Case / Care Manager Resume Samples

The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the case / care manager 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

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.

Create a Resume in Minutes

L Senger

Lois

Senger

163 Jacobi Vista

Los Angeles

+1 (555) 391 2270

163 Jacobi Vista

Los Angeles

Phone

p +1 (555) 391 2270

Experience Experience

Chicago, IL

Case / Care Manager

Chicago, IL

Wiza Inc

Chicago, IL

Case / Care Manager

Contacts multiple providers for a rate comparison of specialty items and identification of the most cost-effective approach
Identifies plateaus, improvements, regressions and depressions; counsels accordingly and recommends help
Negotiates for cost-effective rates for provider services, which includes
Assists with getting information and forms for living wills, health care proxy, DNR order, etc
Makes personal visits/contacts the physician to clarify diagnosis, prognosis, therapies, activities of daily living, etc
Enlists qualified counselor to assist with problems arising from the injury or illness
Documents case summary based on information received and communicates with the beneficiary and involved providers

Houston, TX

RN Case / Care Manager

Houston, TX

Blick-Durgan

Houston, TX

RN Case / Care Manager

Identify and refer potential cases to Disease Management and Case Management
Performs all other related duties as assigned
Answers Utilization Management directed telephone calls; managing them in a professional and competent manner
Participates in system-wide development of clinical best practice pathways
Works collaboratively with interdisciplinary team
Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according to guidelines
May provide guidance and coaching to other utilization review nurses and participate in the orientation of newly hired utilization nurses

present

Boston, MA

Care Services Coordinator & Case Manager

Boston, MA

Luettgen-Hyatt

present

Boston, MA

Care Services Coordinator & Case Manager

present

Manage recordkeeping for the Care Team including preparing recording action steps planned or taken, and data entry into the Maxient system
Correspond with students, faculty, staff, family members, healthcare providers, etc. regarding student issues
Provide supervision and evaluation of the graduate practicum student
Assist with the selection and training of one graduate practicum student annually
Assist with marketing and awareness efforts for the Care Team and Dean of Students
Provide data on Care Team caseload as requested
Support students experiencing difficult life circumstances and crises

Education Education

Bachelor’s Degree in Nursing

Northwestern University

Bachelor’s Degree in Nursing

Skills Skills

Ability to remain knowledgeable regarding available treatments and services
Knowledge of the full continuum of care available to patients, interrelationships of the care components, and their effective integration
Ability to provide appropriate patient care and clinical information when patients are admitted, referred, transferred, or discharged
Ability to collaborate across disciplines to provide comprehensive, integrated care
Ability to develop and implement educational materials and presentations for all levels of learners
Ability to develop appropriate treatment plans, communicates with interdisciplinary teams, and coordinates care
Ability to provide age-appropriate assessments, interpretation of data, and delivery of interventions
Knowledge of medical terminology and related levels of care and treatment
Ability to use multiple electronic systems, software programs, and the internet to review and record information
Ability to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationships

