Field Case Manager Resume Sample
Halie Rutherford
236 Jeanie Unions,
Chicago,
IL
+1 (555) 671 3676
Work Experience
Field Case Manager
01/2016
-
PRESENT
Phoenix, AZ
- Meets with clients in their homes, work-sites, physician’s or hospital to provide management of services
- Responsible for comprehensive members of members post acute care discharge
- Responsible for early identification and assessment of members telephonically, in their home and possibly in provider office or facility
- Conducts regular discussions and updates with member, physician, and Multi-Disciplinary Team
- Conducts in depth health risk assessment and/or comprehensive needs assessment which
- Adherence to College of Nurses standards of nursing practices
- Reviews patient status and assists the prescribing physician to complete patient enrolment, prepare Special Authorization (SA) petitions for public or private coverage by auditing patient charts, assessing previous therapies and tests in order to complete the SA
- Completes all relevant reports (program specific reports, expenses, etc.) as per specified timelines and as per required standards
- Reviews patient status and assists the prescribing physician to complete patient enrolment
Senior Field Case Manager
08/2011
-
09/2015
Detroit, MI
- Ensures patient services are coordinated and tracked, according to KPI’s, resulting in expedited access to therapy
- Reviews patient status and assists the prescribing physician to complete patient enrolment, prepare Special Authorization (SA) petitions for public or private coverage by reviewing patient charts, assessing previous therapies and tests in order to complete the SA
- Demonstrated ability to handle complex assignments and ability to work independently
- Thorough understanding of jurisdictional Workers Compensation statutes
- Advanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned
- Highly skilled at promoting Field Case Management (FCM) products and services internally and externally
- Reviews patient status and assists the prescribing physician to complete patient enrollment, prepare Special Authorization (SA) petitions for public or private coverage by auditing patient charts, assessing previous therapies and tests in order to complete the SA
- Work collaboratively with sales representatives and with FCMs
Field Case Manager Greater Orlando Market
08/2007
-
02/2011
Philadelphia, PA
- Acts as an advocate for the injured worker with all parties while maintaining the injured worker’s privacy and safety; Adheres to Wellcomp's confidentiality policies and procedures. Follows ethical, legal, and regulatory standards
- Participates in the collection of outcome information and Wellcomp’s Quality Improvement process to determine the impact of case management activities on timely injury recovery, medical treatment, return to work, claim costs, and both injured worker and client satisfaction. The result achieves desirable outcomes for all
- Maintains continuing education requirements per state license requirements. Maintains an updated and working knowledge of workers’ compensation and federal laws that impact the delivery of health care and return to work
- Assesses and analyzes injured worker's medical and/or vocational status and develops a viable, realistic action plan for maximum medical improvement from date of referral to closure
- Meets with individuals in their homes, work-sites, physician's or therapist's office to provide ongoing case management services
- Assesses the assigned individual to ensure appropriate safety measures are in place
- Manages progress towards desired outcomes
Education
National American University - Minnetonka Education Center
2003 - 2007
Bachelor's Degree in Nursing
Professional Skills
- Superior verbal and written communication skills, interpersonal skills and
- Strong research and analytical and problem-solving skills
- Excellent analytical and problem solving skills; Required
- Strong organizational skills, creative problem solving and results-oriented
- Strong computer skills; Knowledge of Microsoft Word, Excel, PowerPoint and other Office Programs
- Effective computer skills including navigating multiple systems and keyboarding
- Prior experience in working with EMR or Health Management System
How to write Field Case Manager Resume
Field Case Manager role is responsible for research, health, software, events, travel, insurance, compensation, auditing, training, general.
