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Beverly Frederick is a Registered Nurse at Aetna. She is proficient in English.
Aetna
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Rn Case ManagerAetna Jun 2015 - PresentConducts comprehensive assessments of member’s needs/eligibility and determines approach to case resolution.•Evaluates member’s benefit plan and available internal and external programs/services•Consult with supervisor and Medical directors in meeting goals and objectives •Present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.•Advocate, educate, coordinate care with interdisciplinary team to maximize client outcomes.•Perform evaluation of client and develop treatment plan and identify clientcentered goals.•Coordinate therapies home care providers, behavioral health, DME, and otherneeds as described in plan of care.•Conduct telephonic outreach to the patient and/or caregiver•Work with community based agencies to develop relationships and provide appropriate resources to assist in maintaining patient dependence.•Responsible for admission approvals, discharges, planning, telephone triage, and /or benefit interpretation of medical procedures, inpatient stays or medications.•Assign procedure codes to all treatment plans advised use Interqual guidelines.•Talking directly with patients assessing history, and chief compliant, factoring in underlying health status.•Ensure the patient has everything they need to keep them out of the hospital.
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Rn Case ManagerFidelis Secure Care Apr 2014 - Apr 2015Responsible for the approval or rejection of claims, admissions approvals, discharges planning, telephone triage, and/or benefit interpretation of medical procedures, inpatient stays or medications.•Assign procedure codes to all treatment plans advised using Milliman guidelines and International Classification of Diseases book 9 (ICD-9 ) codes•Concurrent, Prospective and retrospective clinical review of services for medical necessity using InterQual clinical criteria.•Consult with medical director regarding decisions on cases not meeting clinical criteria.•Approve cases for SNF, Psych, General Medicine, HHC, and DME.•Designate patient case load and plan effectively in order to meet patient needs, manage the length of stay, and promote efficient utilization of resources.•Facilitation of precertification and payor authorization processes
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RnHenryford Hospital Apr 2013 - Apr 2015Performed initial assessment, monitor vital signs, telemetry.•Obtain an interpret baseline telemetry strips.•Evaluated patient care needs, prioritized treatment and maintained patient flow.•Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care.•Provide necessary health education and medication management.•Monitor patients with chest pain, syncope, post procedure patients.
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Care Transitions CoordinatorTendercare Of Taylor Oct 2013 - Apr 2014Preadmission onsite visit with medical record review, assessed inpatients to facilitate coordinated care upon admission to skilled facility.•Assisted with resolution to all short stay patient /family concerns.•Daily review of planned admissions and readmissions to hospital within 30 days of admission to skilled facility.•Coordinate patient education regarding disease process and management with interdisciplinary team to include medication management at time of discharge and post discharge follow-up.•Manage extend to home program for all discharges.•Arrange follow-up visits and ordering of equipment for home care.•Attend daily triage and clinical meeting for all short stay patients.
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RnSelect Medical Corporation Oct 2011 - Sep 2013• Ventilator and Tracheostomy care, telemetry.• Educate the patient and family on the plan of care, medications, disease processes.• Delegation of routine tasks to be able to communicate on the management of patient care.• Represented the patient and communicated his/her needs to the interdisciplinary team.• Received admissions and/or transfers to the unit• Competence in Rapid Response and code events.• Interpreting assessment/diagnostic data including labs, telemetry. -
RnSelect Specialty Hospital Oct 2011 - Sep 2013Ventilator and Tracheostomy care, telemetry.•Educate the patient and family on the plan of care, medications, disease processes.•Delegation of routine tasks to be able to communicate on the management of patient care.•Represented the patient and communicated his/her needs to the interdisciplinary team.•Received admissions and/or transfers to the unit•Competence in Rapid Response and code events.•Interpreting assessment/diagnostic data including labs, telemetry.
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RnVibra Hospital Jan 2010 - Oct 2011Coordinated with doctors an registered nurses to develop care plans for patients.•Acted as a patient advocate and implemented total patient care through a team nursing process covering high acuity patients per shift.•Set up PCA pumps, IV fluids, reviewed post-op orders an oriented patients and families to units.•Perform skin assessment and wound care.•Performed venipuncture as required.•Documented condition changes, admit new patients to unit, and prepared patient for discharge.•Initiated and updated care plans.
Beverly Frederick Education Details
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Concordia UniversityCriminal Justice Administration -
Davenport UniversityRegistered Nursing/Registered Nurse -
C.S.Mott Community CollegePara-Legal Technology
Frequently Asked Questions about Beverly Frederick
What company does Beverly Frederick work for?
Beverly Frederick works for Aetna
What is Beverly Frederick's role at the current company?
Beverly Frederick's current role is Registered Nurse.
What is Beverly Frederick's email address?
Beverly Frederick's email address is bf****@****cal.com
What is Beverly Frederick's direct phone number?
Beverly Frederick's direct phone number is +171759*****
What schools did Beverly Frederick attend?
Beverly Frederick attended Concordia University, Davenport University, C.s.mott Community College.
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