Care Coord Resume Sample
Jessica Russel
6025 Skyla Pass,
Los Angeles,
CA
+1 (555) 118 8365
Work Experience
Case Manager Cont Care Coord Rn-pd
10/2015
-
PRESENT
Los Angeles, CA
- Provide effective care coordination, assessment and oversight across a continuum of services and settings
- Promoting effective utilization of health care and monitoring of outcomes based on the needs and input of members
- Provides servcies for individual patients and on identified patient care areas to faciliate optimal patient outcomes
- Supports the deliver of effective, efficient care and assures continuity of care
- Update authorization information in Beacon’s clinical system
- Utilize the nursing process to assess the physical status of identified patients in the clinical setting
- Counsel patients/significant others regarding etiologies, diagnostic testing and management of transplant population
- Provide telephone counseling/triage for patients as indicated. Document per policies
Care Coord
07/2012
-
06/2015
Phoenix, AZ
- Care management of discharge services
- Gathers all relevant data, objectively evaluates data, and obtains information by communicating with the patient/patient’s family, the healthcare provider and other members of the healthcare delivery team and patient’s community support network including external healthcare providers/agencies
- Addresses issues related to Intensity of Service and Severity of Illness to confirm medical necessity for admission and continued stay in conjunction with the centralized Medicare
- Maintains high level oversight of the integrated plan and assures goals are met and/or addressed
- Serves as primary point of contact for physicians and is responsive to physicians' needs
- Makes/ensures that appropriate shift assignments are made, including assignment for physician order review
- Delegates tasks appropriately and within licensure requirements
- Provides clinical leadership to Associates during the shift
Clinical Services Care Coord
07/2008
-
04/2012
Philadelphia, PA
- In collaboration with Clinical Director prepares and conducts performance evaluations as directed
- The Associate is required to have close visual acuity including color, depth perception, and field of vision to perform an activity, such as assessing patients, preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading
- Performs daily rounding with physician and care team to proactively progress the patient’s plan of care and discharge. Queries the physician, residents / interns, mid-level clinicians and other clinicians for clarification and to obtain accurate and complete documentation as needed, based on current clinical findings, prescribed treatment, medical interventions and / or procedures
- Ensures appropriate clinical documentation to support level of care. Analyzes the patient’s current clinical status, treatment plan and past medical history to identify potential gaps on physician documentation. Identifies the principal diagnosis and all secondary conditions, co-morbidities, complications and procedures that have been documented in the medical record
- Contact both medical and behavioral health providers to ensure coordination of aftercare and services. This includes ensuring appropriate follow-up and follow through for members being discharged from higher levels of care
- Assist with managing discharge reporting data in AIS
- Identify resources that are available to members to help assist members to be maintained in the community
Education
University of Phoenix - Omaha Campus
2003 - 2008
Bachelor's Degree in Nursing
Professional Skills
- Works well in a fast paced environment as well as have excellent problem solving skills
- Demonstrates knowledge and skills necessary to provide care appropriate to the age of the patient population served
- Strong computer skills/tech savvy
- Proven exceptional communication skills both verbally and written
- Excellent team communication, diplomacy and conflict management skills
- Leadership skills including decision making, communication, problem solving, negotiation and conflict
- Skills in constructing, integrating and managing systems of patient care
How to write Care Coord Resume
Care Coord role is responsible for health, education, training, oncology, reporting, research, insurance, travel, acute, transportation.
