Nurse Case Manager Care Coordinator in Philadelphia PA Resume Kimberly Bolen

Kimberly Bolen RN CCM, ACM Somers Point, New Jersey 08244 (609) 464.3615 [email protected] LinkedIn I am a knowledgeable Nurse Case Manager and Care Coordinator with over 20 years of experienced in the HealthCare Industry. My mission is to Improve Health Care for one person at a time, to attempt to capture that “sacred moment” for which we become engaged in our own Health and Wellness. To Empower, Educate and Care with Compassion and improve the Outcome for the individual. To Support Health across the Continuum of Life.

2010-2014 Independent Nurse Case Management Consultant ■ Confidential Consultant, please see linked in profile. ■ Patient, Nurse, MD, Administration and Staff Advocate and Collaboration ■ Advocate and Facilitator of Veteran Care and Engagement ■ Ghost Writer-Editor 2013-2013 Community Health Services ■ Medical Record Audit-Review-Analysis ■ Increased patient engagement by 82% ■ Increased medication managment|compliance by 86% in CDM and homeless population ■ Increased team and patient engagement by 88% ■ Decreased overall readmission's to acute care by 89% saving over 1.2 million to acute care costs ■ Coumadin Clinic PT/INR testing|medication|adjustment/compliance|patient education engagement by 98% ■ Cardiology Clinic, increased patient engagement by 97% ■ Decreased readmission rate in co-morbid pathology|MCC by 72% (3 month grant) 2009-2012 Shore Medical Center, Somers Point, NJ ■ Case Management within the Cardiology, Medical and Surgical Telemetry Unit’s. ■ Patient and Staff Advocate ■ Decreased readmission's by 89%, Decreased Length of stay from 7.0 to 1.5 ■ Increased Revenue by 52.3 million ■ Educated and engaged staff on Various Criteria, observation vs inpatient, cost containment etc.■ Daily Care Coordination, meetings, rounding, education etc.■ Safe Discharge Planning across the Continuum ■ Increased patient engagement by 82% ■ Increased Physician and client knowledge on the Benefits of Case Management by 100% ■ Decreased costs to acute care by 22.3 million ■ Discharge Intelligence 2007-2009 Cooper University Hospital, Camden, NJ ■ Case Management within the ED and Clinical Decision Unit. ■ Assessing eligibility of Admission to the acute care facility, transfer to the Clinical Decision Unit, or Outpatient management. ■ Concurrent review for multiple specialty units as assigned. Utilizing best evidence practice, and current standards of care. ■ coordinating care with the Emergency Department Physicians, various Specialty Physicians, Social Work and Homecare. ■Assessing and coordinating Care for the patient at the right time and the right place in their disease process in order to provide a safe discharge plan. ■ Assuring appropriate level of care for reimbursement. ■ Coordinating care and reimbursement with various outside vendors and third party payers. ■ referring all questionable case’s to the Medical Director for Determination and possible intervention with the treating physician. 2000-2004 -Horizon Blue Cross and Blue Shield, Newark, Wall, Mt. Laurel, NJ RN Patient Care Coordinator/Internal Case Management: Acute Inpatient, Post-Acute, Sub Acute, Skilled and Rehabilitative Care. ■ Senior RN Patient Care Coordinator/Internal Case Management. ■ Acute Inpatient, Sub Acute, Skilled and Rehabilitative Care. ■ Performed Real Time CCM and CCR, Both onsite and telephonic. ■ First RN to pilot and coordinate care for members across the continuum and return to Health.

■ Setting standards and protocols for continuation of Health for various populations. ■ assuring that the patient received the Right Care at the Right Time in their disease process. ■ Responsible for Multiple Tandem facility reviews in Multiple assigned Counties throughout New Jersey. 1999-2000 St Barnabas Medical Center Clinical Emergency Medical Staff RN 1995-2000 North Jersey Physician Review-Formerly the Pro of North Jersey, Parsippany, NJ ■ Performed Concurrent and Retrospective Review for Medicare/Medicaid/Third party Payer's for various consumer populations at most Acute Care Facilities throughout the State of New Jersey. ■ Participated Directly in First and Second Level Appeals.■ Participant in Peer Review Organization for North Jersey■ Medical Necessity Reviews in collaboration with Medical Director 1989-1995-RTW- East Orange, New Jersey ■Acute care auditor for various workers compensation and PIP carriers. ■ challenged the DRG and coding assigned by the acute care facility, obtaining financial reductions based on the documentation and billing information provided. ■Filing and arguing appeals before the delegated Peer Review organizations throughout the state of New Jersey with an 88% reversal rate. 1982-1989-University of Medicine and Dentistry Newark, NJ ■ Emergency Trauma Department, Staff RN, Relief Charge Nurse: ■ Clinical Practice in Emergency and Trauma Medicine. ■ BLS, ACLS, PALS, NALS, TNCC, CEN, IV Therapy, EKG and Telemetry interpretation.