Care Nurse Resume Sample

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Savion Homenick
27386 Anika Freeway,  Los Angeles, CA
+1 (555) 177 0666

Work Experience


Progressive Care Nurse Manager
04/2016 - PRESENT
Boston, MA
  • Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
  • Determines appropriate utilization management of services requested
  • Assists with implementation of healthcare initiatives in market
  • Assists in implementation of specific strategies that improve the quality and outcomes of care
  • Assesses and coordinates simple discharge planning (short-term rehabilitation, homecare etc) with physicians, caregivers and ancillary providers to support the member’s continuity of care needs
  • Assesses and coordinates simple discharge planning (short-term rehabilitation, homecare etc.,) with physicians, caregivers and ancillary providers to support the member’s continuity of care needs
  • Assesses and coordinates simple discharge planning (short-term rehabilitation, homecare etc.) with physicians, caregivers and ancillary providers to support the member’s continuity of care needs
  • Uses critical thinking to determine if treatments are consistent with member's diagnosis and clinical needs. Ensures services provided are within benefit plan and that appropriate contracted providers are utilized
Transitional Care Nurse
01/2013 - 01/2016
Chicago, IL
  • Identifies needed information. Works with providers to obtain the information pertinent to evaluating treatment plan, medical necessity, appropriateness of care, timely progression of services and appropriate application of available benefits
  • Initiates interactions with providers regarding anticipated progression of care and transitions across treatment settings. Facilitates referrals for follow up providers and support services
  • Evaluates clinical information to identify and present cases during rounds. This includes identification of members at high risk for complicated medical treatment plans, readmissions potential, and admissions for potentially avoidable conditions
  • Prepares cases for review by medical director when condition or treatment plan varies from established guidelines
  • Documents clinical updates, authorizations, and referrals in the health plan care management system adhering to health plan documentation standards
  • Provides members and/or treating providers with resources to enhance their ability to access services
  • Serve as the lead for review of Payor, ACO, bundled payment quality/efficiency reports and work with the Care Center’s teams as needed to improve scores
Quality of Care Nurse
08/2008 - 07/2012
Los Angeles, CA
  • Assess adequacy of discharge plan and addresses any risk associated with discharge with internal associates and external case managers, PCP’s and others designated to care for the patient
  • Interact in a collegial and collaborative fashion with health plan, ACO, Health Center’s clinical staff to include: RNs, Social Workers, UR/UM, physicians, and nonclinical support staff
  • Consults with the Physician and health plan to resolve any barriers in the patient’s movement along the continuum of care
  • Reviews with the ED and other key department’s monthly readmission reports, quarterly and other reports as needed to assist with the identification of opportunities for improvement
  • Serves as advocate for Patient’s rights and intervenes to promote and defend these in order to insure patient’s safety and well-being
  • Systematically assesses patients’ actual or potential health care needs, prioritizes their urgency and uses creative and effective problem solving/decision making while recommending an appropriate disposition per clinician and protocol direction
  • Documents nursing assessment, planning, implementation in the electronic health record. Documentation is timely and in accordance with policy. Evaluates the patients’ and family’s response to teaching. Documentation includes presenting problem, nursing assessment interventions, education and patients’ response to interventions/treatments and education
  • Contributes to the organization’s drive to achieve “Customer Centricity” by improving the patient’s experience with care; which improves quality and the health of LWC’s population, thus reducing the cost of care for the population
  • Provides telephonic or onsite services to designated hospitals as assigned/necessary to assist hospital care coordination team with discharge planning needs of the members

Education


Central Michigan University
2002 - 2007
Bachelor's Degree in Nursing Required

Professional Skills


  • Strong clinical skills, including an understanding of and ability to implement evidence-based care
  • Maintains clinical skills by reviewing relevant literature, attending workshops and seminars, and networking with colleagues
  • Effective communication skills including both good listening and verbal and non-verbal abilities
  • Applies education and training from internal in-services to daily work to enhance personal nursing knowledge and skills
  • Nursing experience; 2+ years of Community Health experience
  • Case management or Skilled Nursing Facility experience
  • Experience in providing care in a hospital and home setting

How to write Care Nurse Resume


Care Nurse role is responsible for training, health, reporting, oncology, education, insurance, travel, clinical, medical, transportation.
To write great resume for care nurse job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Care Nurse Resume

The section contact information is important in your care nurse resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Care Nurse Resume

The section work experience is an essential part of your care nurse resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous care nurse responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular care nurse position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions. Representative Care Nurse resume experience can include:

