Crafting a Winning RN Case Manager Resume with BestResumeHelp.

com

In the dynamic field of healthcare, the role of a Registered Nurse (RN) Case Manager is crucial in
ensuring the seamless coordination and delivery of patient care. As professionals in this field
navigate through a myriad of responsibilities, a well-crafted resume becomes an essential tool to
stand out in a competitive job market. BestResumeHelp.com offers comprehensive support in
building an impressive RN Case Manager resume that highlights your skills and experience.

Why Choose BestResumeHelp.com for Your RN Case Manager Resume?

1. Industry-Specific Expertise: Our team of professional writers specializes in healthcare and
understands the unique demands of the RN Case Manager role. They are adept at
showcasing your qualifications in a manner that resonates with potential employers.
2. Customized Resumes: One size does not fit all. BestResumeHelp.com ensures that your
resume is tailored to your individual experiences and accomplishments. We work closely with
you to gather information and create a resume that reflects your unique strengths.
3. Keyword Optimization: In today's digital job market, many employers use applicant
tracking systems (ATS) to screen resumes. We employ strategic keyword optimization
techniques to increase the visibility of your resume, helping you get noticed by employers.
4. Emphasis on Achievements: Beyond listing responsibilities, our resumes focus on your
achievements and contributions. This approach helps employers understand the tangible
impact you've had in your previous roles, making you a more compelling candidate.
5. Professional Formatting: Presentation matters. BestResumeHelp.com ensures that your RN
Case Manager resume is professionally formatted, easy to read, and visually appealing. A
well-organized resume can make a lasting impression on hiring managers.
6. Timely Delivery: We understand the importance of meeting deadlines. Our team works
efficiently to deliver your customized RN Case Manager resume promptly, allowing you to
apply for opportunities without delay.

Order Your RN Case Manager Resume Today!

Investing in a professionally crafted resume is an investment in your career. Whether you're a
seasoned RN Case Manager or just starting in the field, BestResumeHelp.com is committed to
helping you put your best foot forward. Order your RN Case Manager resume today and take the
next step towards securing your dream job in healthcare.

Disclaimer: BestResumeHelp.com is not responsible for job placement or guaranteeing employment,