To write great resume for care coord job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Care Coord Resume
The section contact information is important in your care coord 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
- Telephone number
Work Experience in Your Care Coord Resume
The section work experience is an essential part of your care coord 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 care coord responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular care coord position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Care Coord resume experience can include:
- Clinical Judgment and Critical Thinking: Demonstrates sound knowledge bases and actions in the decision making process for designated patient populations
- This job involves oversight and management of skilled patients in nursing facilities
- Demonstrate an awareness of, and adheres to, compliance regulations
- Provide effective assessment and oversight across a continuum of services and settings
- Managing any type of provider collaboration necessary to maintain an appropriate continuity of care
- Assist with trouble shooting clinical reports as assigned, ensuring corrections are made
Education on a Care Coord Resume
Make sure to make education a priority on your care coord resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your care coord 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 Care Coord Resume
When listing skills on your care coord 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 care coord skills:
- Stress Management: Position can be highly stressful. Ability to set priorities and manage stress effectively
- Excellent computer skills (Microsoft Office: Word, Excel, PowerPoint and Outlook)
- 1~2yrs of which in IPA, PHO, or HMO setting performing UM case management or referral authorization. competent Computer navigation skills
- Assist with developing a member’s self-management skills, health education and coaching, based on their health condition
- Education and counseling skills
- Written Communication: Ability to communicate with a wide variety of audiences effectively
List of Typical Experience For a Care Coord Resume
1
Experience For Clinical Care Coord Resume
- Interact effectively with physicians, the acute care coordinator team, and patients and their caregivers
- Assist with reviewing expired auths reporting, check quality of auth letters,monitor temp member eligibilityfor reinstatement of eligibility
- Work with CCMs to proactively identify members needing additional support to be maintained in the community
- Outreach to Member or family to encourage connecting with a Peer Specialists, if appropriate, for additional supports
- Assist with managing bed tracking component of residential services, including but not limited to, analysis of residential census reporting to ensure bed occupancy & tracking reliability
- Assist with conducting bed searches for Members delayed in Emergency Departments
- Outreach calls to beahvioral health providers and Medicaid members to ensure coordination of aftercare and services. This includes ensuring appropriate follow-up and follow through for members being discharged from higher levels of care
- Outreach calls to member or family to encourage connecting with a Peer Specialists, if appropriate, for additional supports
- Assist with preparing the NCI grant submission and annual reviews
2
Experience For Clinical Services Care Coord Resume
- Engages members in care coordination activities by using a person-centered approach
- Documents all activity in the designated system according to required polices and workflows
- Monitors the provision of services, including outcomes, assesses appropriate changes or additions to services, and facilitates referrals for the member
- Collaborates with the health care team to promote clinically appropriate length of stay
- Coordinate use of clinical and ancillary resources within and outside of the health system to achieve treatment goals specified in the patient care plan and facilities discharge
- Manage patient discharge process
- Adhere to infection control and safety guidelines
3
Experience For Tslc Clin Care Coord Rn-ltc Resume
- Adhere to HIPAA, TJC, CMS, and OSHA regulations and policies
- Attend bi-weekly acute care coordinator and patient family services meetings as scheduled
- The Courage Kenny Rehabilitation Institute - Cancer Rehabilitation Care Coordinator works with rehabilitation services, oncology, primary care, and specialty care to facilitate coordinated, timely provision of services
- Cancer treatment is frequently augmented by proactive efforts in rehabilitation to help patients obtain the best possible outcome and improve quality of life. The Cancer Rehabilitation Care Coordinator is responsible to assist patients through coordination of services
- Serves as liaison for oncology programs
4
Experience For Case Mgmt Care Coord MSW Resume
- Identifies and resolves issues affecting the delivery of patient care. Performs quality assurance studies and assists with implementation of quality initiatives
- Collaboration with NCI and other cooperative groups
- Demonstrates clinical expertise in oncology research, assist others in maintaining clinical standards and high quality, safe care, provides consultation to staff on clinical care issues and serves as a clinical resource
- Collaborates with IRBs (Via Christi Hospital, Wesley Medical Center, and NCI Center IRB)
- Increase number of referrals sent to clinical staff from 15% to 42%
5
Experience For Assoc Patient Care Coord Resume
- Triage retroactive review requests, upon eligibility verification, distribute as appropriate
- Monitor CareConnect queues related to request for service to assure that turnaround times are met and maintains departmental productivity ad performance standards
- Responsible for data entry of clinical information/authorization requests received from various EAP client On-Sites
- Perform post-referral follow-up calls to members and/or providers
- Provides leadership in the daily operations of a unit in the role of rehab care coordinator
- Works with the Beacon team to ensure completion of all requirements of the program as outlined by DMAS, including meeting face-to-face with members and Integrated Care Team (ICT) as necessary and appropriate
6
Experience For LPN, Lcsw Managed Care Coord Resume
- Set up appointments and in-person contacts as appropriate
- Arrange transportation as needed
- When appropriate, assist with referrals and access to Medicare-covered services
- Monitor PDIP events for members, specifically targeting ADD/ADHD meds and ensures that appropriate follow up appointments for medication compliance have been scheduled and monitors for acute barriers to compliance
- Conduct the “4 Call Protocol”
7
Experience For CM Ext Care Coord Rn-pd Resume
- Adheres to all Beacon policies and procedures and standards of operations
- Completes all required and assigned trainings
- Attend all mandatory company or department meetings
- Report to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.Completes full scheduled shift
- Works with the Empower team to ensure completion of all requirements of the program as outlined by Arkansas Medicaid, including meeting face-to-face with members monthly
- Acts as the primary point of contact for members, their guardian, and member’s providers
- Develops and maintains the Plan of Care and makes information related to the Plan accessible to providers and Members as needed and upon request. Care Coordinator is responsible for informing the PCP of all Plan of Care goals and tasks
- Reviews discharge plan and follows up with the member within 7 days of discharge from ER, Urgent Care Clinic or Acute Inpatient Hospitalization
8
Experience For Acute Care Coord, RN Resume
- The Care Coordinator is responsible for obtaining copies of all treatment and service plans, and coordinating services between those plans with a goal of preventing duplication of services, ensure timely access to needed services, and identification of any service gaps for the members
- Soliciting and complying with the member’s wishes (e.g., advance directive about wishes for future treatment and health care decisions, prioritization of needs and implementation of strategies, etc.)
