Woodhaven High School Nurse C

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Chanel somerville, RN

5459 Greenway Dr., Trenton, MI 48183 · 313-699-0133


Competent and passionate RN Case Manager with 3 years’ experience in patient advocacy. Adept multi-tasking Registered Nurse with extensive community contacts. Demonstrates excellent interviewing , persistent determination, and unrelenting ethical integrity.

Experience

Nov 2017 – Present

RN Case manager, supplemental home health care

Completes face-to-face comprehensive assessments of patients per regulated timelines.

Facilitates comprehensive waiver enrollment and disenrollment processes.

Develops and implements a case management plan, including a waiver service plan, in collaboration with the patient, caregiver, physician and/or other appropriate healthcare professionals and patient’s support network to address the member needs and goals.

Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.

Promotes integration of services for patients including behavioral health care and long- term services and supports, home and community to enhance the continuity of care.

Assesses for medical necessity and authorize all appropriate waiver services.

Nov 2017 – present

rn case manager, asencion health at home

Coordinates the integration of social services/case management functions into the patient care, discharge and home planning processes with other hospital departments, external service organizations, agencies, and healthcare facilities.

Collaborates with clinical staff in the development and execution of the plan of care and achievement of goals.

Utilization review, quality, and compliance monitoring

Conducts concurrent medical record review using specific quality indicators and clinical decision support criteria as approved by the medical staff, and CMS and other regulatory agencies and document findings.

Serves as liaison with physician performance improvement to ensure the reporting of quality indicators and care concerns.

Reviews all new admissions daily against inpatient screening criteria and communicates necessary changes in status designation to ordering physician and patient access.

oct 2018 – sep 2019

rn case manager, trinity home health care and hospice

Maintained updates of all changes in policies and procedures relating to utilization management, discharge planning and case management process.

Coordinated patient discharge with physician, managed care agency, social work services, patient, and family.

Performed clinical care coordination assessment within 72 hours of admission on all patients and performed ongoing reviews every 48 hours or as necessary.

Made referrals to other hospital departments for collaboration and assistance in discharge planning.

Developed and documented post discharge care plans in conjunction with other members of the health care team based on initial patient assessment.

Identified problematic care patterns or cases and made referrals to the corresponding parties.

aug 2015 – oct 2018

lpn to rn case manager, new dimension

Provided patient education to assist with self-management.

Responsible for tracking and trending variances barriers related to access to care; made recommendations and developed action plans to improve processes and systems.

Assisted in managing performance improvement projects.

Demonstrated initiatives in developing, implementing, and analyzing quality improvement strategies for the case management department.

Assist in the development of case management policies and procedures.

Education

september 2015

associate of nursing, american institute of alternative medicine

Graduated with honors

august 2008

lpn diploma, everest institute

Skills

Patient advocacy

Case conferencing

Quality nursing/care

Quality assessments

Strong clinical judgment

Training/development

Licensures

Registered Nurse- Michigan

BLS/CPR certified


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