but we are dedicated to providing top-notch resume writing services to enhance your job-seeking
journey.
Communicates identified needs and potential solutions to supervisor. Conduct outgoing periodic
follow up on case status and payment. Utilizes patient assessment information to identify quality and
safety indicators to monitor during hospital stay. Ability to interpret medical documentation to
determine reasonable worksite or job-related accommodations. Proactive post discharge follow-up;
telephonically for a minimum of 30 days following discharge. Counsels with patients and family
members in decision making and in meeting psycho social needs of the patient. Authorizing vendor
services on skilled need and medical necessity; negotiate fees for Durable Medical Equipment
(DME) and services needed. Demonstrates good skills in the required paper and electronic systems.
Subject to varying and unpredictable situations, many interruptions, multiple calls and inquiries, and
change. Negotiates appropriate level and intensity of care and disability duration with providers
through use of medical and disability duration guidelines, adhering to quality assurance standards.
Ensures the multidisciplinary discharge plan is consistent with the patient’s clinical course,
continuing care needs and covered services. Louis or Maryland Heights, MO (50 minutes or 50
miles). Experience with provider services, billing and enrollment, member services, and claim
processes and procedures. General knowledge of coding and DRG assignment process is preferred.
Perform appropriate documentation to maintain the standards set by the Agency or Fiscal
intermediary including timely recording of evaluation data, interventions, and client’s response to
interventions. Intermediate level of experience with Microsoft Word, with the ability to navigate a
Windows environment. Maintains follow-up communication with payor as required for authorization
of hospital stay. Develops needs and prioritizes with input from all parties to organize a plan that will
provide maximal outcomes. Embraces diversity and demonstrates the ability to work together.
Focuses the care plan on quality of life, effective utilization of resources, and facilitates goal
achievement and movement through the continuum of care. Previous experience in critical care
nursing with certification (CCRN) preferred. Skills: Microsoft Windows, Outlook, Ceridian,
Peoplesoft, Iv Certified, BLS, ACLS, Great Assessment, Wound Care, IV Therapy, Diabetic Care,
Psyche, Critical Care, Psyche, LTAC, Diabetic, Tele, Rehab, and ER. Maintains all necessary
educational requirements for required licensure and certifications. Educates and connects to other
care providers and community resources to enhance care. Manage schedules and resources to ensure
proper coverage and staffing ratios to support contractual requirements. As applicable, multi-state
licensure is required if this individual is providing services in multiple states. Telephonic Complex
Nurse Case Manager Rn-telecommute. Must live within a commutable distance of our Greensboro,
NC office location. Resolves situations as appropriate within scope of job. Takes in-bound calls and
places out - bound calls as dictated by consumer and business needs.
Document in-person and telephone encounters using the system to identify and re-engage patients.
Uses supplies and equipment effectively and efficiently. Strong knowledge of healthcare,
government and industry trends. Interact (i.e. on incoming and outgoing calls and correspondence)
with attorneys, insurance adjusters, medical providers, court staff, recipients and family members
and client. Assists physicians in selecting the correct status for each patient. Coordinate services as
needed (home health, DME, etc.). Will consider an Associate’s degree in Nursing with equivalent
experience. Prepares and presents inservice and training programs as requested. Experience working
with the needs of vulnerable populations who have chronic or complex bio - psychosocial needs.
Licensed RN in the State of Arizona, Bachelor’s degree preferred. Excellentinterpersonal skills
including verbal and written communication skills. You'll receive a real-time score as you edit,
helping you to optimize your skills, experience, and achievements for the role you want. Experience
utilizing electronic InteQrual or other standardized criteria strongly preferred. Functional proficiency
with DaVita specific clinical software programs, including Capella, required within 90 days of
employment. Ability to lead and coordinate activities of a diverse group of people. Required:Current
Texas licensure as a Registered Nurse. Must be able to demonstrate understanding of national patient
safety initiatives by strict compliance to all safety protocols and procedures as required by both
HCA and Round Rock Medical Center. Ability to operate basic computer and data management
software. Facilitates job modifications when appropriate and educates involved parties regarding
claims process and functionality as it relates to job requirements. Works with interdisciplinary team
to coordinate needed services to ensure efficient continuity of care. Identifies internal obstacles to
efficiency and good patient outcomes and intervenes with healthcare team to eliminate when
possible. Explains home health services and Medicare benefits to patients and families. Provides and
directs nursing care for clients with complex nursing care needs; i.e. multi-system health care issues,
complex psychosocial issues, etc. Ensures follow up appointments and referrals to programs, both
health plan and community are in place. May be required to work extended hours for special
business needs. Conducting skills assessment, planning, implementation, coordination, monitoring
and evaluation. Provide assessments of physical, psycho-social and transition needs in settings not
limited to the PCP office, hospital, or member’s home. Ensure continual assessment of patient and
family needs from admission to Bridges in Complex Care throughout the course of care.
Communicates timely, complete, and accurate information relative to a potential denial to the
appropriate members of the health care team. Completes a comprehensive patient needs assessment
for each patient.
Registered Nurse with degree from an accredited college or university. Encourages appropriate use
of healthcare services while striving to improve quality of care through patient throughput and
maintaining cost effectiveness of cases. Participates in development of procedures, roles, systems and
structures related to the case management practice. Proficiency utilizing Microsoft Word, with the
ability to navigate a Windows environment. Web a nurse case manager develops, implements, and
reviews healthcare plans for patients that are geriatric, recovering from serious injuries, or dealing
with chronic illnesses. Adheres to professional practice within scope of licensure and certification
quality assurance standards and all case management policy and procedures. Two or more years of
experience as a licensed clinician in an acute hospital or rehabilitation setting preferred. Compare
assessment data to baseline assessment to monitor patient’s progress. Current Colorado State nurse