- Ensure that referrals result in timely appointments
- Coordination with other healthcare providers for diagnostics, ambulatory care, and hospital services
- Assist with social determinants of health, such as access to healthy food and exercise
- Coordinate Community-based management of medication therapy
- Completes independent nurse visits for patients as indicated by physician or patient need
9
Experience For Assoc Patient Care Coord, Rancho Dr Resume
- Conducts timely outreach calls to members, according to the member’s benefit package, as specified by the state of Texas Health & Human Services Commission’s requirements for the STAR Kids line of business
- Provides appropriate clinical referrals to members and their families according to identified needs. Follows up with members to determine outcomes of referrals and any additional services needed
- Demonstrate flexibility and creativity, in order to achieve maximum effectiveness and optimal outcomes for members and their families
- Assists members and their families in navigating various service activities such as appointment scheduling
- Provides appropriate and culturally competent referrals for community based services according to the identified needs of members and their families
- Assist member with appointment and aftercare planning
- Manages any type of provider collaboration necessary to maintain an appropriate continuity of care
10
Experience For ASD & Dev Dis Care Coord Resume
- Act as liaison between hospital staff and the member’s family/support system/providers
- Coordinate and oversee Outpatient referrals for integrated medical/behavioral health services to network practitioners based on practitioner specialty and member’s geographic, cultural and language preferences
- Inputs all member data/information obtained in the course of coordinating care into the Case Management System
- Maintains open lines of communication with health plan contacts to ensure coordination of care
- Participates, as appropriate, in case rounds with the health plan contacts to discuss complex cases
- Plays a vital role in identifying trends, deficiencies, and/or barriers related to ambulatory follow up so that appropriate interventions can be designed to improve overall compliance rate
List of Typical Skills For a Care Coord Resume
1
Skills For Clinical Care Coord Resume
- Demonstrates caring behaviors of listening, respect, compassion and accepting individuality
- Skill in typing 40+ WPM with minimal errors
- At least two (2) years’ work experience in community or managed behavioral health care setting
- Skilled at multi tasking
- Experience in rehab nursing
2
Skills For Clinical Services Care Coord Resume
- Provide team management that demonstrates a supportive environment, clear expectations, coaching and accountability for team performance
- Build strong working relationships between care providers, individuals, caregivers and physicians
- Connect members with evidence-based patient education programs
- Reasoning: Ability to take in and interpret large quantities of complex information
- Per -Diem inpatient RN for continuing care nursing for Palliaitive Care team
3
Skills For Tslc Clin Care Coord Rn-ltc Resume
- Maintains clinical expertise by providing direct patient care, serving as clinical resource
- Management of any necessary referrals; including coordinating with medical team support for medical referrals when appropriate
- Document care management activities in approved platforms, according to standard operating procedures for both Beacon Health Options and health plan partners
- Functions as a clinical and leadership mentor and coach to new and existing staff
- Flexible staffing schedule and coverage for the department
- Sensitivity in working with people of divers races and cultures
- Sensitivity in working with people of diverse races and cultures
- Adaptable to an unpredictable clinic setting
- Knowledge of the medical, nursing, and rehabilitation needs of the brain tumor and neuro-oncology population
4
Skills For Case Mgmt Care Coord MSW Resume
- Utilize screening tools to assist in the follow up process for outpatient authorization requests
- Provides support to the member navigating any type of provider service activity
- Monitors care regarding appointments and follow-up as well as needed additional services
- Tracks any upcoming appointments to provide support and mitigate any acute barriers to compliance
- Assist Physician to follow up with patients regarding care such as test results and plan of care
- Collaborate with nursing colleagues and the interdisciplinary team to assure coordination of care
- Registered Nurse from an accredited nursing program
- Provides support to members in maintaining appointments and attempts to mitigate any acute barriers to compliance
5
Skills For Assoc Patient Care Coord Resume
- Current Minnesota Registered Nurse Licensure
- BLS certification or completion within first 3 months of employment
- Assists with preparation and oversight of unit schedules
- Establishes rapport and works collaboratively with insurance companies to facilitate the patient’s transition to an appropriate level of care