To write great resume for field case manager job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Field Case Manager Resume
The section contact information is important in your field case manager resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Field Case Manager Resume
The section work experience is an essential part of your field case manager resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous field case manager responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular field case manager position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Field Case Manager resume experience can include:
- Superior verbal and written communication skills in English and French
- Experience writing care plans for home health and/or community-based case management
- Experience with reimbursement navigation, special authorization, appeals process and conducting field-based reimbursement support and consultation is an asset
- Experience in MH or addictions setting
- Experience in BH managed care or BH clinical setting
- Knowledge and experience working with Health Homes recommended
Education on a Field Case Manager Resume
Make sure to make education a priority on your field case manager resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your field case manager experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Field Case Manager Resume
When listing skills on your field case manager resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical field case manager skills:
- Demonstrated ability to work effectively both autonomously and in teams
- Clinical practice experience 2 years of case management experience
- Prior experience in Home Care; Required
- Prior experience in Case management and/or workers compensation required
- Customer-focused and patient-centric in orientation superior verbal and written communication skills, and attention to detail
- Experience serving special needs patients
List of Typical Experience For a Field Case Manager Resume
1
Experience For Senior Field Case Manager Resume
- Evaluates members progress in setting & meeting established goals; revises individualized care plan accordingly
- Maintain comprehensive case management notes and billing tracking activity sheets
- Ensures that leadership remains apprised and updated on pertinent matters requiring their attention
- Develops proactive course of action to address issues to optimize the short & long-term outcomes, members overall wellbeing and quality of life
- Update changes to treatment plan through on-going assessment and communication with all parties
- Assist MDs in completing Special Authorization (SA) forms, enrolment forms,
- Interact with DES (follow-up & missing info)
2
Experience For Optum Hospice Field Case Manager Resume
- Additional service offerings to Tier 1 designated MDs (example TB testing
- Program explanation/"detailing" to MDs tier 2 or lower
- Assist MDs in completing Special Authorization (SA) forms, enrollment forms,prescription renewals, and other documentation
- Provide detailing/program explanation, in particular to MDs with low to no enrollment volume
- High sensitivity to client facing responsibilities
- Responsible to maintain regular communication with the injured worker, medical providers, attorneys, employers, claims professionals, and ECS management
- Apply all special service instructions required by customers/accounts
- Upholds applicable state and federal regulatory requirements that govern workers' compensation disability. Substantiates case activities carried out/services rendered in all activity reports completed
3
Experience For Field Case Manager Greater Orlando Market Resume
- Accurately report all case activity and billable hours in accordance with client specific guidelines and consistent with company billing practices
- Maintain any required credentials and adhere to all codes of ethics required by these credentials
- Adheres to the highest standard of confidentiality and ensures that all communication and dialogue is handled in same manner
- Attend quarterly claims reviews
- Upholds and abides by MVW standards of business conduct
- Actively follow up with injured associates, medical providers and insurance claims adjusters
4
Experience For Field Case Manager SW Resume
- Assist with other workers compensation claims management activities as directed by Senior Director of Global Claims
- Review and supplement workers compensation reports to the insurance carrier
- Collaborates/coordinates care with Commercial/Medicare Advantage members/family, providers, healthcare personnel
- Conducts individualized clinical assessments to identify health concerns/needs; develops a holistic, member centered plan of care with individualized goals & measurable outcomes
- Interacts/consults with internal multidisciplinary team to help member maximize best health outcomes
- Utilizes influencing/motivational interviewing skills to ensure maximum member engagement; promotes lifestyle/behavior changes to achieve optimum level of health
- Provides coaching, information & support to empower the member to make ongoing independent medical/healthy lifestyle choices
- Helps member actively & knowledgeably participate with their provider in healthcare decision-making
- Collaborates with PCPs/specialists to support their patients treatment plan & members health goals
5
Experience For Field Case Manager Resume
- Evaluates, prioritizes and reports on members plan of care/health outcomes in collaboration with the interdisciplinary care team. In urgent & non-emergency situations, facilitates the escalation of high-priority cases that require direct and/or immediate intervention by care team
