers program and L&I claims.
MDS/Assistant Director of Nursing/Staff Development Life Care of Port Orchard - Port Orchard, WA 01/2008 - 01/2012
  • Completion of the MDS, CAAs and care planning for Medicare/Medicaid/Managed Care/Private pay population Stand in for DNS as needed including all responsibilities State incident log management Hiring, termination, education needs Monitoring and managing of L&I employee injuries Employee immunizations and health screening Infection Control management.
Resident Care Manager Cottesmore of Life Care - Gig Harbor, WA 01/2007 - 01/2008
  • Accountable for resident care on assigned unit.
  • Ensured complete and prompt reporting of incidents with follow-up as necessary to Administrator and Director of Nursing.
  • Actively participated in committee/programs as directed by Director of Nursing.
  • Ensured that significant changes in resident condition were communicated to the physician, family or responsible party.
  • Made daily rounds on unit to ensure resident care needs and environmental standards are met, this included monitoring of dining room during meal times.
  • Work collaboratively with other members of the interdisciplinary care team to provide holistic care Review clinical records for completeness and accuracy as necessary Wound management with weekly rounds of monitoring improvement and/or decline with appropriated adjustments to treatment.
Restorative Coordinator/MDS Cottesmore of Life Care - Gig Harbor, WA 01/2002 - 01/2006
  • Direct and participate in the provision of restorative nursing care Assess all new admissions for restorative care needs including range of motion impairment, bowel and bladder incontinence, mobility deficits, dietary concerns including self feeding and swallow concerns Implementation and management of restorative nursing programs with periodic reviews and changes as required Completion of assigned sections of the MDS for all residents including long-term care and short-term rehab residents Fall and incident report management Restraint/enabler management.
Education
LPN Certification : Licensed Practical Nursing: Olympic College - Bremerton 2001
Bachelor of Science: BSN Program Glendale Community College/Rio Salado College - Phoenix, AZ Currently working towards completion
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Job-winning Care Manager resume

Teresa T. Andrews
Executive Summary
I am in search of a career in the petrochemical industry with a continuously growing company that provides various opportunities with the ability for progression. I am a fast learner with aspiration to take on new challenges and responsibilities
Professional Experience
Safety Admin/Safety Tech Dec 2014 to Current
Brock Services LTD Baytown, Texas
  • LPS Core Team member, Orientated Brock SSW on the ExxonMobile SSW program, Train employee on Site Safety Standards.
  • Safety Technician in the Majors Department, and maintenance at the Baytown Complex.
  • Helped facilitate Brock to achieve the SOI Gold award.
  • Conduct Safety meeting Weekly and Perform daily safety audits on multiple crafts.
  • Inspect fall protection equipment on a monthly basis (competent person)
Guest Service Manager Oct 2013 to Dec 2014
Ambrit Partners dba McDonald's Dayton, Texas
  • Handled customer complaints.
  • Manage a crew of 15 or more people.
  • Inspected the quality and safety of the food.
Care Manager Jan 2013 to Aug 2013
Caring Senior Service, Inc Omaha, Nebraska
  • Continually seek out and hired qualified applicants and maintained a pool of qualified caregivers to meet the demand of client volume and forecasted growth.
  • Conducted new hire orientation and ensure all caregivers had completed background check, EMR, and NAR prior to contact with clients.
  • Performed client supervisory visits to ensure customer satisfaction; made necessary updates in the individual service plan or resolve issues as necessary.
  • Initiated QAPI reporting for infection control, complaints, incidents, and accidents within 24 hour period.
  • Conducted employee and client chart audits and make appropriate corrections to ensure compliance with the company policies at any point in time.
  • Conducted regular performance reviews on caregivers 30 days prior to their anniversary date.
  • Conducted caregiver disciplinary actions and terminations due to poor performance or violations of company policy when necessary.
  • Data Entry which included inputting all applicant and new hires, correct hours for payroll and client/caregiver supervisory visits forms.
Assistant Property Manager Apr 2012 to Jan 2013
American Family Communities Georgetown, Texas
  • Responsibilities included managing property delinquency, setting property and maintenance goals.
  • Supervised maintenance, vendors, and contractors.
  • Ensured compliance with Texas Department of Housing and Community Affairs.
  • Minimized delinquent accounts through filing eviction with county courts.
  • Received and processed payments for residents.
  • Processed rental applications.
  • Issued violations.
  • Effective record keeping and Inventory control.
Certified Medication Aide/Certified Nurse Aide Apr 2004 to Feb 2013
Georgetown Nursing and Rehab Georgetown, Texas
  • Prepared and Administered Medications for Residents.
  • Care for the elderly and assisting with all ADL's.
  • Transport residents to and from appointments and outings.
  • Confirming and scheduling all appointments necessary for all residents.
  • Handling medical records.
  • Answer multi-lined phone.
  • Provide orientation and training for all new CNA's.
  • Inventory control.
Education
High School Diploma 1996 Coronado High School Lubbock, Texas
Information Management Technology August 1998 Texas State Technical College Sweetwater, Texas Information Management Technology
Medical Office Administration February 2011 University of Phoenix Phoenix, Arizona Medical Office Administration
Obtain a Certificate in Phlebotomy July 2011 Central Texas Phlebotomy Institute, LLC New Braunfels Austin, Texas
Obtain a Texas Certificate for Medication Aide May 2012
Construction Site Safety Technician 2017 Construction and Maintenance Education Foundation La Porte, Texas, 77521
References
  • Joe Garcia  Brock Safety Manager  Joe.Garcia@brockgroup.com

