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GENEX Services LLC - Medical Case Manager Resume Example

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Christian Roberts
XXXX XXXXX XXX XXXX X
Costa Mesa, CA 92627
Ph: XXX XXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Professional Summary

RN with 34 years of progressive experience in palliative patient care. Consistently deliver comprehensive assessments. Facilitate implementation of customized care plans collaborating with physicians and healh care professionals to promote optimal outcomes and cost savings to all involved.

Skills
  • Case Management/ CCM Certified 5/2009 Patient intervention Rehabilitative care expert Patient care initiatives Clinical assessment Rehabilitation Nurses Society Member
Experience
Medical Case Manager Feb 1992Present GENEX Services LLC. Anaheim, CA

Field Medical Nurse Case Manager. Attend medical appointments to aggressively and professionally manage Workers Compensation claim files to reach optimal medical and return to work outcomes. Collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's comprehensive health needs. Utilize communication and available resources to promote quality cost effective outcomes.

Precertification And Continued Stay Review Nurse May 1987Feb 1992 Aetna Health Plans Santa Ana, CA

Perform timely initial clinical review as well as provider appeals of select inpatient, outpatient, ambulatory and ancillary services requiring prior authorization. Hospital Perform timely Utilization Reveiw of hospitalizations for continued stay adn  re-certificaiton according tomedical necessity. Manages all aspects of the certification Complete admission authorization, out of network transfers, initiates concurrent authorization, completes retrospective authorizations and minimizes financial risk by maintaining timely communication with all payers.

Registered Nurse- Front and Back Office Mar 1984Jan 1987 Louis Scarcella, M.D. Laguna Hills, CA Back Office Nurse directly to Internal Medicine, Private Practice. Patient care, triage, coordinate physician orders and services, follow up to laboratory and diagnostics testing. Front office as needed. 
Registered Nurse- Medical / Surgical Jan 1983Feb 1985 Hoag Hospital Newport Beach, CA Registered Nurse, Medical/ Surgical unit. Direct patient care
Registered Nurse Oct 1980Mar 1983 Washoe Medical Center Reno, NV Registered Nurse Medical, Surgical, Orthopedic, Oncology, Plastic Surgery units.
Education
Associate of Arts: Registered Nurssing Jun 1978 Pasadena City College Pasadena, CA
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Resume Details

This is a real resume for a Medical Case Manager in Costa Mesa, California with experience working for such companies as Genex Services Llc, Aetna Health Plans, Louis Scarcella. This is one of the hundreds of Medical Case Manager resumes available on our site for free. Use these resumes as templates to get help creating the best Medical Case Manager resume.

Previous Companies:

  • GENEX Services LLC
  • Aetna Health Plans
  • Louis Scarcella

Previous Job Positions:

  • Medical Case Manager
  • Precertification And Continued Stay Review Nurse
  • Registered Nurse Front and Back Office
  • Registered Nurse Medical
  • Surgical

Schools:

  • Pasadena City College

Level of Education:

  • Associate of Arts

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