Nurse Management Resume Samples

4.8 (90 votes) for Nurse Management Resume Samples

The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the nurse management job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

Craft your perfect resume by picking job responsibilities written by professional recruiters

Pick from the thousands of curated job responsibilities used by the leading companies

Tailor your resume & cover letter with wording that best fits for each job you apply

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

Resume Builder
CHOOSE THE BEST TEMPLATE - Choose from 15 Leading Templates. No need to think about design details.
USE PRE-WRITTEN BULLET POINTS - Select from thousands of pre-written bullet points.
SAVE YOUR DOCUMENTS IN PDF FILES - Instantly download in PDF format or share a custom link.

Resume Builder

Create a Resume in Minutes with Professional Resume Templates

Create a Resume in Minutes
RL
R Lynch
Roselyn
Lynch
62453 Arturo Streets
Los Angeles
CA
+1 (555) 228 3293
62453 Arturo Streets
Los Angeles
CA
Phone
p +1 (555) 228 3293
Experience Experience
Phoenix, AZ
Disease Management Nurse
Phoenix, AZ
Koelpin LLC
Phoenix, AZ
Disease Management Nurse
  • Maintains accurate record of disease management activities in the Enterprise Medical Management Automation (EMMA) System using clinical guidelines
  • Case Management Certification (CCM)
  • Performs other duties as assigned
  • Coordinates community resources with emphasis on the development of natural support system. Coordinates benefits, regulations, laws and public entitlement programs for members
  • Manages 100 active cases based on case intensity and acuity
  • Collaborates with Case Managers on cases to review care plans and make changes if necessary
  • Provides telephonic member assessment as the result of inbound and outbound member phone calls
San Francisco, CA
Nurse, Utilization Management LVN
San Francisco, CA
McGlynn and Sons
San Francisco, CA
Nurse, Utilization Management LVN
  • Work directly with the provider(s) and health plan Medical Director to facilitate quality service to the member and provider. 5%
  • Responsible for working closely with supervisor/lead to address issues and delays that can cause a failure to meet or maintain compliance. 5%
  • Collaborates, educates and consults with Customer Service/Claims Operations, Sales and Marketing and Health Care Services to ensure consistent work processes and procedural application of clinical criteria. 5%
  • Proper coding to trigger the record to be routed to a different work queue or to trigger the proper determination notice to be sent out
  • Responsible for providing timely referral determination by accurate: 30%
  • All other job related duties as it relates to the job function or as delegated by the management team. 5%
  • Identification of referrals to the medical director for review
present
Houston, TX
Supervisor, Field Nurse Case Management
Houston, TX
Brekke, Roob and Green
present
Houston, TX
Supervisor, Field Nurse Case Management
present
  • Assisting in updating case management resource tools
  • Assist in development of new processes
  • Participate in quality improvement activities
  • Training including system trainings, new hire training, staff development, and process training
  • Reviewing candidate resumes, interviewing potential candidates, and communicating findings and recommendations to manager and/or talent acquisition partner
  • Knowledge of California work comp rules and regulations
  • Participate in delivering 1:1’s to employees
Education Education
Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
Columbia University
Bachelor’s Degree in Nursing
Skills Skills
  • Knowledge and skill in the application of the techniques and practices of the nursing profession
  • Ability to establish and maintain effective working relationships with Members and their families, JSA, Health Plans and local personnel
  • Excellent communication and computer skills
  • Intermediate Ability to effectively present information and respond to questions from families, members, and providers
  • Intermediate Ability to work in a fast paced environment with changing priorities
  • Intermediate Ability to implement process improvements
  • Ability to understand and implement case and disease management philosophy and principles
  • Ability to explain medical instruction to members and their families
  • Intermediate Ability to effectively present information and respond to questions from peers and management
  • Ability to learn and understand appropriate Federal, State and local regulations
Create a Resume in Minutes

15 Nurse Management resume templates

1

Risk Management Nurse Resume Examples & Samples

  • Degree in a related field
  • Previous Case Management, Quality Improvement, Risk Management, Clinical Documentation, and Utilization / Chart Review
  • Will train a Staff Nurse with 3+ years of Hospital experience in Medical-Surgical, Emergency Room, Critical Care, or OB/GYN
2