- Implements/coordinates care management activities relating to acute cases & chronically ill members/clients across the continuum of care including education, referrals, connections to community resources, care coordination & support for transition to alternative levels of care
- Uses holistic approach consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals & objectives. Presents cases at case rounds/conferences to obtain multidisciplinary perspective & recommendations to achieve optimal outcomes
- Conducts assessments for members discharged from an in-patient hospital/skilled nursing facility, supports post discharge plan of care
- Interacts with members/clients telephonically & in person; requires face to face visits with members/clients in their homes, work-sites, or physicians office
6
Experience For Senior Field Case Manager Resume
- Adheres to care management requirements
- Flex work hours to meet member needs required
- Travel within a designated geographic area for in-person care management activities required
- Provides regular updates to Health Care Providers (HCP’s) on patient therapy status (e.g.: enrolment, reimbursement and adherence)
- Assists Physician’s with patients’ lab-test reminders (if applicable) in order to expedite access to therapy
- Coordinate the delivery of services to a dedicated caseload of 20-25 clients
- Conduct initial evaluation process with the injured worker, employer, physician and other interested parties to ascertain the specific issues that prevent a return to work
- Provide verbal and written reports
- Maintain timely communication with all parties to achieve timely case coordination of services
7
Experience For Optum Hospice Field Case Manager Resume
- Provides reports to Regional Manager as directed
- Monitors and maintains compliance with federal laws and rules, Ohio workers’ compensation laws and rules, and BWC contract requirements as applicable to areas of responsibility as well as OOD laws and rules as applicable
- Identify areas for quality improvement and make recommendations to supervisor
- Increase Patient enrollments by MD
- Engage with a physician and his/her staff as a trusted and well-informed
- Analyze enrollment potential based on prescription volume of other
- Utilize clinical skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options and services to facilitate appropriate healthcare outcomes for members
8
Experience For Field Case Manager Greater Orlando Market Resume
- Collaborate to assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individuals health needs through communication and available resources to promote quality, cost-effective outcomes
- Travel within a designated geographic area for in-person case management activities required
- Certified Occupational Health Nurse (COHN | COHN-S)
- Quickly establish rapport with a variety of personalities
- Handle and manage multiple responsibilities and tasks
- Bilingual English/ French required
9
Experience For Field Case Manager SW Resume
- RN with current, unrestricted New Jersey license
- Conducts in-person, individualized assessments to identify problems, goals, & interventions with corresponding measurable outcomes that drive the content of the holistic, member centered care plan
- Develops a healthy action plan in partnership with the member, defining problems, goals, and objectives to improve the members overall wellbeing/quality of life, continuously partners with the member to evaluate the members progress in setting/meeting the established goals, and revising/updating the health action plan accordingly
- Utilizes influencing and motivational interviewing skills to ensure maximum member engagement; promotes lifestyle and behavior changes to achieve optimum level of health
- Helps members actively and knowledgeably participate with providers in healthcare decision-making; helps members actively and knowledgeably participate with community based organizations able to support in meeting health goals
- Conducts assessments for members discharged from an in-patient hospital or skilled nursing facility, supports post discharge plan of care for both members assigned within their case load and members outside of the case load but residing within their local community
10
Experience For Field Case Manager Resume
- Demonstrates proficiency with operating in a remote environment, connecting hardware/software, managing email in an Outlook account, and using remote communication software such as Skype & WebEx; able to demonstrate proficiency with Word, Excel, and experience documenting within an electronic health record
- Other requirements include: ability to flex work hours to meet the member scheduling needs, ability to travel within a designated geographic area for in-person care management activities distance is reasonable but not fully defined by one-way mileage limits
- Assesses and analyzes an injured employees vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work
- Conducts vocational testing, job site analysis, job development, counseling and placement to manage patients return to work status; monitors patient progress toward desired outcomes through assessment and evaluation
- Arranges referrals, consultations and therapeutic services for patients on a PRN basis; confers with specialists concerning course of care and treatment
- Adheres to all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources
- Certified Rehabilitation Counselor (CRC)