  • Communicates with member, and/or family /significant other, and designated health care providers to assess, plan and implement care plans to transition the member to the appropriate level of care
  • Experience: 1-2 years management experience
  • Review request for health care services, according to guidelines, to ensure quality and cost effective care
  • Establishes good working relationships with all pertinent referral sources
  • Reviews service requests submitted by physicians to include review of evidence/clinical documentation and its medical necessity
  • Medical-Surgical and/or Rehab experience within an Acute Rehab Hospital

Education on a Care Nurse Resume

Make sure to make education a priority on your care nurse resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your care nurse experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Care Nurse Resume

When listing skills on your care nurse resume, remember always to be honest about your level of ability. Include the Skills section after experience. Present the most important skills in your resume, there's a list of typical care nurse skills:

  • Effectively articulate clinical and non-clinical information to persons of all levels
  • Communicates positively and effectively
  • Completion of an accredited nursing program and less than twelve months of nursing experience
  • Medical-Surgical Nursing experience within an acute care hospital
  • Experience within a Long-term Care setting
  • Maintain strong working relations with internal and external customers

List of Typical Experience For a Care Nurse Resume

1

Experience For Transitional Care Nurse Resume

  • Provides on-site services to designated hospitals as assigned/necessary to assist hospital care coordination team with discharge planning needs of the members
  • Assess resource utilization and cost management; diagnosis, past and present treatment and prognosis
  • Interacts with the other departments to ensure smooth transfer of member information across the continuum of care
  • Seeks advice of the Medical Director when medical judgment is required
  • Seeks assistance with appropriate individuals when network issues arise
  • Arrange, negotiate fees for and monitor appropriate cases and services for members
2

Experience For Transition of Care Nurse Resume

  • Conduct an evaluation of case, after closure. Collaborate with patient, family/significant other, physician and health care team regarding follow-up to evaluate status for health care needs
  • Assess clinical information to develop and implement treatment plans for transition to appropriate level of care
  • Coordinate the health care needs with the member, physician, family/significant other and health care providers (skilled nursing facilities, home health providers, rehabilitation facilities to accomplish the goal of transitioning member to the appropriate level of care
  • Establish measurable goals that promote evaluation of the cost and quality outcomes of the care provided
  • Collaborate with member and health care team to set appropriate individual goals and time frames. Identify opportunities for intervention
  • Represents BCBST in a collaborative and professional manner with network providers
3

Experience For Progressive Care Nurse Manager Resume

  • Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development
  • Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
  • Conducts any needed concurrent reviews at assigned hospitals to determine appropriate level of care and length of stay using established criteria
  • Seeks assistance of appropriate individuals when network issues arise
  • Understands the criteria for acceptance of patients, admission to the agency, services provided, appropriate utilization and the reimbursement process as they relate to the delivery of services to the patients of the organization
  • Accepts patient referrals from discharge planning staff of all inpatient facilities (hospitals, skilled nursing facilities, rehab facilities, and assisted-living facilities), social workers and physicians; evaluates the appropriateness for home care; coordinates the patient’s transition to home
  • Understands clearly the various payer sources and the respective qualifications for coverage by those payer sources
  • Obtains appropriate patient information necessary for verification of coverage and benefits; assists as needed in the insurance verification process
4

Experience For Quality of Care Nurse Resume

  • Informs patients of their insurance coverage/benefits and obtains written consent from patient/policy holder when reimbursement is questionable or less than 100%
  • Visits patients who are in inpatient facilities that are referred to Caretenders in order to educate about the services provided and identify individual patient needs/expectations
  • Educates facility personnel, patients, and caregivers on home healthcare coverage and services provided
  • Receives orders, written and verbal, for initiation of home care if a clinician; obtains order verification and approval as required by regulation and/or policy if not a clinician
  • Forwards patient information on all pending referrals to the intake coordinator or other designee in a timely manner
5

Experience For Primary Care Nurse Resume

  • Assists agency staff, physician, and the patient in establishing a home health plan of treatment for the referred patient prior to discharge from the inpatient facility
  • Orders medical supplies and durable medical equipment as needed to facilitate the transition to home
  • Notifies Intake Coordinator, Branch Manager/Clinical Manager of patient discharge from an inpatient facility in a timely manner
  • Secures appropriate physician orders for the provision of care and treatments
  • Returns the complete and accurate original referral to the office in a timely manner
6