Case Management Nurse Resume Examples & Samples

  • New Jersey State RN license
  • 3-5 years of managed care experience
  • Proficient in PC platforms
3

Disease Management Nurse Resume Examples & Samples

  • 3-5 years of Managed Care, Case Management experience
  • Excellent communication and computer skills
  • CDE Certification
4

Case Management Nurse Resume Examples & Samples

  • New Jersey RN or LPN
  • 3+ years of clinical experience
  • 2-3 years of case management experience
  • Utilization management experience
  • Discharge planning experience
  • Excellent communication and PC skills
5

Disease Management Nurse Resume Examples & Samples

  • Our Department of Defense contract requires U.S. Citizenship for this role
  • Active RN license with no restrictions in the state of employment
  • 3 years of clinical RN experience in a hospital or outpatient clinic setting
  • Experience with motivational interviewing techniques
  • Certified Diabetes or Asthma Educator
  • 2 years of Disease Management experience
6

Utilization / Case Management Nurse Resume Examples & Samples

  • 3+ years of Clinical Nursing experience in an Ambulatory and/or Hospital setting
  • Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and Managed Health Care, including HMO, PO and POS plans
  • Previous Utilization and/or Quality Management and/or Call Center experience
7

Medicaid Disease Management Nurse M-F Resume Examples & Samples

  • Coordination of medical management efforts with other Humana departments including, but not limited to Medicaid Administration, Health Services Onsite Staff, Case/Disease Management, Quality Improvement, and Provider Relations
  • Collaborate with Team Leader and Health Services Manager for data collection, reporting and Quality Improvement initiatives on clinical programs, including evaluating ongoing effectiveness and improvement opportunities
  • Case Management experience strongly preferred
  • Working knowledge of Medicaid guidelines
  • Minimum of 3 years’ experience working as a nurse in an acute care setting
  • Prior clinical experience working with Pediatrics
  • Bilingual is a plus – English and Spanish or Creole
8

Nurse Disease Management Resume Examples & Samples

  • Work from home position anywhere within the US
  • Full time position (Monday - Friday 40 hour work week)
  • An unrestricted RN license in GA or FL is required at time of application
  • AS/BS in nursing
  • 3 years of condition specific clinical or home health/discharge planning experience
  • Knowledge and experience working with Microsoft Office Products (Word, Excel, and Outlook)
  • Or any combination of education and experience, which would provide an equivalent background
  • Current unrestricted RN license in GA or FL
9

Case Management Nurse Resume Examples & Samples

  • Maintain effective communication with appropriate parties related to consultative services. Communicate with providers for the purpose of seeking clarification of medical information regarding restrictions and limitations
  • Remain abreast of the dynamic and competitive insurance environment, new products, appropriate claim handling techniques, and the constantly changing legislation that governs the business. Participate in Industry or Association meetings and seminars focusing on any of the following: case management for long term care or disability or critical illness claim issues
  • Provide assistance to the department manager and area director as directed
  • Excellent oral and written communication, human relations, teaching, and organizational skills
  • Ability to work well under pressure and demonstrate a high level of flexibility to meet the needs of a rapidly changing environment
  • Experience in occupational health nursing
  • ICU, critical care, critical cardiac care
10

Nurse Disease Management Resume Examples & Samples

  • An unrestricted IN RN license is required. (You must have this license to be considered, will have to obtain the others once employed)
  • 3 years of RN experience
  • Current unrestricted RN license in IN, even if you do not reside there
11

Pain Management Nurse PRN Resume Examples & Samples

  • Maintains current knowledge of pre and post procedure care of patient undergoing pain management procedures and current techniques
  • Minimum 2 years experience in a Pain Management, PACU setting; preferably in an ambulatory surgery center
  • Additional specialty experience may be required as per facility practices (i.e. Endo, GI, etc)
12