license, valid Driver's license, proof of Motor vehicle insurance required. Responsible for coordinate
and manage relationships with participating provider practices. Attend continuing education sessions
and training relating to your job functions as required. Effectively manages resource utilization to
ensure efficiency and appropriate reimbursement. Active Registered Nurse (RN) license in State of
Arizona required. Profession certification as a Case Manager is preferred. Preferred experience in
public health, home care or Hospice nursing. Must have local unencumbered driver’s license and
proof of automobile insurance. Minimum of three years RN clinical experience, preferred.
Motivational Interviewing or Shared Decision Making techniques. Established case management
contacts are performed per account requirements. Proficiency with Microsoft programs and a strong
computer acumen. Ability to provide a high level of customer service while working in a fast-paced
environment. Must live within a commutable distance of either our Greensboro, NC or Maryland
Heights, MO office locations. Propose alternative treatment to ensure a cost effective and efficient
plan of care. Initiate the letter of agreement process, working with Network Management to ensure
Service Level Agreements are completed in a timely manner when applicable. Monitors patients’
progress and adequacy of planning process through regular communication with patients and service
providers. Document in-person and telephone encounters using the system to identify and re-engage
patients. Current driver’s license in state employed with positive driving record and able to meet
requirements of insurance coverage required. Minimum two (2) years of clinical experience as an RN
in an acute care setting required. Must have excellent PC skills (Word, Outlook, ability to navigate
around the internet). Counsels with patients and family members in decision making and in meeting
psycho social needs of the patient.
Ability to work independently with a minimum of direction, anticipate and organize workflow,
prioritize and follow through on responsibilities. Strong knowledge of healthcare insurance industry,
terminology, provider networks, contracting and credentialing. Works collaboratively and maintains
active communication with physicians, nursing, and other members of the multidisciplinary team in
order to effect timely, appropriate patient management. Communicates with all members of
multidisciplinary team to facilitate care coordination process for assigned workload. Responsible RN
with excellent communication skills demonstrated by 26years of experience in healthcare. Critical
thinking skills as a case manager and able to formulate innovative plan of care for complex cases.
Current licensure in Texas as a Registered Nurse with Bachelor of Science in Nursing preferred.
Interpret clinical information and assess implications for treatment, based upon knowledge of
Medical and Behavioral Healthcare management and delivery. Professional certification in case
management preferred. Provide patient education about common mental health and substance abuse
disorders and the available treatment options. Develop customer’s individualized plan of care, as
well as communicate the plan of care to the customer. You will participate in round tables,
coordinate services and ongoing treatment. A minimum of 2 years experience in case management or
utilization review. Promote compliance with Federal and State Regulations. Aspiring RN case
managers will need several relevant experiences to be considered for the role. This position is
primarily Work At Home but minimal travel will be required to the Miramar, FL office 1-2 times a
month and also possible 2-3 provider visits required per month in Treasure Coast area down to Palm
Beach area. Perform patient assessment of all major domains using evidence based criteria (physical,
functional, financial and psychosocial). Ability to participate in an on call rotation which currently
includes 4-6 nights per week including weekends, weeknights and holidays. Proactively identifies
hospital services and available resources to meet the patients needs. Conveys issues and barriers to
manager for resolution. The preferred candidate is a nurse with healthcare and case management
experience in medical or hospital practice or the insurance or bio-pharma industry. Excellent
organizational and problem solving skills. Current Texas State RN license or compact license is
accepted. Experience with making diagnoses and choosing, initiating, and modifying selected
therapies to assist patients with optimizing their level of function and self-care. Knowledge of
medical health conditions, levels of care, and discharge planning. Ability to work with databases,
Microsoft Suite and EPIC. Interacting with Medical Directors on challenging cases. Competency in
a minimum of one clinical specialty area. Identify and problem solve issues with appropriate services
to ensure positive member outcomes utilizing cost efficient covered services. Facilitates
communication and coordination among stakeholders involving the patient in the decision-making
process on order to minimize fragmentation of care.
Working knowledge of and basic skills with computers. Proactively ensures that required clinical
justification is provided to third party payers to obtain recertification for continued hospitalization
and treatment and that transfer of this information, together with days approved and contact
information is provided timely to the PAS and CVO via computerized insurance review
documentation. Clinical information is faxed or transmitted electronically as needed. Web use this
resume template download nurse case manager resume sample (pdf) create my resume build a
professional resume. BSN Degree is highly desirable; National certification in Case Management is
preferred. Informs release of information vendor about missing or insufficient medical record
documentation. Participation in a rotating on call schedule which includes weeknights, weekends
and holidays. Current, unrestricted RN license in the state of Arizona. Require the ability to work
successfully under sometimes stressful conditions. Professional Resume Reviews Get video feedback
on your resume or CV from our expert team. Has sufficient endurance to perform tasks over long
periods of work hours. Documentation as established per coaching requirement. Requires working in
a fast-paced setting and self-motivated. Functioning as an advocate for members and decreasing
unnecessary hospitalizations and emergency room visits. Provide patient education to assist with self
management -Coordinate care for members. Excellentinterpersonal skills including verbal and written
communication skills. Attends Utilization Management Committee, performance improvement and
departmental meetings as appropriate. BSN or higher degree for Nurses, Master’s degree or higher
for Behavioral Health Clinicians. Develops and implements action-oriented and time specific case
management plans by determining and documenting specific objectives, goals, and actions designed
to meet the client’s health and human service needs identified through the assessment process.
