RN, Care Manager Resume Sample

4.9
13 votes

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Leatha Jaskolski
66314 Connor Mount,  Houston, TX
+1 (555) 812 8935

Work Experience


RN, Care Manager
02/2018 - PRESENT
Boston, MA
  • Consistently exhibits behavior and communication skills that demonstrate HealthCare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer
  • Implements and monitors current medical group care management programs within the policies and procedures set by the Care Management department
  • Reviews patients’ clinical records of acute inpatient within 24 hours of notification
  • Reviews patients’ clinical records within 48 hours of SNF admission
  • Prioritizes patient care needs and meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan
  • Participates actively in assigned Care Management Committee (CMC) meetings. Documents pertinent patient information, all communication and CMC decisions
  • Ensures appropriate utilization of medical facilities and services within the parameters of the patients’ benefits and/or CMC decisions. This includes appropriate and timely movement of patients through the various levels of care
  • Follows patients on ambulatory care management programs, including CHF and home health in order to optimize clinical outcomes
  • Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
RN Care Manager Complete Care-telecommuter
08/2012 - 11/2017
Houston, TX
  • PC proficient; ability to communicate and interact professionally with co-workers, management patients, and Providers; ability to counsel and/or consult; working knowledge of HMO’s, PPO’s, Medicare, Medicaid, and insurance plans; knowledge of CPT4/ICD 9 & 10/HCPCS codes
  • Meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan
  • Leads the coordination of patient care with other disciplines within the care team, monitoring the appropriateness and timeliness of care
  • Ensures the interdisciplinary care plan is consistent with the patient's clinical course, continuing care needs and covered services by monitoring diagnostic testing, treatments and procedures, and other aspects of patient care as appropriate for acute care
  • Discusses with physicians, the appropriateness of resource utilization, consultations, treatment plan, estimated length of stay, and discharge plan
  • Focuses on complex patients, frequent emergency department utilizers, chronic pain patients, and substance abuse
  • Coordinates the transfer of patients to tertiary centers, including the transfer of patient information required for continuity of ongoing treatment and services
  • Provides oversight and collects data required for regulatory and accreditation compliance
  • Manages frequent emergency department visitors by conducting a focus study review of the previous and current admissions
RN Care Manager, Senior Care Options
01/2006 - 02/2012
New York, NY
  • Discusses with physicians, the appropriateness of resource utilization, consultations, treatment plan, estimated length of stay and discharge plan
  • Focuses on complex patients, frequent emergency department utilizers, chronic pain and substance abuse patients, and homeless patients
  • Collaborates with acute care case managers to ensure appropriateness on ongoing care
  • Provides oversight and collects data required for regulatory/accreditation compliance
  • Performs initial patient assessment to include physical, psychosocial, safety and environmental assessment. Includes participation and input from patient and family, making appropriate referrals after getting physician orders
  • Coordinates patient care with other disciplines; integrating input from disciplines. Ensures orders and changes in care are documented on physician orders and submitted for timely signatures. Performs ongoing nursing assessments and changing plans of care as needed. Initiates discharge planning at start of care; notifying patient of pending discharge
  • Monitors staff efficiency and productivity. Monitors cases for appropriate case assignments
  • Orients new employees by providing outpatient specific orientation for all new field staff. Ensures that staffing is adequate to support the orientation process. Meets regularly (at least monthly) with employees during the first three months of employment to facilitate transition to a fully productive status
  • Completes and legibly documents all pertinent information in accordance with established policies and procedures

Education


William Penn University
2001 - 2005
Bachelor's Degree in Nursing

Professional Skills


  • Excellence: Demonstrates competence in continuous improvement, continuous learning, accountability, and teamwork
  • U.S. based work experience as a licensed RN in one or more of the following areas
  • Experience providing patient education and self-management support
  • Dignity: Demonstrates competence in communication and interpersonal relations
  • Service: Demonstrates competence in customer/patient focus and adaptability
  • Justice: Demonstrates competence in community orientation and stewardship
  • Valid California driver’s license, insurance and vehicle for work-related travel

How to write RN, Care Manager Resume

RN, Care Manager role is responsible for medical, health, design, finance, training, wireless, insurance, travel, government, basic.
To write great resume for rn, care manager job, your resume must include:

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

Contact Information For RN, Care Manager Resume

The section contact information is important in your rn, care manager 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 RN, Care Manager Resume

The section work experience is an essential part of your rn, care manager 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 rn, care manager responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular rn, care manager position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions. Representative RN, Care Manager resume experience can include:

