Rebecca Mooney
Omaha
Summary
Accomplished Psychiatric Nurse Care Manager with a proven track record at CHI Health Immanuel Medical Center, showcasing expertise in Utilization Review Processes and Patient Engagement Skills. Elevated patient care quality through innovative discharge planning, reducing readmission rates and connecting families to the available resources. Demonstrated leadership in mentoring staff and fostering interdisciplinary collaboration for optimal patient outcomes.
Overview
34
34
years of professional experience
Work History
Psychiatric Nurse Care Manager
CHI Health Immanuel Medical Center
08.1998 - Current
- Developed successful discharge plans to help continuity of care upon patient release.
- Collaborated with interdisciplinary team members for effective treatment planning and optimal patient outcomes.
- Provided education to patients'' families regarding mental health disorders, treatment options, and community resources available for support.
- Evaluated the efficacy of implemented care plans through regular monitoring of patient progress toward established goals.
- Served as a resource person for colleagues seeking guidance on complex psychiatric cases or clinical challenges encountered within the unit.
- Contributed to a positive work environment by fostering open communication, teamwork, and mutual respect among colleagues and patients alike.
- Assisted in training and mentoring new nursing staff, providing guidance on best practices and sharing insights gained from years of experience in psychiatric care.
- Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated clients and families on community resources, treatment options and health care services to better manage conditions.
- Established and maintained relationships with clients, families and community partners to coordinate services to meet client's needs.
- Maintained detailed records in compliance with agency standards and regulations.
- Participated in interdisciplinary case conferences fostering teamwork collaboration sharing best practice insights to optimize patient care outcomes.
- Served as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals for seamless care coordination efforts.
- Maintained network of community resources to provide most comprehensive support services possible to clients.
- Reduced hospital readmission rates by providing comprehensive discharge planning and follow-up support.
- Utilized electronic health records systems proficiently for efficient documentation of clinical information according to regulatory standards.
- Collaborated with insurance providers to secure authorization for necessary services, maximizing patients'' benefits coverage.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
- Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices.
- Minimized financial risk associated with denials or payment discrepancies through validation of medical necessity for inpatient services.
- Improved patient care quality by conducting thorough utilization review and providing recommendation for optimal treatment plans.
Utilization Review Nurse
FHC Options
09.1995 - 08.1998
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Provided accurate documentation of all utilization review findings, ensuring a clear audit trail for future reference or analysis.
- Contributed to cost savings by applying evidence-based guidelines to determine medical necessity and appropriateness of care.
- Performed admission reviews based for medical necessity based upon Medicaid guidelines.
- Identified solutions for irregular requests and issues.
- Completed on-sight concurrent reviews to determine medical necessity for inpatient mental health treatment.
Psychiatric Registered Nurse
St. Joseph Center for Mental Health
07.1991 - 08.1995
- Responded to numerous volatile situations and violent outbreaks to restore safety and security of patients and staff.
- Built trust with patients from various cultural backgrounds through culturally competent care practices tailored to individual needs.
- Ensured patient safety by closely monitoring behaviors, administering medications as prescribed, and intervening during incidents of aggression or selfharm.
- Oversaw care of suicidal patients and acted swiftly to reduce risk of harm to themselves or others.
- Collaborated proactively with psychiatrists to adjust treatment plans based on observed changes in symptoms or behavior patterns among patients.
- Demonstrated adaptability by providing coverage in various psychiatric units as needed, maintaining high standards of care across diverse patient populations.
- Promoted a therapeutic environment by establishing rapport, maintaining boundaries, and fostering open communication with patients and families.
- Administered medication and treatments to patients to observe and record responses.
- Explained useful coping methods to relieve depression and anxiety.
- Performed patient assessments to monitor expected response to medications and altering treatment plans.
- Enhanced treatment efficacy by collaborating with interdisciplinary teams to provide comprehensive mental health care.
- Provided direct quality care to patients by monitoring, recording and evaluating psychiatric conditions.
- Facilitated group therapy sessions for diverse populations addressing issues such as coping skills, anger management, substance abuse recovery, and relapse prevention.
- Served as a resource for nursing staff, providing guidance in the application of evidence-based practices in the psychiatric setting.
- Optimized clinical decision-making by conducting thorough psychosocial assessments upon admission and throughout patients'' stays.
- Mentored nursing students during clinical rotations at the psychiatric facility, sharing knowledge and expertise while promoting their professional growth.
- Contributed to improved team morale by demonstrating a positive attitude, supporting colleagues during challenging situations, and celebrating shared successes.
- Monitored vital signs, nutritional intake and signs and symptoms of complications to report deviations to supervisor.
- Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated family members and caregivers on patient care instructions.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
Education
Bachelor of Science - Nursing
Creighton University
Omaha, NE05-1991
Skills
- Analytical and detail oriented
- Proficient in Utilization Review Processes
- Proficient in Milliman Care Guidelines
- Strong Prioritization Skills
- Patient and Insurer Engagement Skills
Timeline
Psychiatric Nurse Care Manager
CHI Health Immanuel Medical Center
08.1998 - Current
Utilization Review Nurse
FHC Options
09.1995 - 08.1998
Psychiatric Registered Nurse
St. Joseph Center for Mental Health
07.1991 - 08.1995
Bachelor of Science - Nursing
Creighton University
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