List of Typical Skills For a Field Case Manager Resume
1
Skills For Senior Field Case Manager Resume
- Medical / Surgical experience in a clinical setting
- Experience in using multiple online tools to capture care management plans and activities
- Case management/discharge planning experience; Required
- Experience with Special Needs Plan (SNP)
- Prioritize the work
2
Skills For Optum Hospice Field Case Manager Resume
- Experience with Special Needs Plan
- Experience and background in Rheumatology is an asset
- Clinical practice experience (required for NCM role only)
- Three or more year’s workers compensation case management experience or related field
- Clinical practice experience is required
3
Skills For Field Case Manager Greater Orlando Market Resume
- Home care/hospice experience
- Clinical practice experience with 3 years in acute; Required
- Case management experience; Preference
- Case management experience required
- Clinical practice experience; Required
- Case Management Experience; required
- Years case management experience required
- Clinical practice experience required
4
Skills For Field Case Manager SW Resume
- Registered Nurse Experience with emphasis on occupational health
- Clinical practice experience, required
- Case management experience, required
- Completes all relevant reports (time sheets, expenses, mileage, validate reports, etc.) as per specified timelines and as per required standards
- Clinical (acute and/or post-acute) experience
- Clinical practice experience & 2 years of Home Care/Hospice Care required
- Maintains effective dialogue and communication with peers, leaders and associates
5
Skills For Field Case Manager Resume
- Utilize data to as a tool to assist in tracking and trending outcomes and clinical information
- Maintains safe, secure, and healthy work environment by establishing and following safety standards and procedures
- Travel 75% of the time throughout the Greater Tampa Bay area, mainly Hillsborough and the surrounding cities
- Participate in an on call rotation which currently includes 4 - 6 nights per week including weekends, weeknights and holidays
- Interact with Data Entry Specialists (follow-up & missing info)
- Current Nursing license and/or certification
- Knowledge of laws and regulations governing delivery of rehabilitation services; required
- Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
- Pennsylvania State Registered Nurse license
6
Skills For Senior Field Case Manager Resume
- And this is a 40 hour benefited position that is not based on case load!
- And this is a 40hour benefited position that is not based on case load!
- Travel 75% of the time locally throughout Brevard County
- RN licensure (current, unrestricted) in Missouri
- Communicate and comprehend medical information / read patient charts
- Work with minimal supervision, autonomously
7
Skills For Optum Hospice Field Case Manager Resume
- Build and maintain relationships with physicians
- Call on HCPs
- Conduct CHE events with HCPs
- Speak multiple languages an asset
- Local travel to various clinics required regularly
- 10-15% overnight travel required
- Possible 5-10% overnight travel
- Current, active, and unrestricted licensure as a health professional (RN)
8
Skills For Field Case Manager Greater Orlando Market Resume
- Knowledge of the disability and workers' compensation industry including rules and regulations and an understanding of clinical procedures and all processes involved in the delivery of quality health care to an injured worker
- Bilingual in English and Spanish ideal
- Registered nurse (RN) diploma REQUIRED
- Bilingualism - French/English required
- Registered nurse (RN) or Registered Practical Nurse (RPN)
9
Skills For Field Case Manager SW Resume
- Registered nurse (RN) or Registered Practical Nurse (LPN)
- Registered nurse (RN) diploma- License to practice with the OIIQ
- GA RN license required
- Knowledge of current laws and regulations that govern delivery of rehabilitation services
- Knowledge of human behavior and performance
- Demonstrate strong customer service knowledge including needs assessment, meeting quality standards for services and evaluation of customer satisfaction
- Practice case management within the scope of his/her licensure (based on the standards of the discipline)
- This license needs to be unrestricted license to practice independently in BH field
10
Skills For Field Case Manager Resume
- CCM, COHN, CRRN or national certification required
- Home Care/Hospice Care required Ability to travel within a designated geographic area for in-person case management activities
- BA/BS or MA in related field with a CCM, CDMS, or CRC or other related designation or
- CCM required based on state guidelines
- Home Care/Hospice Care is required
- Travel within a designated geographic area for in-person case management activities around 50 miles; Required
List of Typical Responsibilities For a Field Case Manager Resume
1
Responsibilities For Senior Field Case Manager Resume
- Certified Disability Management Specialist (CDMS)
- Certified Vocational Evaluator (CVE)
- Responsible for case management of eligible Aetna members with complex care needs; partners with an interdisciplinary team to deliver comprehensive, community-based case management services focused on helping the member maximize best health outcomes. Interacts with members in-person, in their home on a regular basis; also meets members at an agreed upon community location such as a library
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