Create a Resume in Minutes

15 Case / Care Manager resume templates

Read our complete resume writing guides

Case / Care Manager Resume Examples & Samples

Contacts members of the medical team to discuss the patient’s course of progress and needs
Arranges for all services required; coordinates services with the health care team to eliminate duplication of service and conserve benefit dollars
Contacts/visits family to check understanding of the patient’s diagnosis, prognosis and ability to provide caregiver support
Checks home for safety factors and structural barriers, arranges for modifications
Reevaluates equipment, supplies, and services
Identifies problems, anticipates complications and acts to avoid them; provides health instruction to the patient/family; refers the patient back to the physician or other health care team members as needed
Identifies plateaus, improvements, regressions and depressions; counsels accordingly and recommends help
Makes personal visits/contacts the physician to clarify diagnosis, prognosis, therapies, activities of daily living, etc
Provides authorizations for any modalities of treatment recommended; investigates and suggests alternative treatments when appropriate
Assists with getting information and forms for living wills, health care proxy, DNR order, etc
Shares pertinent information about the patient with physician to achieve the best outcome
Documents case summary based on information received and communicates with the beneficiary and involved providers
Conducts personal visits to the patient’s home/hospital as needed
Facilitates transfer of beneficiary throughout the different regions and within the region by collaborating with the military liaison to transition the beneficiary with minimal disruption of their health care services
Coordinates the basic benefit and identifies and submits benefit modifications as appropriate or submits a request to TMA for benefit exceptions/special programs
Assesses the benefit plan for coverage and limitations
Negotiates for cost-effective rates for provider services, which includes
Contacts multiple providers for a rate comparison of specialty items and identification of the most cost-effective approach
Researches and identifies appropriate equipment that meets the beneficiary’s needs and pursues contracts with these providers
Suggests medically appropriate alternatives to accomplish treatment plan goals more cost effectively
Counsels the patient/ family on budgeting and notifying creditors
Identifies financial distress and refers patient/family to appropriate community resources
Helps patient /family sort and prioritize bills
Acts as liaison among secondary insurance payers
Explores patient’s feelings about his/her injury or illness; helps with associated trauma and frustration
Monitors family’s feelings about the patient’s illness and observes the family’s ability to manage new emotional stress
Offers information about patient’s condition
Enlists qualified counselor to assist with problems arising from the injury or illness
Contacts patient within 48 hours of discharge assuring proper support and services are in place to make a full recovery (i.e., equipment, home health, other services, transportation, etc.)
Ensures patient effectively navigates the health care system
Assesses patient’s condition, understanding of their injury and their ability to follow the treatment plan
Contacts patients with upcoming medical or surgical admissions and discusses what they may expect before, during and after the admission
Contacts members of the medical team to discuss the patient’s course of progress and needs utilizing available discharge information (if there was a hospitalization) and the initial needs assessment
Valid Registered Nurse, Clinical Psychologist, or Licensed Clinical Social
Worker license, Valid State Drivers License, and Certified in Case Management (CCM) Strongly recommended. Must have and maintain current, valid and unrestricted clinical licenses

Case Manager Extended Care Coordinator Rn-pd Resume Examples & Samples

In conjunction with physicians and healthcare team, develops an individual care plan based on patient assessment/evaluation and diagnostic tests
Provides individualized patient/family education which focuses on teaching self management
In conjunction with physicians and healthcare team, develops treatment program procedures, clinical guidelines/protocols and program evaluation/outcomes measures
Educates the Inpatient Case managers about appropriateness of transfers to the Skilled Nursing facility and protocol for transfers
Issues reports

Case Manager Extended Care Coordinator RN Resume Examples & Samples

Implements strategies to assure that patients and caregivers comply with and understand the importance of follow through on plan of care in collaboration with the Multidisciplinary team
Screens by using senior metrics for Skilled patient expected Length of Stay
Responsible for educating the Inpatient Case managers/designees about the appropriateness of admissions to the Skilled Nursing facility and protocols for admission

Care Transition Case Manager Lcsw Resume Examples & Samples

Develops and maintains case management policies and procedures to assure optimal and appropriate member utilization of services
Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals for outside services
Participates in the development of care paths
Arranges and monitors follow-up appointments
Develops and presents in-service training and communication to both internal and external stakeholders
Coordinates repatriation of patients and monitors their quality of care. Provides administrative case management oversight to Inpatient Psychiatric Facilities, Crisis Residential Programs, and IMDs to ensure that services delivered to our members meet Kaiser's Quality and Utilization expectations and guidelines
Previous experience, usually two (2) years in an inpatient psychiatric setting or psychiatric emergency service
Demonstrated expertise in crisis management

