Rn-rn Case Manager Resume Sample

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Margaretta Schimmel
62994 Heidenreich Plain,  Los Angeles, CA
+1 (555) 298 9963

Work Experience


Case Manager Utilization RN
09/2017 - PRESENT
New York, NY
  • Plans, develops, assesses & evaluates care provided to members
  • Assesses high risk patients in need of post-hospital care planning
  • Develops & coordinates the implementation of a discharge plan to meet patient's identified needs
  • Acts as a liaison between in-patient facility & referral facilities/agencies & provides case management to patients referred
  • Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use
  • Develops and coordinates the implementation of a discharge plan to meet patient's identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies
  • Participates in the Bed Huddles and carries out recommendations congruent with the patient's needs
RN Inpatient Case Manager
10/2013 - 07/2017
Dallas, TX
  • Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred
  • Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources
  • Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities
  • Evaluates and identifies members' needs
  • Interfaces with Primary Care Physicians, Specialists and various disciplines on the development of case management plans/programs
  • Develops individualized patient/family education plan focused on self-management, delivers patient/family education specific to a disease state
  • Ensures that accurate records are maintained of the care associated with each patient
  • Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, and contract providers and outside agencies
  • Facilitation of precertification and payor authorization processes
RN Telephonic Case Manager
09/2006 - 09/2013
Philadelphia, PA
  • Facilitation of the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement
  • Support and coaching of clinical documentation efforts and serving as a clinical resource for coders ensuring that documentation accurately reflects severity of illness and intensity of service
  • Coordinating communication with physicians
  • Adapt to new electronic processes
  • Individual case/disease management/advocacy services, precertification of selected services or procedures, concurrent review, discharge planning and retrospective review
  • Assists in the development of policies, procedures and new programs relating to care management and quality improvement activities
  • Acts as patient/family advocate in coordinating and gaining access to needed health care services and interacts on a regular basis with claims administrator personnel to exchange required certification information

Education


University of Connecticut - Waterbury Campus
2001 - 2006
Bachelor's Degree in Nursing

Professional Skills


  • Utilize critical thinking skills, nursing judgment, and decision making skills
  • Utilize critical thinking skills, nursing judgement and decision making skills
  • Strong written and verbal communication skills to communicate effectively with individuals at all levels of the organization
  • Demonstrated PC skills, experience with electronic health record documentation
  • Strong computer skills including windows, keyboarding, MS Office and toggling
  • Prior clinical experience in an acute care, skilled or rehabilitation clinical setting 3-5 years
  • Strong skills in medical assessment/medical record review and/or behavioral health assessment

How to write Rn-rn Case Manager Resume

Rn-rn Case Manager role is responsible for health, software, record, computer, medical, word, documentation, typing, clinical, training.
To write great resume for rn-rn case manager job, your resume must include:

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

Contact Information For Rn-rn Case Manager Resume

The section contact information is important in your rn-rn case 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-rn Case Manager Resume

The section work experience is an essential part of your rn-rn case 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-rn case 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-rn case manager position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions.

Representative Rn-rn Case Manager resume experience can include:

  • Analytic skills necessary to clinically assess patients’ needs, and to develop, coordinate and prioritize complex treatment and discharge plans
  • Independently collaborates effectively with Interdisciplinary care team (ICT) to establish an individualized transition plan for members
  • Demonstrates exemplary knowledge of utilization management and care coordination processes as a foundation for transition planning activities
  • Experience in a hospital, acute care, home health / hospice, direct care setting or in case management
  • Knowledge of availability and criteria for admission to Crisis House, Residential, and Skilled Nursing Facility Programs
  • Two (2) years of experience working with vulnerable populations and people with chronic or complex conditions

Education on a Rn-rn Case Manager Resume

Make sure to make education a priority on your rn-rn case 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-rn case 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-rn Case Manager Resume

When listing skills on your rn-rn case 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-rn case manager skills:

