Mary Ellen Henderson
Temecula
Summary
Accomplished Case Manager adept at handling high caseloads without sacrificing quality of care. Operates exceptionally well in high-pressure environments. Recommends best resources and courses of action to benefit patient needs and return each to optimal quality of life. Compassionate Case Manager known for high productivity and efficiency in task completion. Possess specialized skills in needs assessment, care plan development, and client advocacy. Excel at communication, problem-solving, and time management to effectively support clients in achieving wellness goals.
Overview
17
17
years of professional experience
Work History
Registered Nurse
Anthem INC
Indianapolis
10.2008 - Current
- Performed pre-certification, concurrent, and retrospective reviews of inpatient and outpatient services.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Coordinated discharge planning to ensure continuity of care post-hospitalization.
- Evaluated patient care and outcomes to identify opportunities for improvement in treatment plans.
- Referred cases to secondary review for failure to meet criteria.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Generated reports related to utilization management activities such as length of stay trends, denials rates.
- Coordinated with healthcare teams to develop care plans that meet patient needs and insurance coverage.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Coordinated with healthcare team to establish, enact and evaluate patient care plans.
- Participated in multidisciplinary team meetings to discuss patient care issues and utilization review findings.
- Collaborated with case managers to facilitate timely discharge planning and transition of care.
Nurse Inpatient Case Manager
Inland Valley Medical Center
Wildomar
06.2008 - 09.2008
- Implemented crisis intervention strategies as needed to address emergent client issues.
- Developed and maintained relationships with community resources and service providers.
- Provided referrals to appropriate medical, mental health, and social services.
- Managed caseloads effectively, ensuring timely documentation and reporting.
- Communicated with legal services providers, social services agencies, and local judicial systems regarding cases.
- Developed trusting relationships with social services, health care providers and governmental agencies.
- Established and maintained relationships to meet community needs and avoid service duplication.
- Collaborated with other service providers to ensure continuity of care for clients.
- Acted as an advocate for vulnerable populations by advocating for policy changes at the state level.
- Maintained confidentiality and adhered to professional ethics and standards.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Advised staff members on effective strategies for working with challenging client behaviors.
- Coordinated comprehensive care plans for clients to meet their individual needs.
- Educated clients and their families about their rights and available community resources.
Education
Associate of Arts - Nursing
Pasadena City College
Pasadena, CA01-1991
Skills
- Utilization management
- Electronic health record
- Patient care coordination
- Discharge planning
- Treatment plan evaluation
- Case management
- EMR / EHR
Timeline
Registered Nurse
Anthem INC
10.2008 - Current
Nurse Inpatient Case Manager
Inland Valley Medical Center
06.2008 - 09.2008
Associate of Arts - Nursing
Pasadena City College