Experience For Patient Care Nurse Manager Resume

  • Provides both formal and informal educational programs to inpatient facility staff and other physicians on various aspects of patient care
  • Maintains current knowledge of coverage issues, Medicare guidelines, and all services and products available from the organization
  • Contributes to and promotes the positive image of the organization and maintains a commitment to professional growth and competence
  • Participates in the orientation of new personnel as assigned
  • Understands, supports, and participates in the philosophy and implementation of the organization’s Quality Improvement practices
  • Supports the goal of continuous Quality Improvement by making pertinent suggestions to supervisory personnel to improve efficiency and/or to contain costs, to improve customer service and customer satisfaction
  • Contributes to the goal of providing exceptional customer service by demonstrating a willingness to ensure that the patient’s needs/expectations are always addressed to the fullest extent
  • Participates in data collection for Quality Improvement activities as requested
7

Experience For Onsite Chronic Care Nurse Resume

  • Supports the principles of the Corporate Compliance Program, attends orientation and in-services
  • Regularly attends and actively participates in assigned meetings and committees as required
  • Assesses the discharge planning needs regarding Home Health and/or elective procedures as needed. Coordinates with facilities, Medical Management staff, providers and members
  • Complies with all departmental policies and procedures
  • Participates in departmental and company in-services as appropriate
  • Provides community based care management to medically complicated, high risk patients who have been discharged from an acute or sub-acute inpatient facility. This includes but is not limited to patients with certain chronic conditions and co-morbidities such as Diabetes, CHF, COPD, Depression, and Dementia
  • Develops an individualized care plan for the patient and family caregivers based on the comprehensive assessment done via telephone. Conduct follow up to educate, problem-solve and advocate for patients for 30 days after discharge
8

Experience For HIV Primary Care Nurse Resume

  • Perform telephonic patient assessment, gathered with information from the patient, family, treatment team, including the primary nurse/charge nurse, social workers, physicians and/or discharge planners if applicable, outside agencies
  • Communicates and collaborates as appropriate with other health team providers including PCP, specialists, and visiting nurses etc. to facilitate a smooth transition to next level of care
  • Demonstrates awareness of self-learning needs and seeks ways to meet these in order to maintain current competency and respond to new clinical and educational demands. Interfaces with resource people in order to provide expert client care and facilitate self-development. Attends appropriate conference/inservice to maintain current knowledge base
  • Defines professional and educational goals and reviews with management team on a semiannual basis. Participates in professional organizations. Attends mandatory education programs annually as directed by CCHS standards
  • Licensure: Licensed in the state of Texas or compact nursing license
  • Attends daily inpatient rounds
  • Performs intensified and frequent outreach to identified "Red" (high risk for readmission as per job aide)
  • Expedite discharge follow-up appointments to specialist as needed
9

Experience For Outpatient Care Nurse Resume

  • Works in collaboration with Post Discharge Coordinator to identify and address potential risk for readmission
  • Engages physicians in the Palliative Care Program and motivates them to participate as appropriate in Palliative Care Conferences with patients/families
  • Monitor utilization of acute care services for palliative care patients
  • LPN in state of practice, active, is required
  • Registered Nurse with an active Tennessee license or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law required
  • Other Strong decision-making and administrative skills
  • Experience in patient education, planning, and management desired
10

Experience For Inpatient Care Nurse Resume

  • Three years of recent palliative and/or hospice experience
  • Preference for certification in hospice and palliative care nursing
  • A current nursing licensure in Illinois
  • Reliable transportation, current state driver's license
  • RN active unrestricted license in the state of Connecticut operations with 3 to 5 years of experience in a medical group or Health Plan setting with strong clinical skills and critical thinking required
  • Knowledge of Microsoft Office Word (40 WPM)

List of Typical Skills For a Care Nurse Resume

1

Skills For Transitional Care Nurse Resume

  • Care management experience in a managed healthcare setting
  • At least 12 months of previous nursing experience
  • Medical-Surgical or Rehab experience within an Acute Rehab Hospital
  • Experience in community health
  • Experience in utilization management or case management with a health plan or hospital based
  • : Long term care experience
  • Recognizing and encouraging our residents’ ability to make choices
2

Skills For Transition of Care Nurse Resume

  • Building relationships that bring joy into the lives of our elders and your co-workers
  • Providing compassionate and professional person-centered care
  • Understanding of the community-based social service delivery system and its interaction with the healthcare system
  • Being a licensed Registered Nurse in KY
  • Provides consultation as requested for questions dealing with palliative care and advance care planning
  • Provides on-site consultation for patients and families needing education, advance care planning, pain and symptom management
  • Updates the Palliative Care Patient Tracking Tool on the shared drive
  • Meets with the patient (or identified family members) to review and provide clinical education on the following topics
3

Skills For Progressive Care Nurse Manager Resume

  • Condition Management – education, symptom management, warning signs
  • Works with healthcare staff in identifying appropriate cases through patient care rounds and chart reviews
  • A current nursing licensure in Indiana
  • A current nursing licensure in MO
  • Maintain member confidence and protect operations by keeping all patient information confidential in compliance with HIPPA requirements
4