  • Problem solving skills - ability to address and resolve clinical and social issues with members, members’ family/care giver and healthcare providers
  • Experience with case management and discharge planning and patient education for adult acute and skilled care
  • RN experience in a hospital, acute care, or direct care setting, or experience as a Telephonic Case Manager for an insurance company
  • Competent computer skills in word processing and spreadsheet utilization. Able to use computerized medical record to retrieve and record patient information
  • This Per Diem position is in the field, and is primarily housed at a Skilled Nursing Facility/Facilities (SNF) with daily huddling with department team
  • Demonstrated working knowledge of quality improvement and understanding of health care

List of Typical Experience For a Rn-rn Case Manager Resume

1

Experience For Case Manager Utilization RN Resume

  • Be familiar with the employee’s job by acquiring a Detailed Job Profile in order to determine with the business to see if there is work availability
  • Assist members to remain in their homes safely receiving the care they deserve and need
  • Maintain current licensure to work in State of employment and maintain hospital credentialing as indicated
  • Decision-making is based on regulatory requirements, policy and procedures and current clinical guidelines
  • Refers cases to UM Medical Director as appropriate for review for cases not meeting medical necessity criteria or for complex case situations
  • Monitors for any quality concerns regarding member care and reports as per policy and procedure
2

Experience For RN Inpatient Case Manager Resume

  • Document the patient’s plan of care in Midas as per department policy
  • Identify the patient’s insurance coverage or other source of payment for services
  • Identify and addresses as appropriate the patient’s risk factors or obstacles to care
  • Communication: Provide members and families with ongoing, current information and support to enhance satisfaction throughout the continuum of care. Facilitate communication among members of the health care team
  • Current Ohio and Michigan Registered Nurse or LSW license required
3

Experience For Case Manager Utilization Rn-pd Resume

  • Documentation: Documentation follows current Paramount procedures. Has good knowledge of Advantage coverage, exclusions and Medicaid guidelines for appropriate system documentation. Demonstrates good skills in the required paper and electronic systems
  • Determine specific goals and objectives to meet the employee’s and GE needs using appropriate resources and benefits available to them
  • Support members with condition education, medication reviews and connections to resources such as providers, and community services
  • Consistently demonstrates the knowledge, skills, abilites, and behaviors necessary to provide professional, superior, and culturally sensitive service and information to each other, to our members, and to customers, contracted providers, and vendors
  • Independently serves as the clinical liaison with hospital, clinical and administrative staff as well as performs a review for clinical authorizations for inpatient care utilizing evidenced-based criteria within our documentation system
  • Performs expedited, standard, concurrent, and retrospective onsite or telephonic clinical reviews at in network and/or out of network facilities. The Case Manager documents medical necessity and appropriate level of care utilizing national recognized clinical guidelines for all authorizations
  • Interacts and effectively communicates with facility staff, members and their families and/or designated representative to assess discharge needs, formulate discharge plan and provide health plan benefit information
  • Identifies member’s level of risk by utilizing the Population Stratification tools and communicates during transition process the member’s transition discharge plan with the ICT
  • Valid State of Michigan RN license
4

Experience For RN Telephonic Case Manager Resume

  • Recent experience in an inpatient bedside role
  • Conducts a transition discharge assessment onsite and/or telephonically to identify member needs at time of transition to a lower level of care
  • Independently confers with UM Medical Directors and/ or Market Medical Directors on a regular basis regarding inpatient cases and participates in department huddles
  • Enters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 90% or better on a monthly basis
  • Manage transplant patients from evaluation to one year post transplant
  • Coordinates/facilitates patient care progression throughout the continuum
  • As a Case Manager, the work location is primarily in the Emergency Department
5

Experience For RN Advantage Case Manager Resume

  • Maybe asked to travel to Kaiser Kraemer Medical center for coverage (voluntary basis)
  • Provides seamless backfill to the team, and provide support as needed, such as when daily caseload is managed
  • ED Case Management Position for nights and weekends
  • Clinical expertise in Critical Care/Emergency Medicine, Neurology, Cardiology/Telemetry, or Pediatrics
  • Rotation to weekends (approximately 2x per month)
  • Rotation to weekends (approximately 2x per month) required.
  • Shift times are also variable as the needs arise
6