- Evaluates patients’ educational needs concerning continuum of care and available services and provides information and materials regarding community resources, discharge options, and pre and post treatment options and costs to patient and patient families. Provides assistance in resolving clinical, psychosocial and financial barriers
- An understanding of challenges facing people with behavioral health conditions and familiarity with the behavioral health delivery system in VA required
- Resolve escalated issues in collaboration with nursing support for requested PA reviews/dispositions based on business rules and workflow policies
- Work independently and document within care management system
- Intermediate level of knowledge of Microsoft Word and Excel programs
6
Skills For LPN, Lcsw Managed Care Coord Resume
- Collaborate with other OMS Units to resolve claims issues that involve PA’s
- Travel in between SNF assignments
- Travel in between SNF assigned
- Outcome oriented Case Management action plans on assigned cases
- Team oriented with multiple stakeholders, assist in Quality and PI metrics
- Travel between SNF assignments and hospital
- Team oriented, works with multiple stakeholders, assist in Quality and PI metrics
7
Skills For CM Ext Care Coord Rn-pd Resume
- Current active unrestricted license as an RN to practice as a health professional within the scope of licensure in applicable states or territory of New York state required
- Demonstrated ability to work and collaborate with primary care providers
- Data Analysis: Ability to analyze data and interpret reports. Ability to assess trends
- Verbal communication: Demonstrates a high level of verbal communication skills. Ability to effectively communicate with staff, providers, patients, families and outside agencies
- Conflict Resolution: Ability to work effectively/creatively through difficult situations
- Ethical Decision Making: Demonstrates ability to maintain confidentiality of patient, personnel, and institutional information
8
Skills For Acute Care Coord, RN Resume
- Self-Development: Demonstrates self-directed learning needs and seeks ways to meet own professional development
- Experience working with people with disabilities or other chronic health conditions
- Experience working with people with disabilities or other chronic health conditions across continuum of care
- Proven ability to assess and support preventive health care for people with chronic illness/disability
- Proven ability to apply the principles of rehabilitation
- Proven ability to assess and support all obstetric conditions, normal to abnormal
- Proven ability to establish and develop rapport with patients and families, and a multidisciplinary team
- Reading: Ability to read and interpret complex and detailed information
9
Skills For Assoc Patient Care Coord, Rancho Dr Resume
- Problem Solving: Ability to solve complex problems quickly, efficiently and creatively
- Basic competency in Microsoft Office programming
- A high level of ability and knowledge regarding telephonic communications
- Initiative: Ability to identify needs in the workplace and creatively work to resolve situations independently and implement new strategies
- Additional Practice Competencies: Demonstrates expert practice skills that include the above in addition to; negotiation, networking, decision-making skills and work delegation
- Experience in nursing care of clinical specialty (rehab nursing) in an acute care setting required
- Experience as a charge nurse and a preceptor required
- Relevant experience in Customer Service
- A high level of ability to work well under pressure and multi-task between multiple priority items
10
Skills For ASD & Dev Dis Care Coord Resume
- Knowledge of fetal anomalies
- ACLS required on telemetry units within 12 months
- The ability to be flexible and excel in many different settings
- This includes knowledge of growth and development over the life span, assessment and interpretation of the patient's status, identifying patient requirements relative to age and development
- Knowledge of Medicare & Medi-Cal
- Deliver exceptional customer service to both internal and external customers
- Independently manage time and responsibilities
- Establish and develop rapport with members, their families, and health and social service providers
List of Typical Responsibilities For a Care Coord Resume
1
Responsibilities For Clinical Care Coord Resume
- Along with the primary care provider (PCP) or behavioral health provider (BHP), serve as a team member of the Interdisciplinary Care Team (ICT) for members with primary behavioral health conditions
- Assist member in understanding services that require prior authorizations or referrals and assist in procuring those authorizations/referrals
- Serve as a role model in promoting the interdisciplinary team to ensure comprehensive coordination of care
- Participates in the facilitation of weekly huddles, rounding and case presentations
- Assess learning readiness based on cultural, age and education level
2
Responsibilities For Clinical Services Care Coord Resume