Case Manager Lead Foster Care Resume Examples & Samples

Conducts field visits per agency policy requirements at various locations: foster homes, group homes, other residential placements, family and/or relatives' homes, adoptive homes, hospitals, schools, day care, etc. to develop relationships with children and families
Monitoring appropriateness of child's placement, assesses safety, strengths, and needs
Completing progress notes, and other required reports, letters, and other correspondence as needed, and maintains an organized and up-to-date case file in accordance with agency policy
Completing support plans, forms, reports, etc. to comply with Arizona Long-Term Care System (ALTCS) and Division requirements, and authorizes services in FOCUS
Arranging and authorizing services to children, families and foster parents, etc
Knowledge of Federal and State statutes and agency policies and procedures relating to the care and assistance for individuals with developmental disabilities
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Knowledge of principles and practices of case management
Child development principles and the effects of abuse and neglect
Skills developing intervention and service delivery plans appropriate to the needs of the child and family
Engaging family members in constructive and collaborative case work relationships that empower families and promote joint case assessment planning and services provision
Ability to work collaboratively with DCS Guardians and representative of the juvenile courts, their relatives, other professionals, schools, the mental health system, community agencies and others in order to provide the services needed by the family
The ideal/preferred candidate will have foster care experience
Candidates for this position shall be subject to a search of the Child Protective Services Central Registry pursuant to A.R.S. 8-804

Case Manager Extended Care Coordinator RN Resume Examples & Samples

Recent inpatient case management or skilled nursing experience preferred. Knowledge of Inpatient
Quality Management and Continuing Care Quality Management preferred
Demonstrated experience in coordinating care for patients across the continuum is preferred
Outcome orientated, performance driven, self-motivated with great time management skills who can multi-task preferred

Clinic Care Manager, Mgmg Case Mgmt .DV Resume Examples & Samples

Complies with federal and state law and accrediting and licensing agencies at all times, to include but not limited to, JCAHO and federal compliance regulations
Identifies the targeted population and implements clinical interventions and protocols within practices site(s) per PCP referral, risk stratification, registry report and patient lists, including patients with repeated social and/or health crises
Assesses over time the healthcare, educational and psycho-social needs of the patient/family, utilizing standardized assessment tools, including but not limited to, depression screening, functionality and health risk assessment
Collaborates with PCP, patient and members of health care team, including continuum of care settings and community. Responsible for developing, monitoring and revising a comprehensive individualized plan of care and targeted interventions. Maintains required documentation for all care management activities
Provides patient self-management support and fosters a team approach and includes patient/family as active members of the team empowering them to achieve optimal health and independence to build capacity for self-care
Implements evidence-based care, chronic disease protocols and guidelines. Monitors individual patient progress and population management. Implements systems of care that facilitate close monitoring of high-risk patients to prevent and/or intervene early during acute exacerbations
Coordinates and ensures patient care by linking patients to resources through ongoing collaboration with PCP, patient/ family, community and other members of the health care team. Takes the lead in ensuring the continuity of care which extends beyond the practice boundaries. Serves as liaison to acute care hospitals, specialist and post-acute care services
Provides follow-up with patient/family when patient transitions from one setting to another. Completes timely post- hospital discharge calls and follow-up including medication reconciliation, PCP or specialist follow-up appointment, assessing symptoms, teaching warning signs, reviewing discharge instructions, coordinating care and problem solving barriers
Participates with practice and PO/PHO leadership to continuously evaluate process, identify problems and propose/develop process improvement strategies to enhance care management and Patient Centered Medical Home delivery of care model
Participates in continuous quality improvement to enhance care management in the office setting
Enhances professional growth and development through participation in educational programs, current literature, inservice meetings, and professional conferences
Participates and attends meetings and in services as required and/or assigned