Experience For Case Manager, Ltss-rn / LSW / Lisw Resume

  • Work days include weekends and holidays
  • Travel to both hospitals in Lancaster and Palmdale
  • The position is located at Downey Medical Center 9333 E. Imperial Hwy. Downey, CA 90242
  • To cover vacancies in ED Case management and Bed Placement
  • Position is in the Physician Callback / RN program
  • Typical shifts vary between Emergency Dept. (2 x 12 hour shifts per pay period) and Inpatient (2 x 8 hours shifts per pay period)
  • Bilingual Spanish; ability to read, write and speak fluently
7

Experience For Case Manager Spec RN PD Resume

  • Clinical direct care, home based case management or hospice/palliative care
  • Work locations could include other KP Facilities
  • Primary work location is Emergency Department at Palomar.
  • This is a 10 hour shift, the 8 hour back-up shift is 7:00pm to 3:30pm.
  • Work schedule includes every other weekend.
  • Position is primarily for Bed Coordinator
  • Experience in working directly with patients who exhibit symptoms and behaviors related to the presence of severe mental illness and/or chemical dependency related issues
  • This is a ten (10) hour shift position, 3 days a week, 30 hours a week
  • Current, unrestricted RN license required in the state of TX
8

Experience For Case Manager, Chronic Conditions RN Resume

  • Case Management Certification (CCM) or ability to obtain CCM within 12 months after the first year of employment
  • Read, analyze and interpret information in medical records and health plan documents
  • Problem solve and identify community resources
  • Current, unrestricted RN license in the state of employment
  • Read, analyze and interpret information in medical records, and health plan documents
  • Variable work hours - 8hrs or/and 12 hours
9

Experience For RN Telephonic Case Manager, Advanced Illness Resume

  • Bilingual (English/Spanish) desirable
  • Primary department is Emergency
  • ED position: 8 hours back up
  • Bilingual (English/Spanish) abilities desirable
  • Availability to cover both ER and Inpatient
10

Experience For Case Manager / Service Coordinator, RN Resume

  • 40 hours per pay period. Total of 5- 8 hour shifts
  • Work schedule could include travel to other Kaiser facilities as needed. Floats between Zion and SDMC
  • Work schedule could include travel to other Kaiser facilities as needed
  • Floats between Zion and SDMC
  • Registered Nurse – current, unrestricted Texas license
  • Knowledge of Kaiser and community based programs related to the treatment of psychiatric and chemical dependency issues
  • At least two (2) years of experience in working directly with patients who exhibit symptoms and behaviors related to the presence of severe mental illness and/or chemical dependency related issues
  • Multiple state licensures (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses

List of Typical Skills For a Rn-rn Case Manager Resume

1

Skills For Case Manager Utilization RN Resume

  • Minumum 3 years acute care experience with discharge planning/ transitional care knowledge
  • Diverse clinical experience in caring for the acutely ill patients with multiple disease conditions
  • Experience in a hospital, acute care or direct care setting
  • Experience as an RN working with Chronic Kidney Disease, Renal, Dialysis care or as a Telephonic Case Manager for an insurance company
  • Experience with case management, discharge planning and patient education for adult acute care
  • Move between company work stations and departments; ability to communicate on telephones and operate general office equipment, including computers
  • Clinical experience in field of Pediatrics and/or Obstetrics
  • Clinical expertise in Critical Care/Emergency Medicine, Neurology, Cardiology/Telemetry, or Pediatrics experience
  • Clinical practice experience with current clinical knowledge as it relates to chronic disease management
2

Skills For RN Inpatient Case Manager Resume

  • Managed care and/or case management experience
  • Managed care and/ or case management experience
  • Clinical acute care experience
  • Renal, Chronic Kidney Disease or Dialysis Care experience
  • Experience with utilization review criteria
  • Public health or home care experience
3

Skills For Case Manager Utilization Rn-pd Resume

  • Is the employee’s advocate and advisor to help facilitate quality and cost-effective care
  • Evaluating health care needs that qualify for the Autism benefit and arranging for services and supplies to support the beneficiary’s condition
  • Evaluating health care needs that qualify for the Autism benefit, and arranging for services and supplies to support the beneficiary’s condition
  • Understanding of managed care and case management concepts
  • Identify gap in care and address accordingly. Ex calling PCP office, referring to other disciplines, etc
  • Coordinates and certifies services based upon information received from attending physician and/or other providers using established medical criteria
  • Monitors the case to its conclusion, while maintaining contact with all involved parties during all episodes of care
4