Disease Management Nurse Resume Examples & Samples

  • Perform telephonic Case Management, which includes patient evaluation, education regarding disease and early symptom identification
  • Participates in the identification, collection, and analysis of data for potential enrollment of members to the Disease Management program
  • Applies critical thinking skills and problem-solving techniques to the disease management process. Accurately conducts a thorough and objective holistic evaluation of the patients’ current status, including psychosocial, physical, financial, and educational needs, prognosis, and past and present treatment course and services
  • Partners with physicians for effective clinical management and utilization of resources for patient population
  • Provides clinical direction and coordination to the interdisciplinary team to formulate and implement a plan of care
  • Maintains current knowledge of disease processes, available resources, and treatment options appropriate to patient population
  • Consistently documents all activities according to policy, including automated systems
  • Continuously demonstrates a positive attitude and understanding of case/disease management, supports team building, and is motivated to fulfill department objectives
  • Maintains ongoing communication of the action plan and timeline to the center for implementation
  • Consistently demonstrates excellent communication and interpersonal skills with supervisor, case manager, physicians, clinic staff, and corporate personnel. Identifies opportunities and readily participates in performance improvement activities
  • Acts as a liaison for member as needed
  • Ability to educate member as well as clinic personnel on the DM Program
  • Minimum: 5 years’ experience in the healthcare field
  • Preferred: 2 years Case Management/Disease Management experience
  • Preferred: Critical Care experience
  • Knowledge and skill in the application of the techniques and practices of the nursing profession
  • Ability to understand and implement case and disease management philosophy and principles
  • Ability to explain medical instruction to members and their families
  • Ability to establish and maintain effective working relationships with Members and their families, JSA, Health Plans and local personnel
  • Ability to learn and understand appropriate Federal, State and local regulations
  • Ability to interact and deal tactfully with the public
  • Ability to read, speak and understand the English language fluently
  • Computer skills required (MS Word, Excel, Outlook)
  • Ability to travel locally
13

Disease Management Nurse Resume Examples & Samples

  • Our Department of Defense Contract requires U.S. citizenship for this position
  • Active licensed RN in state of employment
  • Three years clinical experience in a hospital/outpatient clinic. Must have three years psychiatric experience if position is for depression/anxiety disorder DM program
  • Bachelors degree in nursing (BSN)
  • Two years disease management experience
  • Certified Asthma Educator
14

Nurse Disease Management Resume Examples & Samples

  • Preferred locations are Nashville TN and Norfolk VA
  • If you are 50 miles from the Nashville or Norfolk office you will be required to work in office
  • Office locations
  • Current unrestricted RN license in TN or VA (compact state) even if you do not reside there
  • 5 years of condition specific clinical or home health/discharge planning experience
  • 2 year of case management
15

Disability Management Nurse Resume Examples & Samples

  • Provide leadership on the short term disability management program (medical case management component)
  • Provide individual medical case management of work & non-work related illness or injury for Albian team members. This requires early case identification, assessment & intervention techniques, effective case management & follow-up to mitigate factors (e.g. medical & non-medical) that interfere with employees' safely remaining at work or returning to work as soon as possible
  • Coordinate/expedite clinical investigations, health assessments, medical case management & action plans as appropriate
  • Key focal person for internal & external health care providers, including WCB & EI/LTD insurer
  • Provide recommendations regarding medical fitness to work, & job restrictions / limitations
  • Provide supervisors/managers & HR with appropriate written &/or oral case updates
  • Provide consultation & appropriate feedback to team members, supervisors/managers & HR re medical case management & the short term disability management program
  • Perform Drug & Alcohol Testing (e.g. for post rehab cases)
  • Maintain medical confidentiality & personal information privacy, as well as accurate health records, per external & internal requirements
  • Support co-workers with SIC case load, as well as other occupational health services, as requested by supervisor
  • Undertake health promotion initiatives consistent with Shell Health strategic objectives, as required
  • You must be legally entitled to work in Canada by way of Canadian Citizenship, Permanent Residency, or a valid work permit. This would authorize you to work for Shell in the occupation for which you are applying and provide confirmation and proof of status if an offer is advanced
  • Current RN/NP licensed/registered & member in good standing with the College & Association of Registered Nurses of Alberta (CARNA)
  • Occupational Health Nursing Certificate with Certification required
  • Minimum 5 years experience in private sector (preferably petrochemical industry) occupational health and nursing, & specifically in disability case management role
  • Previous experience conducting pre-placement & periodic fitness to work/medical surveillance, as well as transfer medical, assessments preferable
  • Strong clinical nursing background (e.g. in ermergency or acute care) would also be preferred
  • Additional certification in disability management preferred
  • Current breath alcohol & drug sample collector certification required
  • Current audiometry technician certification preferred
  • Current spirometry certification preferred
  • Current vision screening preferred
  • Current ITLS or Alberta Advanced Occupational First Aid Training Certification preferred
  • Current ACLS certification preferred
  • Strong clinical skills for individual medical case management
  • Strong problem-solving skills, particularly for complex cases
  • Excellent verbal & written communication skills
  • Excellent organizational & time management skills to effectively manage a number of cases at the same time & meet deadlines/KPIs
  • Ability to work in a flexible work environment
  • Extensive disability management experience is an asset
  • Ability to learn/utilize various commercial software packages, & attention to detail to ensure proper information/data entry
  • 2 year term-certain
  • LI-MA
16