Care Manager / Case Manager Resume Examples & Samples

Telephonic collaboration with providers and county agencies regarding members in Care Management
Under supervision of a licensed care manager, report coordinate care, track and report all assigned Members in FlexCare Care Management module
Work collaboratively with the health plan to coordinate a supportive environment and clear communication
Attend Clinical meetings
Registration with CA BBS, preferred
Knowledge of managed care and state-specific expertise preferred
Demonstrated experience exercising influence and negotiation skills to effectively manage patient care and health care outcomes
Demonstrated experience meeting strict deadlines and established cycle times through effective prioritization and follow-up

RN Case / Care Manager Resume Examples & Samples

This position will allow for a more flexible response to increased work volume, staffing challenges and improved discharge and transition of care planning. Network Nurse Case Manager covers duty assignments as directed for various IPA's. Coverage assignments are directed to assist with new Medical Management Network Inpatient Initiatives across the Network along with cover of nurse case managers who are on PTO, leave, or assigned other temporary duties etc.
Performs utilization review activities, including pre-certification, concurrent, and retrospective reviews according to guidelines
Determines medical necessity of each request by applying appropriate medical criteria to first level reviews and utilizing approved evidenced based guidelines/criteria
Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services
Answers Utilization Management directed telephone calls; managing them in a professional and competent manner
Refers case to a review physician when the treatment request does not meet necessity per guidelines, or when guidelines are not available. Referrals must be made in a timely manner, allowing the review physician time to make appropriate contact with the requesting provider in accordance with departmental policy and within CMS or URAC mandated turn around times
Reviews, documents, and communicates all utilization review activities and outcomes including, but not limited to, all calls made and received in regard to case communication and all demographic and service group information. Sends appropriate system-generated letters to provider and member
May provide guidance and coaching to other utilization review nurses and participate in the orientation of newly hired utilization nurses
Identify and refer all potential quality issues to the Clinical Quality Management Department, and suspected fraud and abuse cases to Compliance Department
Conducts rate negotiation with non-network providers, utilizing appropriate reimbursement methodologies
Documents rate negotiation accurately for proper claims adjudication
Identify and refer potential cases to Disease Management and Case Management
Current RN license, applicable for practice in the applicable state
2 years of experience in managed care OR 5 years of nursing experience as an RN
Proficient in PC software computer skills
Excellent communication skills both verbal and written skills
Possess planning, organizing, conflict resolution, negotiating, and essential interpersonal skills
Previous Prior Authorization experience
Utilization Review/Management experience
ICD-10, CPT coding knowledge/experience
InterQual or Milliman Knowledge/experience

Care Transition Case Manager Resume Examples & Samples

Plans, develops, coordinates, assesses, and evaluates services provided to members to promote quality and cost effective outcomes
Coordinates the transmission of clinical and benefit information and treatment to patients, families and outside agencies including issuing Non-Coverage and Denial of Benefits letters consistent with Health Plan Regulations
Previous experience, usually two (2) years of care management or clinical experience, and responsibility for a large caseload (50-100) for an extended period of time
Demonstrated experience in utilization data collection and cost benefit analysis
Master's (Social Work or Psychology), or PhD (Psychology) required
Knowledge of TJC, and other local, state, and federal regulations
Must be able to work in a Labor Partnership Environment

Senior Chronic Care Case Manager Resume Examples & Samples

Responsible for case management with patients, physicians and insurers primarily over the telephone
Partner with the Physician’s office to deliver a plan of action for patients
Provides detailed, technically complex information to patients to facilitate the beneficial therapeutic relationship with the company
Maintains and utilizes database information to provide patients with information regarding medical questions/concerns and product counseling
Communicates benefit information to patients and physicians as required
RN license required for the state of Kansas
3 years clinical experience in an inpatient setting; hospital preferred
Previous case management experience is required
Previous experience with documenting in an electronic medical record (EMR)
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to case management