Skills For RN Telephonic Case Manager Resume

  • Provides assessment, coaching, teaching and referral to the Autism population’s family members and caregivers as required
  • Educates members of the healthcare team concerning their roles & responsibilities in the discharge
  • Ensures all activities are patient-focused and individualized, resulting in personalized attention to each individual’s unique needs
  • Identifies interventions and resources to assist patient in reaching personal health-related goals
  • The closest Kaiser building in Palm Springs MOB 1100 N. Palm Canyon Drive, Suite 208 Palm Springs, CA 92262
  • Work schedule includes rotating weekends and possible work at other KP locations
  • Coverage throughout the hospital including ED
  • Knowledgeable in Microsoft Office applications including Outlook, Word, and Excel
5

Skills For RN Advantage Case Manager Resume

  • Push or pull heavy objects using up to 10 pounds of force
  • Work locations include floating between Zion Medical Center and SDMC. Other locations as needed
  • Knowledge of the availability and criteria for admission to IOP, PHP, Eating Disorder and Chemical Dependency Programs
  • Willingness to obtain CCM or CHPN designation within 24 months of being hired, if not a credential already held
  • Primary work location is going to be Emergency Department at Zion Medical Center
  • Primary work location is going to be Emergency Department
  • Primary work location is going to be Emergency Department at SDMC
6

Skills For Case Manager, Ltss-rn / LSW / Lisw Resume

  • Knowledge of utilization management, quality improvement and discharge planning
  • Knowledgeable in Microsoft Office applications including Outlook, Word and Excel
  • Knowledge of utilization management, quality improvement, and discharge planning
  • There is a possibility of increasing to every 3rd weekend
  • Cross training to ED required
  • Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
7

Skills For Case Manager Spec RN PD Resume

  • Basic understanding of healthcare economics and consumerism within healthcare
  • Completion of an accredited RN training program that allows graduates to take RN license exam
  • Bachelors of Science in Nursing is required
  • Identifies patterns and improvement strategies to help patients improve their health and achieve optimal care goals
  • Work location could include other Kaiser Facilities
  • Rotation to weekends required approximately twice per month
8

Skills For Case Manager, Chronic Conditions RN Resume

  • Rotation to work weekends required approximately twice per month
  • Bilingual Spanish (speak, read and write fluently)
  • On site case management for inpatient and emergency room Kaiser members at Non Kaiser hospitals
  • The primary work address is on site at Desert Regional Medical Center: 1150 N. Indian Canyon Dr., Palm Springs
  • 12 hour shifts with backup of 1500-2330
  • Per Diem for the Emergency Department
  • Work locations include the Fontana and Ontario Medical Centers
9

Skills For RN Telephonic Case Manager, Advanced Illness Resume

  • Current, unrestricted RN license in the state of Colorado
  • Certification in Case Management highly desired
  • In patient Case Management Position for Days and weekends
  • Mayl be cross trained to Inpatient and Emergency Department case manager functions
  • Rotation to work weekends required approximately twice per month required
  • Works every other weekend
10

Skills For Case Manager / Service Coordinator, RN Resume

  • Maybe requested to travel to OC Anaheim to cover per operational needs
  • Six (6) 12-hour shifts per pay period, three (3) shifts each week
  • Work locations can include Kaiser Permanente contracted facilities
  • Travel could vary from 50-60%
  • Rotation to weekends (approximately 2x per month) required
  • Per Diem West Ventura
  • Consistently demonstrates the knowledge, skills, abilities, and behaviors necessary to provide professional, superior, and culturally sensitive service and information to each other, to our members, and to customers, contracted providers, and vendors
  • Per Diem Night Shift ED Case Management
  • Function independently and as part of a team, working effectively with various facilities, internal and external staff, patients, patients’ family, and physicians to facilitate patient care