Skilled in: personal leadership, relationship building, problem solving, planning and organization,
conflict resolution, accountability, persuading and influencing. Ability to work with databases,
Microsoft Suite and EPIC. Bachelor of Science in Nursing or equivalent experience. Able to assess
patient care needs and utilize available resources to provide safe discharges. Knowledge of funding,
resources, services, clinical standards and outcomes. Familiarity with Medicaid programs and
community resources preferred. Recent SNP and PD call experience strongly preferred. Performs on
site evaluations of HHAs and volunteers. Familiarity with American Indian Tribes’ programs and
policy. How much of this is different from the work you’ve done. Responsibilities may vary
dependent upon specific client requirements.
Collaborating with physicians, office staff and ancillary departments. Acts as a liaison with patient's
insurance carrier (case manager, utilization reviewer) to coordinate post hospital services and referrals.
Two (2) years clinical experience as an RN in an acute care setting required. Basic Life Support
(BLS) for Health Care Providers, required prior to employment. MIDAS, CuraSpan and InterQual
Certified Instructor (IQCI) training with proficiency testing. Work with members to identify and set
personalized health improvement plans and goals and support members in achieving those goals.
Ability to lead and coordinate activities of a diverse group of people. Excellent problem
identification and problem solving skills and follow through skills. Multiple state licensure (in
addition to Compact License if applicable) or ability to obtain multiple state nursing licenses within
12 months. Current recognition by a national professional organization in case management must be
obtained within 2 years of hire date. Successful experience in conflict management and negotiations.
Skills: Case Management, Computer, Communication, Leadership, Team Player, Customer Service.
Demonstrate a proficiency level typically achieved with 5 years clinical experience. Identifies
resources available to address the needs identified, coordinate referrals, and document plan. Seeking
to gain employment in a stable company with excellent managers and team-oriented employees; to
advance my career and complete my MSN; to bring my attributes to your company that will enhance
and bring about favorable results and knows that I make a difference. Proven proficiency utilizing
Microsoft Word, with the ability to navigate a Windows environment, Excel (trainable) and Outlook.
Knowledge of case management or utilization review as normally obtained through the completion
of a bachelor's degree in case management or health care. Perform basic nursing procedures
including, but not limited to, wound care, dressing changes, post-op care including suture removal.
Attend accountable care training sessions, as required. Develops, implements, and manages case
findings and screening processes to identify candidates for case management and to define the
appropriate level of case management for members. The position reports to the Director of Clinical
Operations and coordinates, supervises and is accountable for the daily activities of a team of RN
Case Managers, Patient Care Coordinators and Social Workers. Provides health-related counseling
for GE employees within scope of nursing knowledge and practice. Current Registered Nurse
\(R.N.\) license in Arizona. Supports medical operations; including high risk case care management
and other support for PNS operations. Experience working in a health plan or other managed care
setting. Will consider an Associate’s degree in Nursing with equivalent experience. Excellent verbal
and written communication skills, strong listening skills, problem- solving skills, organizational skills,
effective time management, ability to set priorities, and the willingness to adapt quickly to changing
priorities, if necessary. Reviews all new admissions daily against inpatient screening criteria and
communicates necessary changes in status designation to ordering physician and Patient Access.
Assesses, evaluates and documents patients records to reflect current status of patient. Participates in
the development of appropriate QI processes, establishing and monitoring indicators.
Communication to third party payors and other relevant information to the care team. All staff will
be cross-trained and oriented to the ED Case Management Practice. Must be willing to obtain and
maintain multiple state licenses as needed. Confronts difficult or conflict situations constructively
and seeks appropriate assistance. Current, unrestricted RN license in state of residence. Collaborates
with physician when additional documentation needed to support level of care. Ability to effectively
present information and respond to questions from groups of managers, clients, customers, and the
general public. Multiple state licensure (in addition to Compact License if applicable) or ability to
obtain multiple state nursing licenses within 12 months. Two or more years of experience as a
licensed clinician in an acute hospital or rehabilitation setting preferred. Maintains follow-up
communication with payor as required for authorization of hospital stay. Communicate with all
stakeholders the required health related information to ensure quality coordinated care and services
are provided expeditiously to all hospitalized members. Confirm documentation of eligibility for
beneficiaries. Bachelor's degree in nursing or healthcare related field (preferred) OR current
equivalent related work experience (4) four years. Identifies Quality Improvement (QI) indicators
and provides timely reporting to the QI department. Responsible for processing Medi-Cal TARS
(Treatment Authorization Request) and obtaining physician signature in a timely manner. Proactively
initiates discharge planning and placement to facilitate timely patient transition to the next level of
care. Implements, coordinates, monitors, and evaluates the case management plan on an ongoing,
appropriate basis. This includes seeking education for self development. Conduct transitions in care
and medication reconciliation. Must be a Registered Nurse with a current, unrestricted Texas
License. Facilitates the movement of the member through the continuum of care in a proactive
manner. Facilitates early referrals to social work, rehab services, patient advocacy, and quality
management as needed. Possession of a current professional license as a registered nurse (RN).
Manages and secures all records pertaining to Drug and Alcohol testing and reviews the records with
the MRO when needed. Uses technology for risk management, quality improvement activities, data
collection, process improvement and evaluation of improvement interventions. Working knowledge
of clinical research concepts, ethics, processes and protocol implementation and management. Make
outbound calls to assess members' current health status post hospitalization. Identifies quality and
risk management issues; refer issues for corrective action as appropriate. Participates in quality
improvement initiatives as assigned. Communicates with home health agencies, third-party payors,
and other community resources as needed to coordinate discharge needs.