Palliative Medicine Complex Care Case Manager Resume Examples & Samples

Advocacy & Education: Patient/Family Self Care Management, Patient/Family Health Management Education, Bioethics Referrals & Management, Physician, Staff & Community Education, Case Management Education & Training, Risk Management Identification & Referral
Clinical Care Coordination/Facilitation: Plan of Care & Outcomes Management, Patient Care Integration, Resource Management, Patient/Family Care Conferences, Interdisciplinary Care Communication/Coordination, Continuity of Care Planning Management
Continuity/Transition Management: Capacity/Access Management & Throughput, Discharge Planning, SNF/Rehab/LTAC/Assisted Living Placement, Board and Care/Attendant Care Placement, Transportation & Travel Arrangements, DME, Home Health/Home Infusion, Mental Health Service Coordination, Hospice
Dialysis Coordination & Arrangements, Pharmaceutical Authorization/Management, Community Resource Coordination, Advance Directives, Palliative/End-of-Life Care, Health Care Resource Management/ Clinical Cost Efficiency, Financial Assistance/Referrals, Appeals Management, Entitlement Program Coordination, Patient Benefits Coordination: CCS/GHPP/Medicare/Medi-Cal/SSI
Performance & Outcomes Management: Federal/State/Local Regulatory Agency Compliance, Joint Commission Standards Compliance, Clinical, Documentation Education/Support, Clinical Guidelines/Pathways/Evidenced Based Practice, Organizational Financial Performance/Management, length of Stay, Cost per Case, Denial Management
Psychosocial Management: Crisis Intervention, Psychosocial Assessment/Functioning, Counseling Support & Referral, Abuse/Neglect Identification & Referral (Partner, Child, Elder), Family Issues Affecting Care, Coping/Emotional Adjustment, Grief/Bereavement Support (Individual & Group), Adoption Resources, Health/Wellness Promotion, Substance Abuse Screening/Resources, Psychiatric Screening/Behavior, Management, Staff Support and Crisis Intervention (Critical Incident Stress Debriefing)
Research & Practice Development: Clinical Practice Improvements, Evidenced Based Clinical Practice, Social Work Best Practice Standards Development, Social Work Competency Development, Case Management Best Practice Standards Development, Case Management Competency Development
Utilization Management: Avoidable Delay Identification, Intervention & Tracking, Utilization Review, Medical Necessity Review, Care Plan Progression, Pre-Admission Planning, Third Party Payer Communication, Level of Care Appropriateness Coordination, Admission Status Determination, Clinical Denial Prevention
Knowledge of contemporary case management principles and practice methods, including assessment, treatment planning, utilization management, and quality assurance
Ability to use multiple electronic systems, software programs, and the internet to review and record information
Knowledge of medical terminology and related levels of care and treatment
Ability to collaborate across disciplines to provide comprehensive, integrated care
Ability to develop and implement educational materials and presentations for all levels of learners
Ability to develop appropriate treatment plans, communicates with interdisciplinary teams, and coordinates care
Ability to monitor and assure the patient's access to the appropriate level of care; the right health care providers; and the correct setting and services to meet the patient's needs; promote coordination and continuity in patient health care
Ability to provide appropriate patient care and clinical information when patients are admitted, referred, transferred, or discharged
Ability to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationships
Ability to understand, interpret and apply complex federal and state hospital compliance laws, rules, regulations and guidelines
Knowledge of financial processes of various private and public funding sources for health care services/procedures
Knowledge of hospital operations, organization, systems and procedures and laws and regulations pertaining to the operation of hospitals in California
Knowledge of the full continuum of care available to patients, interrelationships of the care components, and their effective integration