List of Typical Responsibilities For a Rn-rn Case Manager Resume

1

Responsibilities For Case Manager Utilization RN Resume

  • Work well in a fast-paced setting and with multiple physicians and multidisciplinary departments
  • Per Diem for Emergency Department
  • Work location is primarily in the Emergency Department
  • Understand and articulate short view of care and long view of care
  • Four 10-hr shifts per week. Based out of Downey Medical Center
  • Primary work location is Palomar
  • Crossed trained to Bed Coordinator
2

Responsibilities For RN Inpatient Case Manager Resume

  • Able to work variable hours
  • This per diem position is for inpatient and ED case management
  • Residence in MST, PST time zones
  • PerDiem Case Manager for our south county plan hospitals, Inland Valley, Rancho Springs and Temecula Valley
  • Assignments rotate between facilities
3

Responsibilities For Case Manager Utilization Rn-pd Resume

  • Position covers both inpatient and ED case management
  • Includes weekends and holidays
  • Weekends required and availability to work all shifts
  • Active RN license in GA & SC without restrictions
  • Able to work variable shifts - 8 hrs. 10 hrs or 12 hrs, weekends and holidays
  • Position requires every other weekend rotation
  • This per diem position is for coverage in the ED and Bed Coordniator for night shift
  • This is a 10 hour shift position
4

Responsibilities For RN Telephonic Case Manager Resume

  • Access to dedicated work space from home for in home office set up
  • Day shift inpatient case manager position
  • Every third weekend required, holidays required
  • Shifts varies between 12:00 pm- 8:30 pm and 3:00 pm -11:30 pm
  • Certification as a CCM, CMC or equivalent case management certification
  • Need to possess the ability to focus on both the details and the "big picture" simultaneously
  • Relationship-building, effective written and verbal communication skills that allow clear and concise presentation of conclusions and recommendations to a variety of audiences, critical thinking and problem-solving, ability to plan and organize effectively, proficient in typing and in use of computer applications (Excel and Outlook)
  • Knowledge of admission criteria for all internal and external patient admissions
5

Responsibilities For RN Advantage Case Manager Resume

  • Weekends and availability to work all shifts required
  • This is an office position located at 2222 W. Dunlap Ave. Phoenix, AZ
  • Be knowledgeable of patient’s available benefits / coverage / payor information
  • Assist in monitoring of annual financial goals for inpatient case management LOS, readmission’s, and denial rates, cost savings, patient/provider satisfaction and achievement of outcomes
  • Function independently and as part of a team, working effectively with various departments, internal and external staff, facilities, patients, patients’ family, and physicians to facilitate quality and efficient patient care
6

Responsibilities For Case Manager, Ltss-rn / LSW / Lisw Resume

  • FL licensed RN with previous Work Comp Case Management (Florida knowledge) experience is required (2 years)
  • Fluent in negotiating electronic health record (i.e., Health Connect), Access and Excel databases, email
  • Registered Nurse (RN) with active FL license
  • Walk and stand 80% of work time
  • Lift, bend, push, pull, stoop sufficiently enough to meet patient’s physical needs
  • Shift: 8 hour day shift / occasional weekend & holiday rotations
  • Transitional Case Manager
7

Responsibilities For Case Manager Spec RN PD Resume

  • Four (4), 10 hour shifts
  • This per diem position is for coverage in the ED and Bed Coordinator for night shift
  • Inpatient Case Management, 8 hour shift, weekend requirement
  • Inpatient Case Manager for Riverside outside medical plan hospitals (Inland valley, Racho Springs, Temecula)
  • Inpatient Case Management for Riverside outside medical plan hospitals in Coachella Valley (Desert Regional, JFK and High Desert)
8

Responsibilities For Case Manager, Chronic Conditions RN Resume

  • Night shift ED position
  • Every other weekend required, holidays required
  • Flexible shift - 8 hours, 10 hours or 12 hours
  • Per Diem case manager for Inpatient and ED
  • Knowledge of Milliman or Interqual
  • This is a temporary position for approximately four (4) months
  • Excellent interpersonal skills to develop relationships necessary to accomplish assessment, interventions, discharge planning, etc., with a wide range of patients, families, physicians, hospital staff, payers and community resources. Telephonic communication skills to develop professional rapport to provide clinical information and negotiate with external agencies

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