- Assist and participate with ongoing data collections, research and QA projects
- Identify, assess, and holistically manage complex behavioral health cases for those members who are in the dual eligible program
- Advocate for and empower member
- Develop ICP for each member in coordination with all team members, adhering to timelines and including comprehensive assessment of health needs, individualized care plans, implementation, monitoring and evaluation of care outcomes
- Collaborate with PCP, BHPs, other members of the health care team, Health Plan Complex Care Managers, Social Care Managers, Pharmacy, and others to arrange and coordinate services for the member to help member reach their highest level of functioning and optimize the member’s ability to engage in the appropriate plan of care
- Coordinates necessary services with participating ancillary service providers including community based providers, peer specialists, and public agencies as appropriate to ensure quality cost effective care for the member
- Collaborate with Health Plan and strategic partners in locating a primary care provider (PCP) with an open panel or locating in-network BHP
- Arrange for health care services within the scope of available benefits
- Document care activities and progress in Flexcare 360
3
Responsibilities For Tslc Clin Care Coord Rn-ltc Resume
- When delegated, oversee activities associated with member welcome and orientation. Ensure that initial member assessment and annual updates are completed and documented
- Support the member in all administrative aspects of the program such as benefit coverage, including pharmacy and behavioral health, eligibility guidelines and enrollment procedures, verification of eligibility, research and resolution of enrollment/eligibility issues and fulfillment of member materials (e.g., ID cards, member handbooks, etc.)
- Provide support to the members’ needs such as access to multilingual capabilities, access through TTY or TDD for those who are hearing impaired, assistance with locating non-emergency transportation services and information on available services within the community such as food pantries and other public assistance programs
- Responsible for completing work in a timely manner
- Convene needed care conferences as required in the IL contracts
- Work closely with the Beacon and the Health Plan’s Member Services/Customer Services, Claims, Quality and Compliance, Appeals and Grievances, and other departments to effectively respond to member needs
- Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect
4
Responsibilities For Case Mgmt Care Coord MSW Resume
- Provide effective care coordination, assessment and care plan oversight across a continuum of services as a member of the CKRI Advanced Primary Care Clinic
- Provide clinical direction to the Community Liaisons and their assigned activities
- Participate in case rounds with the health plan contacts to discuss complex cases
- Works collaboratively within the fetal team tin development of clinic care pathways
- Effectively engage/communicate and or lead a multidisciplinary team in a group setting, including planning, coordination of monthly multi-disciplinary fetal care meetings
- Promoting effective utilization of health care and monitoring of outcomes based on the needs and input of all stakeholders
5
Responsibilities For Assoc Patient Care Coord Resume
- Provide effective care coordination, assessment and oversight of Givens Brain Tumor Center patients across a continuum of services and settings
- Facilitates collaborative relationships within the brain tumor center and additional partners
- Provides clinical expertise in brain tumor and neuro-oncology specialty area to enhance program for identified patient populations
- Familiar with DSM-IV Criteria
- Familiarity with role of Managed Behavioral Care organization in mental health & substance abuse treatment
- Complete telephonic assessments; distinguish emergency, urgent and routine situations for appropriate referrals
- Desire to work with people with physical or mental disabilities
6
Responsibilities For LPN, Lcsw Managed Care Coord Resume
- Desire to work collaboratively and facilitate professional relationships
- Commitment to the coordination and organization of services needed by the brain tumor and neuro-oncology patient population
- Passion for patient service
- Certification in Case/Care Management such as: Accredited Case Manager through the American Case Management Association, Certified Case Manager through the Commission for Care Management Certification, or Care Manager, Certified through the National Academy of Certified Care Managers, RN-BC (ANCC), RN-C (ANCC)
- Population = 20,370
- Local travel
- When assigned, acts as the primary point of contract for members. This includes educating the member about the program, benefits, obtaining appropriate consent/s, collaborating with the medical care coordinator and conducting all activities in a holistic, person centered manner and ensuring that referrals result in timely appointments and if not, escalate appropriately
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