Case Manager Long Term Care-gateway Resume Examples & Samples

Traveling to members’ homes, nursing facilities, and other community based settings in order to complete face to face needs assessments with subsequent telephonic contact with the member in accordance with state and national guidelines, policies, procedures, and protocols. Assessing, planning, coordinating, implementing and evaluating care for eligible members with chronic and complex health care, social service and custodial needs in a nursing facility or home and community-based care setting
Coordinating care across the continuum of services and assisting members physical, behavioral, long term services and supports (LTSS), social, and psychosocial needs in the safest, least restrictive way possible while considering the most cost-effective way to address those needs. Facilitating authorization, coordination, continuity and appropriateness of care and services in community or HCBS
Facilitating transitions to alternate care settings such as hospital to home, nursing facility to community setting using an integrated care team to address the member’s specific needs. Educating members or caregivers regarding health care needs, available benefits, resources and services including available options for long term care community or facility-based service delivery. Providing education, resources, and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment. Developing a plan of care in conjunction with members or caregivers toidentify services to meet the member’s specific needs, and goals
Identifying resources needed for a fully integrated care coordination approach including facilitating referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management. Collaborating with the member's health care and service delivery team including the DSHP Plus LTSS Member Advocate, ICT, and discharge planners, to coordinate the care needs and community resources for the member in order to maintain the member in the least restrictive safe environment possible. Assisting members in developing, implementing and amending a back-up plan for gaps in provider coverage
Ensuring approved support services are being provided as outlined in the plan of care. Evaluating the effectiveness of the service plan and making appropriate revisions as needed in accordance with per policy & procedures and state contractual requirements
Assisting members in overcoming obstacles to optimal care through connection with community resources, including communicating with providers and formulating an appropriate action plan. Documenting all case management services and intervention in the electronic health record
Adhering to all company, State and Federal requirements related to privacy practices, HIPAA, and quality performance standards
Performing other duties as assigned/requested
Working flexible hours to meet member’s needs
Reliable transportation daily to be able to travel within assigned territory
Ability to meet regulatory deadlines
Has a dedicated home work space used only for business purposes and is able to comply with all telecommuter policies
Experience in geriatric special needs, behavioral health, home health
Understanding of the importance of cultural competency in addressing targeted populations
Experience with electronic documentation system(s)
Experience with cost neutrality and budgeting

Long Term Care Case Manager Resume Examples & Samples

3-5 years experience in Long Term Care claim or Disability claim environment
Experience working with/ familiarity of Medical Records
Excellent analytical and critical thinking skills with effective time management skill-set
Clinical background in Nursing or related field is a plus, with the ability to decipher medical records

Care Services Coordinator & Case Manager Resume Examples & Samples

One or more years providing case management services
Experience in managing confidential and highly sensitive matters
Experience utilizing case management software
Demonstrated effectiveness in managing crises
Demonstrated experience with the development and facilitation of educational programs and presentations for a variety of audiences
Ability to work independently in crisis management situations using professional discretion within the scope of the role regarding how and when to apply protocols and policies to assist students in crisis or at risk
Written, verbal, and interpersonal communication skills sufficient to successfully interact with students, large groups, faculty, staff, law enforcement, family members, the public, and other professionals
Ability to manage a varied caseload in a fast-paced environment
Knowledge of conflict resolution and de-escalation techniques
Ability to recognize and set appropriate boundaries with students, including challenging and supporting students to develop critical thinking and decision-making skills, self and other awareness, independence, and make healthy choices
General understanding of current trends and issues impacting student populations and higher education
Computer skills including Word, PowerPoint, Outlook, and Excel
One or more years working in a higher education environment
Training and experience addressing students, faculty, staff, and guests who are displaying signs of distress, are disruptive, or are potentially dangerous through a multi-disciplinary team approach
Experience in conducting research and analyzing data for trends to make recommendations relating to programs, services, policies, and protocols
Familiarity with creating web-based and print marketing materials including various social media platforms (Facebook, Twitter, etc.)
Membership in the Higher Education Case Managers Association
Membership in the National Behavioral Intervention Team Association

