• Promoted continuity and cost-effectiveness of care plans through the implementation of case management, utilization review and daily rounds and team huddles.• Assisted patients with goal setting, caregiver support and referrals; also advised patients regarding post-discharge nutrition/food, housing, social, home care and legal needs.• Evaluated discharge needs of patients and identified high-risk patients, including those with special needs (e.g. discharge to nursing homes, chronic care management).• Collaborated with medical social workers and physicians to prepare patients and family members for discharge; identified readmission risk factors and counseled patients accordingly.• Cultivated and maintained a network of community resources, including social workers, nursing home administrators, home care nursing agencies and medical equipment suppliers.• Member of the Continuing Education Committee, Documentation Committee, Procurement Committee and Admissions & Discharge Committee.• Served as preceptor for new care coordinators, nurses and medical social workers.

• Performed care coordination, discharge planning and utilization review duties on medical and surgical units.• Performed utilization review duties including initial and concurrent reviews with third party payors. • Partnered with treatment teams to ensure efficient transition from admission to discharge.• Provided advocacy, information and referral services to patients and their families to address medical and psychosocial needs.

Provided chronic hemodialysis therapy, preparation and monitoring of dialysis machines and systems, patient assessments, and maintained documentation of patient medical records.

• Provided case management services that included identifying and determining medical eligibility. • Developed, implemented, monitored and revised service plans for children with complex medical needs. • Coordinated available health care resources and benefits. • Participated in community education programs regarding services.

• Performed duties as a Staff Nurse and supervised nursing support staff, medication administration, evaluation of patient care, and development of treatment plans.• Completed initial and concurrent reviews and obtained authorization for psychiatric and medical services and treatment. • Provided education to the medical team regarding the utilization review process.

• Performed duties including case management, utilization review, claims processing, and authorization for inpatient and outpatient psychiatric and medical services. • Educated providers and members regarding the health plan.