           713-724-0871

  • Juan Mata Brock Ins. Supervisor  Juan.Mata@brockgroup.com  

          281-905-7548

  • Veronica Zarate  Purchasing  Veronica.Zarate@brockgroup.com

          281-834-4213


Skills
  • Construction Site Safety Technician
  • OSHA 30
  • 3 Yrs. Experience in Industrial Work
  • Familiar with Exxon-Mobile Baytown Safety Rule and Initiatives.
  • Healthcare: intravenous therapy, MEDISOFT, computerized charting, STD counseling, breastfeeding educator People skills: great bedside manner, enthusiastic people person, advanced problem-solving, great organizational skills caregiver, CNA, client, clients, customer satisfaction, Data Entry, filing, forms, infection control, Inventory control, managing, payroll, performance reviews, Phlebotomy, policies, quality, record keeping, reporting, safety, scheduling, supervisory, phone
Other Skills
  • Working knowledge of Outlook E-Mail.
  • Word Processing Software (Microsoft Word)
  • Working Knowledge on Excel and Power Point
  • Language Skills
              English- Fluent/Read Write Speak
              Spanish- Fluent/ Read Write Speak
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Experienced Care Manager resume

Lori Hochstetler
Professional Summary

Registered nurse with 14 years experience in a hospital clinical setting, providing nursing care to diverse populations. Delivers patient-focused nursing care with a background in cardiac and stroke care and treatment. Care manager since January 2016 on 4100 cardiac and dialysis floor. November 2016 care manager on 2100-CDU floor. Performs intial assessments to assess patient care needs for safe discharge planning. Coordinates home care, medical equipment, and places referrals to skilled nursing facility or rehabilation center. Performs utilization review to ensure payment from insurance companies for patient services. Develops and provides community resources to help ensure quality services are provided to patient when discharged to home. Utilizes appropriate consults for physical and occupational therapies, social work, substance abuse, pharmacy concierge services to help patients with acute and chronic illnesses. Collaborates with nursing staff and director of 2100 to determine length of stay and quality measures needed for safe discharge to home.

Certifications
Basic Life Support
Skill Highlights
  • Skilled in conducting of initial assessments
  • Collaborates with staff to deliver safe and effective discharge planning
  • Provides appropriate resources to aid in a safe return home for elderly population
  • Consults Area of Aging Agency for long term home health care for the disabled and economically disadvantaged 
  • Collaborates with primary care physicians for discharge planning needs
  • Posseses strong communication and clinical skills needed to make appropriate referrals for long term care needs
Professional Experience
Cleveland Clinic Akron General Medical Center January 2005 to Current Registered Nurse, Care Manager
Akron, OH
Evaluates patient care needs, prioritized treatment and developed and implemented appropriate care plans. Documented patient information obtained from initial assessments. Utilizes strong assessment skills to determine necessary patient care. Precepted new graduate nurses while working on 9100-neurosurgery and stroke floor. Collaborates care with primary care physicians of patient.
Summa Health System January 2006 to June 2014 Registered Nurse
Akron, OH
Provided primary care, assessment, and evaluation of telemetry and stroke patients. Displayed strong leadership abilities when performing charge nurse duties. Preceptor to nursing students in their senior practicum for the past five years. Resource person for fellow nurses regarding extensive cardiac experience. Provided patient education, evaluated patient care needs and prioritized treatment accordingly.
Barberton Citizens Hospital August 2003 to March 2005 Registered Nurse
Barberton, OH
Provided patient care on a telemetry unit, performing assessments, intiated and followed nursing plans for up to 12 patients a shift. Handled all aspects of treatment, medication, and wound care.
Education and Training
St. Vincent-St. Mary High School 1986 High School Diploma Akron, OH
Stark State College 2003 Associate of Science: Nursing North Canton, OH
Ohio University 2015 Bachelor of Science: Nursing Athens, OH
Graduated Cum Laude
Member of Tau Sigma National Honor Society
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