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Candidate's Name , RN CCMPhone: PHONE NUMBER AVAILABLE Email: EMAIL AVAILABLEExperience HighlightsoExperienced health coach and case manager, able to implement and coordinate care and services of selected member populations across a rfd continuum of care.oAble to recognize and activate effective and timely utilization management to achieve optimal clinical and resources of outcomes.oProficient in conducting telephonic assessments of the members health status, health literacy, and level of support needed to reduce barriers to evidenced-based care.oSelf-motivated and self-directed individual who is able to work independently and utilize time management skills, to prioritize for effective results.oDemonstrated efficiency analyzing, tracking and reporting disease management activity to department leads, in accordance with URAC measures.oComplimentary manner whenever working with the members physician, pharmacists or caregivers to ensure coordination of care and to overcome barriers to care.Professional SkillsoConfident in prioritizing and developing strategy for results-oriented outcomesoWilling to go above and beyond to successfully complete the challenge at hand.oSupportive and adherent to corporate development methods to enhance and maintain membership satisfaction.oAdvanced assessment and teaching skillsoStrong comfort level working in a team setting to successfully problem solve.oFamiliarity with legal terminology and liability issues, as well as ability to handle ethical or management risks.Technical Skills and Knowledge AreasoCertified Case Manager  2013  PresentoUtilization and Quality Management/Outcomes experienceoExperienced in case management, utilization review, discharge planning, and single-case payor agreements for physical and substance abuse rehab settings.oManagement and coordination of care for patients who have multiple co-morbiditiesoResponding to diverse needs of commercial and Medicare population, which includes both over 65 and under 65 aged adultsoProfessionally competent and able to demonstrate creativity, critical thinking, counseling, interviewing, negotiating and research skills to prioritize effectively for external customer base.Clinical ExperienceoRN HEDIS Health Coach  2016  PresentoFederal Employee Program Medical Case Manager  2013  2016oFederal Employee Program Medical Health Coach  2011  2013oIntegrated Behavioral Case Manager  United Behavioral Health (OPTUM) 2009  2011oCo-owned and operated small business (Floral Shop) 2005 - 2009oBehavioral Health Case Manager  Acute setting  Florida Hospital, Orlando, 2002  2005oUM Program Manager (Interim) First Health Services Corporation of Florida 1999-2000oSenior Licensed Behavioral Health Care Analyst - First Health Services Corporation of Florida 2000 - 2002oExternal Quality Review Surveyor  First Health Services Corporation of Florida 1999  200oLicensureoNorth Carolina - Compact licenseRN 205354oPennsylvania  Re-activation pending approvalRN 231566LThe Commission for Case Manager CertificationCertified Case ManagerCertification #: 4213219oMilitary ExperienceUnited States Naval ReservesFebruary 1, 1968  January 31, 1974Honorable DischargeoEducationVillanova University, Villanova PABA Psychology/Education 1974St. Agnes Medical Center, Philadelphia PADiploma/ADN Nursing 1979