Nurse Disease Management Resume Examples & Samples

  • Work from home position, you must reside in NV, CA, WA, or OR
  • An unrestricted CA, NV, and/orWA RN license is required. (You must have one of these currently to be considered, will have to obtain the others once employed)
  • This position will require you to obtain additional licenses , you must be willing to do this with assistance from the department
  • 3 years of clinical RN experience
  • Current unrestricted RN license in CA, NV, or WA, even if you do not reside there
17

Nurse Disease Management Resume Examples & Samples

  • Work from home position, you must reside in NJ, NY, VA, or NC
  • An unrestricted NY or NJ RN license is required. (You must have one of these currently to be considered, will have to obtain the others once employed)
  • If you are 50 miles from the Norfolk VA, 5800 Northhampton Blvd, Norfolk VA 23508, will require you to train and work in office
  • Current unrestricted RN license in NJ or NY even if you do not reside there
18

Disease Management Nurse Resume Examples & Samples

  • Completes a comprehensive assessment and develops a care plan utilizing clinical expertise to evaluate the members need for alternative services. Assesses short-term and long-term needs and establishes disease management objectives
  • Emphasizes the importance of health education and teaches member behavior modification techniques
  • Utilize evidenced based guidelines to educate members on their specific disease process
  • Monitor members per results of the clinical assessment on a continual basis
  • Promote and encourage members regarding adherence to their care plan and treatment as set by the caregiver Provide referrals as appropriate
  • Communicate with providers regarding member needs
  • Act as liaison and member advocate between the member and their family, physician and facilities/agencies
  • Required 1+ year of experience in disease management
  • Preferred Other Managed care experience
  • Intermediate Demonstrated negotiation skills
  • Required Licensed Registered Nurse (RN)
19

Nurse Disease Management Resume Examples & Samples

  • Work from home position anywhere within the US, preferred location Norfolk VA
  • (Is you are within 50 miles of Norfolk Office, will be required to do on-site training and come in office when needed based on needs of business)
  • You must have a current RN license in one of the following states to be considered,
  • Monday - Friday 8:30 AM to 5:30 PM EST
  • Monday - Friday 9:30 AM to 6:30 PM EST
  • Current unrestricted RN license in Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, New York, New Jersey, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin even if you do not reside there
20

Nurse, Utilization Management LVN Resume Examples & Samples

  • Experience in EZ-CAP preferred
  • Medical Terminology preferred
  • Preferred Education: BA or BS in Nursing
  • Minimum Experience: 3 to 5 years of acute care experience
  • Licensure must be current and unrestricted in the appropriate jurisdiction
  • Must be able to work in sitting position, use computer and answer telephone
21

Case / Care Management Nurse Resume Examples & Samples

  • Perform telephonic review of prior authorization requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
  • Active and unrestricted RN license in state of Washington
  • 2+ years of clinical nursing experience
  • Prior Authorization experience is a plus
22