  • Actively addresses and monitors resource utilization using evidence based standards during the patient’s stay
  • Experience with in-home and telephone patient case management, knowledge of health-related information, education, and resource and referral services
  • Location/Facility – Baylor, Scott & White - Irving
  • Researches, evaluates and recommends resources to meet medical and non-medical needs of patients and families. Collaborates, refers, and communicates across all programs to ensure appropriate coordination of services
  • Coordinates the discharge planning processes in collaboration with other hospital departments, external service organizations, agencies and healthcare facilities
  • Acts as patient advocate by negotiating for, and coordinating resources with payers, agencies and vendors during inpatient and transition phases. Acts as a resource and provides staff and physician education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery

Education on a RN, Care Manager Resume

Make sure to make education a priority on your rn, care manager resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your rn, care manager 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 RN, Care Manager Resume

When listing skills on your rn, care manager 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 rn, care manager skills:

  • Skill and proficiency in applying highly technical principles, concepts, and techniques that are central to the nursing profession
  • Excellent written communication and the ability to document grammatically correct notes
  • Recent clinical experience
  • Valid Driver's License (DL): Required
  • Thorough understanding of RN scope of practice
  • Location/Facility – Baylor Medical Center of Irving

List of Typical Skills For a RN, Care Manager Resume

1

Skills For RN Care Manager Complete Care-telecommuter Resume

  • Shift/Schedule – FT Weekends (Sat/Sun; 7a to 730p) to include days during the week, as well
  • Basic knowledge of government and private insurance benefits, e.g. Medi-cal, Medicare, DRGs, and managed care.
  • Performs evaluation of patient’s care and progress for the episode of care and/or across the continuum for the identified population
  • Attends and participates in process improvement activities related to specific populations, department(s) and organization wide initiatives
  • Specialty/Department/Practice –Comprehensive Care Management
  • Shift/Schedule – FT TDA (Two-Day Alternative); Sat & Sun, 12 hour Shifts
  • Specialty/Department/Practice – Comprehensive Care Management (Med/Tele & PCU)
  • Specialty/Department/Practice –Comprehensive Care Management (Case Mgmt.)
2

Skills For RN Care Manager BSN Resume

  • Shift/Schedule – FT Days (M - F; 8a to 5p)
  • Shift/Schedule – PRN Days (flexible)
  • Shift/Schedule – FT Days - No weekends
  • Active Washington State license as a Registered Nurse is required
  • Certification in case management from the Commission for Case Management Accreditation (CCM). The American Nurses Credentialing Center (RN-BC), or the American Care Management Association is desirable
  • Skill in assessing, planning, and managing patient care as acquired through three years of clinical nursing experience in an acute care hospital; rehabilitation or home care experience
3

Skills For RN Care Manager, Senior Care Options Resume

  • Proficiency in Microsoft Office: Excel, Word, Access; Lotus Notes
  • Identifies and communicates quality and risk issues to the appropriate staff/departments in a timely manner. Identifies and communicates relevant information to the care team related to patients frequently seen or frequently re-admitted
  • Issues insurance notices of non-coverage and assists in appealing insurance denials for assigned units. Partners and communicates with Finance department per department policy to support and ensure accurate billings, pro-active audit and denial management
  • Work collaboratively with all stake holders to ensure knowledge of the action plan, including participation in telephonic conferences when appropriate
  • Participates on committees or workgroups, as directed by Manager
4

Skills For RN Care Manager Minnesota Senior Health Options Resume

  • Works as a resource to the ED clinical team as needed
  • Refers to the Social Worker for follow-up as needed
  • Responds to processes to identify patients with frequent ED visits and/or readmissions to maintain and enhance the plan of care
  • Provide targeted health education to the enrollee, and their family members/caregivers about available benefits, community resources, health care alternatives, and the importance of proactive disease and/or condition management approaches healthcare and wellness
  • Complies with departmental workflow and documentation policies and procedures.
  • Review and investigate member and provider requests to determine appropriate utilization of benefits
5

Skills For RN Care Manager, Total Population Health Resume

  • Location/Facility – Baylor University Medical Center (Downtown Dallas)
  • Provide support to members and their friends and families; identify developmental, physical, psychosocial, and psychological needs to assess and coordinate appropriate services
  • Location/Facility – Baylor All Saints Medical Center (Ft. Worth)
  • Location/Facility – The Heart Hospital Baylor Plano (THHBP)
  • Assist the member in making appropriate applications for public assistance, Medicaid certification or re certification, housing, and other necessary entitlements
  • NYS RN License required
  • Coordinates and implements the discharge plan for patients with post-care needs (i.e., home health, DME, transfers to Acute Rehab etc.) Identifies patients/families appropriate for referral to the Social Worker: those who would benefit from support that better enables them to deal with the impact of illness on individual family functioning and to achieve maximum benefits from healthcare services
  • Act as the clinical coordinator collaborating with members, caregivers, providers, TPH multi-disciplinary team, and health care and community resources to evaluate member needs through a variety of assessments (care management) to identify areas of (medical, financial, environmental, health insurance benefit, psycho-social, caregiving) concern and potential gaps in care

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