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Yyyyyy x. yyyyyy
968 Greendale Drive, Charleston, WV xxx-xxx-xxxx Abc@xyz.com
Profile of Qualifications
- Accomplished Professional with 25 years of experience strategically managing cases and performing nursing duties.
- Regarded for ability to maintain quality control throughout Medicare and Medicaid case management operations.
- Proven ability to create highly effective training and development programs.
Key Areas of Expertise
|
Case Management Patient Care Leadership |
Medicare/Medicaid Knowledge Treatment Plan Creation Health Risk Assessments |
Medication Administration Training & Development Organizational Management
|
Professional Synopsis
Prestera Center, Charleston, WV 2014-Present
Case Manager
Assume integral case management role, strategically overseeing Medicare and Medicaid operations for both medical and behavioral clients.
Resourcefully assess individual client needs and develop innovative treatment plans to promote health.
Provide follow up to IM antipsychotic medication administration, carefully addressing adverse reactions and side effects.
Genesis Health Care, Oak Ridge Center 2013
Utilized subject matter expertise to properly identify patient needs and develop effective care plans appropriately.
Ensured quality control throughout documentation of patient assessment, status and needs.
Promoted open lines of communication throughout daily staff interactions.
Right at Home, Charleston, WV 2011-2012
Case Manager
Resourcefully oversaw case management operations for Medicaid Aged and Disabled Waiver clients, while simultaneously performing nursing operations.
Maintained quality control by conducting annual and semi-annual assessments.
Leveraged nursing expertise to educate new hires on best practices.
Chief responsibilities included case management billing, utilization review, reviewing waiver forms and managing monthly contacts.
Mountain State Blue Cross Blue Shield, Parkersburg, WV 2000-2009
Network Credentialing Specialist
Fulfilled key role maximizing efficiency throughout Medicare credentialing policy and procedure development and implementation.
Maintained adherence to NCQA, URAQ and Centers for Medicare and Medicaid Services regulations throughout daily operations.
Relayed appropriate information and outcomes to provider.
Highland Hospital, Charleston, WV 1999-2000
Behavioral Health Nurse
Utilized nursing expertise to develop individualized treatment plans for adult and adolescent behavior health patients.
Administered appropriate care based on individual needs.
Yyyyyy x. yyyyyy
968 Greendale Drive, Charleston, WV xxx-xxx-xxxx Abc@xyz.com
Previous Positions:
Regency Place, Scott Depot, WV 1998-2000
RN Consultant
West Virginia Home Health/Highland Hospital, Charleston, WV 1996-1998
Behavioral Health Nurse
Home Health Nurse
Savage Laboratories, Melville, NY 1993-1996
Pharmaceutical Representative
Charleston Area Medical Center Charleston, WV 1990-1993
Orthopedic/Trauma Nurse, General Division
Education & Professional Development
Bachelor of Science in Nursing, University of Charleston, Charleston, WV - 1992
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