Supervisor Nurse, Care Management Resume Examples & Samples

  • Ability to understand confidentiality and the legal and ethical issues pertaining to patient health; understand medical terminology, how to obtain an accurate history; establish treatment goals; establish working relationships with referral sources; develop treatment plans
  • Ability to understand methods for assessing an individual’s level of physical/mental impairment; understand the physical and psychological characteristics of illness; be able to assist individuals with the development of short- and long-term health goals
  • Ability to understand the requirements for prior approval by payer; be able to evaluate the quality of necessary medical services; be able to acquire and analyze the cost of care; understand the various health care delivery systems and payer plan contracts; be able to demonstrate cost savings
  • Ability to understand case management philosophy and principles; apply problem solving techniques to the care management process; document care management services; understand liability issues for care management activities
  • Knowledgeable on how to access and evaluate the available resources to meet a client’s needs; able to develop new resources
  • Excellent interpersonal, verbal, and written communication and negotiation skills
  • Current working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement
  • Understanding of pre-acute and post-acute venues of care and postacute community resources
  • Strong organizational and time management skills, as evidenced by a capacity to prioritize multiple tasks and role components
  • Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families
23

Case / Care Management Nurse Resume Examples & Samples

  • Assure compliance with established referral, pre-certification and authorization policies, procedures and processes by related Medical Services staff
  • Assure compliance with established onsite and concurrent review, case management, referral, pre-certification and authorization policies, procedures and processes
  • Facilitate on-going communication between case management staff, utilization management staff and contracted providers
  • Assist with the implementation of policies and procedures regarding medical case management
  • Conduct telephonic review of cases with doctors, hospitals, and other providers
  • Compile and review multiple reports for statistical and financial tracking purposes to identify case management trends and assist in financial forecasting
  • License/Certification: Valid FL driver's license
  • 3+ years of nursing experience in an acute care setting particularly in a medical/surgical, pediatrics, or obstetrics environment
  • 1+ year of case and/or utilization management experience
  • Working knowledge of a specialized or technical field such as clinical nursing, case and/or utilization management
  • Previous experience as a lead in a functional area or managing cross functional teams on large scale projects
24

Case Management Nurse Resume Examples & Samples

  • Provide disease care management to best meet the member’s specific healthcare needs and to promote quality and cost-effective outcomes
  • Oversee a collaborative process with the member and those involved in the member’s care to assess, plan, implement, coordinate, monitor and evaluate care as needed
  • Must have Registered nurse (RN) license (must have a current unrestricted RN license for medical care management), in a state or territory of the United States and at least 3 years (or full time equivalent) of direct clinical care
25

Case Management Nurse Resume Examples & Samples

  • Ability to work collaboratively and cooperatively with an interdisciplinary team required
  • Effective critical thinking/analytical skills required
  • Ability to effectively evaluate care across the continuum required
  • Understanding of related patient registries and data bases preferred
  • Experience leading/supervising a team preferred.Based on position, certification preferred in one or more of the following areas including Advanced Cardiac Life Support (ACLS) , Blood and Marrow Transplant Certified Nurse, Certified Diabetes Educator (CDE), International Board Certified Lactation Consultant (IBCLC), Oncology Nursing Certification (OCN), Oncology Nursing Society Chemotherapy and Biotherapy, Pediatric Advanced Life Support (PALS), transplant coordination, and/or Trauma Nursing Core Course (TNCC) preferred
26

Case / Disease Management Nurse Resume Examples & Samples

  • Identify at-risk and high-risk members from claims data who would benefit from outreach which requires working with variety of patient ages and conditions/diagnosis
  • Utilize goal-setting and motivational interviewing to assess patient needs, then educate and empower members to manage their disease(s), using accepted standards of care as a guide
  • Collaborate with the patient/family and inter-professional team to ensure they understand our health care benefits as defined by the Plan and how to maximize these benefits to get the best care possible; assist in problem solving with provider, claims or service issues
  • Function independently, prioritize workload, organize workflow, and manage multiple responsibilities with little supervision
  • Understand key business drivers and use this understanding to maximize the impact patient advocacy has on our members and prove return on investment
  • Provide recommendations and assist in the development of program goals and objectives for the future
  • Graduate from an accredited nursing program ADN required (BSN preferred)
  • 5 years of experience as an RN required
  • Current and valid license in the state of Wisconsin or another compact state license required
  • Disease Management experience required
  • Case Management experience (preferred)
  • Coaching/motivational interviewing experience preferred
  • Previous experience with data collection techniques and methods of analyzing and reporting data preferred
  • Exposure to/experience with project management a plus
  • Knowledge of Microsoft Office, including Word, Excel, Outlook, and PowerPoint required
27