Case Management & Value Based Care Product Manager Resume Examples & Samples

Actively participate in the creative design of new project offerings and features based on current healthcare related trends, business needs or client requests
Acts as a resource to other members of the team providing clinical relevance, competitive information, and relevant product use case scenarios
Ability to document clinical and technical requirements analysis for product design and enhancements
Provide education and consultation to clients as well as internal colleagues and training of staff to operationalize the solution
Assist in review of release notes and documentation and collaborate with Content Team as necessary for content development
Perform demonstrations as needed of all solutions where case management staff would workflow would impact Case Management and Population Health across the continuum
Maintain knowledge of industry trends for all Midas related business in disciplines of case management, including but not limited to payer authorizations, transitions of care, utilization review, and care coordination as they apply to inpatient, outpatient, payer, rehab, etc
Maintain knowledge of industry trends and growth potential for population health. Assisting in the integration of analytic data into Juvo to identify population health opportunities at patient and population levels
Actively design and participate in educational sessions in person at client sites or at the annual Midas Symposium as well as webinars and recorded sessions to promote best practice use of the Midas solutions and to educate clients on new product features
Explain desired effect to Business Analysts, Developers and Software Architects in order to facilitate development and troubleshoot software
Work collaboratively with Conduent and partner vendors to integrate multiple software solutions into one client experience
Interpret regulatory and vendor specifications to determine what has changed, what will be changing and develop plans to implement the change for any of the Midas effected solutions
Minimum of 3 years in healthcare setting
Experience in areas of case management, payer authorization, care transitions, ACO, etc
Bachelor’s degree in healthcare related field, preferably RN or SW
Leadership skills
Technical ability to quickly pick up new programs and applications
Knowledgeable about web-based application development processes, HTML, clinical interfaces and HL7
Familiar with national organizations and accreditation organizations that effect Case Management and Population Health

Foster Care Case Manager Resume Examples & Samples

Bachelor’s degree in human services or related field and one year of related work experience working with the population served preferred
Licensed Social Worker (LSW) eligible in Ohio
Valid driver’s license in good standing
Car registration and vehicle insurance if providing transportation for individuals receiving services
Successful clearance of local and/or state background checks

Case Manager, Integrated Care Resume Examples & Samples

Triages student healthcare evaluation requests from students, clinical staff, GW faculty and staff, and all concerned community members
Takes brief history of students including clinical assessment of psychiatric/suicidal risk to determine urgency of needs. To include requesting and collecting of treatment records prior to appointments or during the course of treatment
Actively manages high-risk students from intake to referral
Coordinates the integrated care management team working with mental health and primary care clinicians to ensure best possible care
Educates students, as well as families and the community, regarding the integrated healthcare services and policies
Develops relationships with community healthcare providers, maintains an expert knowledge of health community resources, grows an extensive list of in- and out-of network providers for insurance plans, to enable the best possible care for students
Manages referral process, works with providers during hospitalizations or intensive/specialized out-patient care
Manages administrative processes in conjunction with integrated care
Experience in outpatient medical and/or mental health setting
Excellent interpersonal communication skills- in person, in writing and via technology
Highly developed organizational and time management skills
Evidence of organizational understanding and an ability to work collaboratively
Experience in organizing and prioritizing workload to meet required deadlines and department objectives
Knowledge of and experience with electronic medical records (EMR), Word and Excel
Sensitivity to confidentiality, diversity, and multicultural issues

RN Case / Care Manager Resume Examples & Samples

Patient advocacy while adhering to plan of care
Works collaboratively with interdisciplinary team
Performs intake assessments for new patients
Identifies barriers to successful clinical outcomes
Facilitates medication management
Hands off communication; works with medical home, documents assessments, interventions, plans, and education in the EMR

Care Coordinator / Case Manager Upstate Resume Examples & Samples

Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals
Maintains ongoing member case load for regular outreach and management
25- 40% local travel required
RNs are assigned cases with members who have complex medical conditions and medication regimens

Care / Case Manager Resume Examples & Samples

1) Pass documentation audits
2) Monitor new patient referrals
3) Monitor the hospitalizations of the patients enrolled into ACM and maintain logs

Download Case / Care Manager Resume Sample as Image file