Skills For Quality of Care Nurse Resume

  • A current nursing licensure in Ohio
  • A current nursing licensure in the state in which the branch is located
  • Education leading to the completion of an approved RN program
  • A current nursing licensure in Indiana is required
  • A current, unencumbered nursing license in Texas
  • Gastrostomy Management (Feeding/Medication)
  • Empower patients and team members as a nursing leader
  • BSN or Associates in Nursing with commitment to obtain BSN within three years of date of hire
5

Skills For Primary Care Nurse Resume

  • Updates physicians on the changing needs/condition of patients until discharge
  • Maintains appropriate records according to organizational policies and procedures
  • Documents accurate, pertinent patient information, including demographics
  • Completes and consistently submits an accurate log of referrals from each inpatient facility according to policies and procedures
  • Performs transition of care assessment using questionnaire / assessments provided
  • Ensures patient / member compliance with keeping PCP and other identified provider follow-up appointments
6

Skills For Patient Care Nurse Manager Resume

  • Health Insurance Utilization Management and Case Management background
  • Use health services management systems LI-RG1
  • Enters patient information on palliative care referrals into Midas Focus Study and assures accuracy of data
  • Documents clearly and completely in the patient’s medical record based on established guidelines (Midas)
  • Healthcare Management Systems (Generic) Ability to use health services management systems is required
  • Healthcare Management Systems (Generic) Ability to use health services management systems is required LI-RG1
7

Skills For Onsite Chronic Care Nurse Resume

  • Understanding of the health care system and its component parts including sites of care, delivery models, and the roles of various providers and health care professionals
  • Experience in an acute clinical/surgical position(s)
  • Work with other patient experience staff to address identified issues or concerns
  • Current and Valid License in the state position is based
  • Acute care oncology or cardiology experience
  • Think broadly and longitudinally, constantly assessing and anticipating the needs of the patient and his/her environment
  • Manage patient complexity and multiple patients with diverse needs
8

Skills For HIV Primary Care Nurse Resume

  • Comfort with an independent role
  • Assertiveness, maturity, and confidence
  • Collaborate and facilitate relationships and consensus among the patient, family, and multidisciplinary providers from many different disciplines
  • Use health services management systems is required LI-RG1
  • Meet and maintain established turn around time standards
9

Skills For Outpatient Care Nurse Resume

  • Job responsibilities require use and disclosure of a member’s protected health information
  • Proficient in Microsoft Office such as Excel, Word and Outlook is required
  • Active New Jersey State Practical Nurse license
  • Current experience in utilization management to include pre-authorization, utilization review, concurrent review, discharge planning, and/or skilled nursing facility reviews
  • Three years of acute care experience
  • Attends hospital unit interdisciplinary rounds, as appropriate
  • For identified patients, reviews the hospital medical record to assist in the development of the Patient Discharge Instructions
  • Discharge Medications – additions, changes or deletions
  • Post-Discharge follow-up appointments– confirms and/or schedules appropriate physician follow-up,
10

Skills For Inpatient Care Nurse Resume

  • Post-discharge support – assures that the patient and family has access to healthcare, community and transportation resources during the immediate post-discharge period
  • Assists with attainment of PCP/Specialist upon patient request
  • Provide follow-up with patient's PCP as needed
  • Work with hospital clinical staff to identify appropriate patients for Transition of care outreach
  • Work the other hospital leadership to review

List of Typical Responsibilities For a Care Nurse Resume

1

Responsibilities For Transitional Care Nurse Resume

  • Knowledge of nationally recognized medical criteria such as lnterQual, etc
  • Registered Nurse with an active Tennessee license or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law
  • Education in Palliative Care, Hospice and communication about End of Life Issues
  • Experience in an acute clinical/surgical position(s), current experience in utilization management to include pre-authorization, utilization review, concurrent review, discharge planning, and/or skilled nursing facility reviews is required
  • CPR, BLS/ACLS Certification
  • LVN with current licensure
2

Responsibilities For Transition of Care Nurse Resume

  • Utilization management within a hospital, Insurance, managed care company or other settings is required
  • Location/Facility – Baylor Scott and White LakePointe
  • Primary Care background
  • Palliative care work
  • Completes discharge plan incl: appropriate physician appt(s) made, reconciled medication list with teach-back to patient/caregiver, assessment of potential barriers to medication adherence & proposed resolution(s), demonstrated adequate knowledge of condition(s), discharge instructions and self-care, barriers to care (financial, transportation) addressed & follow-up diagnostic studies in place

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