Supervisor, Field Nurse Case Management Resume Examples & Samples

  • Reviewing candidate resumes, interviewing potential candidates, and communicating findings and recommendations to manager and/or talent acquisition partner
  • Training including system trainings, new hire training, staff development, and process training
  • Participate in quality improvement activities
  • Analyze metrics to support team successes
  • Assist in development of new processes
  • Mentoring team members
  • Assisting in updating case management resource tools
  • Participate in delivering 1:1’s to employees
  • Supervision of team members
  • Client meetings/trainings
  • Interface with clients for positive and negative issues
  • Support unit and organizational goals
  • Be able to oversee unit when manager is not available
  • Be flexible in hours, if necessary
  • Promote team spirit
  • Must be an RN with an active, unencumbered license in resident state
  • Field case management preferred
  • Knowledge of California work comp rules and regulations
  • Knowledge of national worker’s compensation regulations is preferred
  • Knowledge of basic computer skills including Excel, Word, Outlook Email; secure, private area for home office, and direct access to broadband internet
  • Home office must be HIPPA compliant
28

Case Management Nurse Resume Examples & Samples

  • Provide palliative clinical care management to best meet the member’s specific healthcare needs and to promote quality and cost-effective outcomes
  • Oversees a collaborative process with the member and those involved in the member’s care to assess, plan, implement, coordinate, monitor and evaluate care as needed
  • Must have unrestricted Registered Nurse (RN) licensure and at least 3 years (or full time equivalent) of direct clinical care
29

Case Management Care Transitions Nurse Resume Examples & Samples

  • Effective verbal and written communication skills required
  • Based on position, certification preferred in one or more of the following areas including Advanced Cardiac Life Support (ACLS) , Blood and Marrow Transplant Certified Nurse, Certified Diabetes Educator (CDE), International Board Certified Lactation Consultant (IBCLC), Oncology Nursing Certification (OCN), Oncology Nursing Society Chemotherapy and Biotherapy, Pediatric Advanced Life Support (PALS) department dependent required, transplant coordination, and/or Trauma Nursing Core Course (TNCC) preferred
  • Prior nursing experience in related field preferred
  • Based on position, prior experience in one or more of the following areas including oncology, cardiovascular care, neonatal intensive care, nephrology, solid organ transplantation, general medical/surgical care, emergency care, critical care, med spa, dialysis, interpretation, and explanation of physical/laboratory/screening results preferred
  • Experience with graphic software preferred
  • Experience with patient teaching materials preferred
  • Experience leading/supervising a team preferred
30

Case Management Nurse Resume Examples & Samples

  • Experience leading/supervising a team preferred.Based on position, certification preferred in one or more of the following areas including Advanced Cardiac Life Support (ACLS) , Blood and Marrow Transplant Certified Nurse, Certified Diabetes Educator (CDE), International Board Certified Lactation Consultant (IBCLC), Oncology Nursing Certification (OCN), Oncology Nursing Society Chemotherapy and Biotherapy, Pediatric
  • Advanced Life Support (PALS), transplant coordination, and/or Trauma Nursing Core Course (TNCC) preferred
  • EXCEPTION A: Candidate must meet all of the following: (1) has current experience directly applicable to position; (2) is deemed the best candidate for the position; and (3) written approval to hire a candidate without a BSN is received from the appropriate levels of operational leadership, nursing professional practice leadership and the Chief Nursing Officer. If a candidate is hired without a BSN after meeting these criteria, the candidate must either have 30 years of experience directly applicable to the position or sign a written agreement consenting to obtain a BSN within four years from his/her hire date
31

Case / Care Management Nurse Resume Examples & Samples

  • Graduate of Nursing program, BSN Degree preferred
  • Five years clinical experience in a health care environment; including Care Coordination, Nurse Advice/Triage, Case or Disease Management. Managed care experience preferred
  • Must have acute care experience
32

