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Click here or scroll down to respond to this candidateCandidate's Name
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Mobile Phone: PHONE NUMBER AVAILABLEE-mail: EMAIL AVAILABLEOBJECTIVEHealthcare Professional who is self-motivated, has excellent communication skills, works well with and in collaboration with other team members and possesses exceptional ability to multi-task while producing quality results.WORK EXPERIENCEMaternity Clinical Coordinator MedicaidAugust 2019- PresentCoordinate maternity and womens health clinical initiatives for the Medicaid members to ensure a focused, clinically sound, cost effective Medicaid care management model.Engage with Medicaid providers about evidence-based clinical best practices and DHS regulatory focus topics related to maternal health and womens health initiatives.Work with Health Plan clinical leadership, quality leadership, and network management to ensure coordinated care for members and support best practice and high-quality care with providersSupervisor Mobile Maternity Team UPMC Health PlanMay 2017- August 2019Day to day management eight Care Managers and one Licensed Social WorkerConduct interviews, responsible for hiring, yearly evaluationsComplete daily managerial reporting, conduct team meetingsSpecial projectsOn-site Provider office outreachSr. Care Manager UPMC Health Plan Maternity Mobile Care ManagerApril 2017- May 2017Face to Face encounters with antepartum membersEducate on all aspects of Maternal/Child well-beingResource and Advocate for membersDevelop, initiate, and execute comprehensive Plans of CareWork in collaboration with Health Plan (HP)Maternity Care Management Team, Providers, Facilities to achieve optimal outcomesCoordinate care with appropriate HP servicesProject creation, and implementationSr. Care Manager UPMC Health PlanJanuary 2016- April 2017Project DevelopmentResource person for colleaguesProvide patient education to patients and care giversDevelop and initiate comprehensive discharge plans of careWork in collaboration with hospital Case Management team, hospital staff, physicians, home care/hospice agencies, DME companies, post-acute care facilitiesSchedule follow up appointments and testingCoordinate care with UPMC Health Plan servicesContact/Resource representative in facility for UPMC Health Plan servicesProvide excellence of care through dedication to UPMC Mission StatementOn-Site Transition Coordinator UPMC Health Plan at Butler Memorial HospitalOctober 2011- PresentProvide patient education to patients and care giversDevelop and initiate comprehensive discharge plans of careWork in collaboration with hospital Case Management team, hospital staff, physicians, home care/hospice agencies, DME companies, post-acute care facilitiesSchedule follow up appointments and testingCoordinate care with UPMC Health Plan servicesContact/Resource representative in facility for UPMC Health Plan servicesProvide excellence of care through dedication to UPMC Mission StatementCommunity Nurse LiaisonOctober 2008 October 2011Concordia Visiting Nurses Cabot PANurse Liaison to local hospitals and skilled facilitiesMarketing to physicians and hospitals providing information on home care servicesKnowledge of insurance payer types, qualifying diagnosis and durable medical equipmentProvides expertise in verbal, electronic and written communication to other health care providers to ensure seamless transition between inpatient and homecare settingCreator and Manager of MIED ProgramApril 2004-October 2008Concordia Visiting Nurses Cabot PACreated, managed and facilitated Mom/Baby programResponsible for writing policies, procedures, competencies, hiring of personnel, annual evaluations and case managementMaintained case load of antepartum, postpartum and newbornsMaintained State Survey readiness for mom/baby programMom/Baby Home Health NurseJanuary 2002-February 2004Armstrong County Memorial Hospital Kittanning PAPerformed antepartum/ postpartum/ newborn home visits, physical and emotional assessments of mom and baby, referrals to community and government agencies, insurance authorization for home visits,Education of patients and familiesStaff Nurse Labor/Delivery/Postpartum/Newborn NurseryNovember 2000-January 2002Armstrong County Memorial Hospital Kittanning PAStaff nurse part time employment rotating through labor/delivery/postpartum and newborn nurseryRegistered Nurse OB/Gyne OfficeNovember 2000-January 2002Office of Dr. Joseph Rhageeb Natrona Heights PAServed as RN in office setting assisting with procedures alongside physician, assessing patients, coordinating hospital testing and admissions, insurance authorizations, chart review, ordering and maintaining office supplies and equipmentPreformed low risk antepartum checks for physician when unavailableObstetrics Staff NurseJune-1984-October 2000Citizens General Hospital New Kensington PAPrenatal Class instructorManaged outpatient Prenatal ClinicProvided expert care to antepartum, laboring and postpartum patients and newbornsCharge nurse and lead RN on all shifts, preceptor for new hiresServed on Steering Committee for implementation of HBO computer based laboratory systemEDUCATIONEnrolled Western Governors University Masters in Nursing Education ProgramEstimated graduation date July 2020Commission for Case Manager Certification (CCMC)December 2015Certified Case Manager (CCM)Vickie Milazzo InstituteOctober 2015Certified Legal Nurse ConsultantSlippery Rock UniversityMay 2014Bachelor of Science in Nursing (BSN)Citizens General Hospital School of NursingAugust 1980-June 1984Diploma School ProgramDuquesne UniversitySeptember 1978-December 1978AWARDS & HONORSUPMC Health Plan Superstar Award 2015Magna Cum Laude Slippery Rock University May 2014Sigma Theta Tau International Honor Society of Nursing 2013Golden Key Honor Society 2013Recipient of Dale Carnegie Championship Award in Dale Carnegie Sales Advantage Course December 2009COMMITTEES & ORGANIZATIONSNational Alliance of Legal Nurse ConsultantsCo-chair Profession Practice Council (PPC)UPMC Health PlanREFERENCESAvailable on request 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