-Identified and monitored PACE participants admitted to Philadelphia hospitals, shared clinical information between hospitals and PACE interdisciplinary teams.-Assisted clinical teams in determining post-hospital disposition for admitted participants.-Presented case data and led discussion during weekly resource management meetings.-Tracked length of stay data for participants in skilled nursing facilities.-Identified frequent hospital and ER utilizers, assisted clinical teams in creating plans to decrease utilization.

-Founding member of nursing team overseeing care for ten women with co-occurring substance use and mental health disorders -Monitored new clients experiencing opiate and alcohol withdrawal using COWS and CIWA scales -Participated in interdisciplinary rounds with psychiatric care team.-Connected clients to medical providers in community, scheduled and accompanied to appointments as needed -Tracked all medication changes, coordinated with outside physicians and pharmacy for prescriptions and deliveries- Completed pharmacy transfers and medical aftercare planning for clients preparing for discharge.

-Acted as charge nurse for mixed long-term and skilled nursing floors. -Conducted intake assessments for new residents; triaged residents to emergency care as needed -Reported incidents and changes in health status to doctors, family members, and other responsible parties; documented changes in electronic medical record. -Created resident assignments for CNA staff, delegated tasks to CNAs as needed -Assessed wounds and performed wound care treatments -Administered medications (PO, SubQ, IV, and PEG routes); managed PEG tubes, IV lines, and Foley catheters

-Coordinated medical care and case management for more than 70 patients with histories of homelessness and chronic mental illness -Participated in daily interdisciplinary rounds to communicate changes in patient status to medical and social work teams -Visited program participants at home to monitor chronic conditions and provide health education-Triaged participants receiving primary care at program office -Accompanied patients to medical appointments in community -Administered long-acting anti-psychotic injections