Nurse, Care Management Resume Examples & Samples

  • Assures clinical interventions are appropriate for the admitting diagnosis and Level of Care that reflects the standard of care, as defined by the medical staff and the organization; identify inappropriate admit status based on identified criteria and ensures the patient is registered at the appropriate level of care. Utilizes McKesson Interqual® clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination
  • Takes appropriate action when cases do not meet criteria. Escalates to the attending physician, and the Care Management physician advisor of any concurrent denials. Prepares case reports; documents treatment plan, progress notes and discharge summary related information as required by Medicare, MediCal, Title 22 and other mandated regulations according to Department standards. Reassesses the patient's condition when changes occur and revises the care plan when appropriate
  • Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social work, and other healthcare providers and agencies. Completes an initial assessment within 24 hours of admission and documents findings in the electronic health record. Processes referrals and authorizations that adhere to federal, state and local insurance regulatory agencies and offer patient choice per regulation
  • Identifies potential problems prevents and or resolves barriers to the discharge plan. Along with the social work team member
  • Mobilize resources to effect rapid and timely movement of the patient through system to achieve targeted discharge times established by AHS
  • Identifies and mobilizes patients and family strengths to optimize use of healthcare and community resources. In coordination with patient and family wishes, guide/assist in securing needed post discharge services
  • Collaborates with Care Management teams (i.e. Care Transition team and CM teams at other facilities) for high risk patients for timely follow-up appointments and confirms prior to discharge that complex patients are appropriately linked to community services
  • Provides community resource education and coaching, focusing on individual patient self-management principles. Ensures continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning and obtaining authorizations/approvals as needed for outside services for the patient
  • Communicates with physicians and multidisciplinary health team members to provide continuity of care, supporting and maintaining the multidisciplinary team approach to ensure effective resource utilization and appropriate level of care
  • Makes independent assessments and recommendations regarding course of action in complex situations
  • Ensures all applicable department and regulatory targets for department performance process improvements are attained (e.g., readmissions, throughput, LOS)
33

Nurse Disease Management Resume Examples & Samples

  • Work from home position, you must reside in NY, NJ, CT, MD, VA, NC, SC, FL, GA, PA, DE
  • If you are 60 miles from the Norfolk VA, 5800 Northhampton Blvd, Norfolk VA 23508, will require you to train and work in office
  • Current unrestricted RN license in current state you reside in
34

Nurse Disease Management Resume Examples & Samples

  • This position will allow you to work from home, but you must reside VA, NC, FL, GA, IN, or TX
  • You must have a current RN license in the state of IN (Must be an IN RN license, no compact)
  • Current unrestricted RN license in IN
35

Pain Management Subject Matter Expert / Nurse Resume Examples & Samples

  • Advanced degree in clinical field, e.g., Nurse, Nurse Practitioner, Physician’s Assistant, Psychologist, Social Worker or Physician plus 10 years of experience with 5 years specifically in pain management
  • Advanced degree/board certification commensurate with specific type of clinical experience. For example, a Nurse Practitioner: Graduate of an accredited RN School of Nursing. Completion of Nurse Practitioner Program. Current State registered nurse license; Current Nurse Practitioner certification
  • Proficiency with Windows based computer programs including Microsoft Office
  • Experience working within the Federal Government system (e.g., as military, civilian employee or government contactor) preferred
  • Ability to communicate clearly, both orally and in writing in English
  • To qualify, applicants must be legally authorized to work in the United States and should not now or in the future, require sponsorship for employment visa status
36

Case Management Nurse Resume Examples & Samples

  • Performs Health Risk Assessments HRA on Special Needs
  • Provides prospective, concurrent and retrospective reviews for inpatient acute care, rehabilitation, referrals and select outpatient
  • Responsible for educating and motivating employees to participate in wellness programs
  • Support health promotion and disease prevention and care management services
  • Provide Clinical Assessments, health education as needed
  • 8:00am-4:30pm Monday – Friday
  • Active RN License in the state of Pennsylvania
  • 2+ years clinical practice experience