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Janna
jannarolfe@aol.com
813-404-7652
Wesley Chapel, FL 33543
Case Manager, HEDIS
37 years experience W2
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Summary

Registered Nurse (Rn) & Masters Of Public Health (Mph)

  • Highly motivated, very detail-oriented, possesses analytical, organizational, and time management skills. Adept in partnering knowledge of nursing with strong interpersonal and communication skills with ability to establish a rapport with clients, patients, physicians, insurance companies and co-workers. Excellent academic credentials, compassionate and caring attitude, fiscal responsibility and demonstrated ability to work in a variety of multi-tasked environments

Relevant skills include:

  • Registered Nurse
  • Master of Public Health
  • Case Management and Utilization Review
  • Program Management
  • Healthcare Quality Assurance
  • Patient Data Management
  • InterQual
  • MCG and NCCN and EClinical and Internet Research
  • Cerner
  • Healthcare Quality Management
  • Microsoft Word, PowerPoint, & Excel

Certifications/Licenses:

  • State of Florida Registered Nurse (RN2598542 since 1993 to present)

Experience
Case Manager
Information Technology
Jan 2017 - Jan 2020
Zephyrhills, FL
  • Performed patient education about diseases and medication, chart audits for capitated insurances and Medicare, completed referrals, arranged home health services, long term care and skilled nursing, made sure HEDIS criteria were met, improved healthcare documentation (CDI)
Audit Health Services Administration HEDIS Home Health Medicare Nursing
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Case Manager
Healthcare
Jan 2015 - Jan 2016
Dade City, FL
  • Performed Utilization Review for admissions in all units of hospital, educated patients and families about health care plans and options, arranged for discharge needs, communicated daily with insurance plans
Utilization Review
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Clinical Resource Coordinator/Case Manager
Healthcare
Jan 2010 - Jan 2015
Tampa, FL
  • Performed Utilization Review for admissions in all units of the hospital, educated patients and families about health care plans and options, arranged for discharge needs, communicated daily with insurance
Utilization Review
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Humana Cares Nurse Case Manager
Medical Devices
Jan 2008 - Jan 2010
  • Humana Cares Nurse Case Manager
  • Provided monthly contact with members of program to develop a comprehensive plan of care assure they did yearly screening and followed up with MD after a stay in hospital or SNF, assisted with arranging home health services and discharge planning when needed
Health Services Administration Home Health Nursing
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Review Case Manager/Medicare Appeals
Medical Devices
Jan 2007 - Jan 2008
Tampa, FL
  • Review Case Manager/Medicare Appeals
  • Performed chart audits and reviews for patients who made Medicare discharge appeals or who had complaints about medical service providers
Appeals Audit Medicare
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Coordinator
Healthcare
Jan 2000 - Jan 2006
Tampa, FL
  • Public Health Practice Program
  • Coordinator for Master's program for medical professionals, did the advertisements, arranged class schedules, managed budget and arranged for assistance with students special projects
No skills were added
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Staff Nurse/Preceptor
Information Technology
Jan 1996 - Jan 2000
Tampa, FL
  • Served as triage nurse, provided in office patient care, provided patient education and also connected with worker's compensation for those who were injured on jobs with GTE
Nursing Triage
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Volunteer Nurse (Part Time)
Medical Devices
Jan 1994 - Jan 1996
Brandon, FL
  • Served as triage nurse, provided education about diagnosis and treatments plans and helped patients connect with community services
Nursing Triage
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ER Staff Nurse/ ACLS Certified/ Preceptor
Jan 1990 - Jan 1992
Saline, MI
ACLS ER Nursing
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Staff Nurse/ Charge Nurse/ Preceptor/ Neuro ICU
Jan 1987 - Jan 1990
Ann Arbor, MI
Nursing
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Staff Nurse/ Charge Nurse/ Preceptor
Jan 1985 - Jan 1987
Ann Arbor, MI
Nursing
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Edit Skills
Non-cloudteam Skill
Education
Master's in Planning for a Potential Pandemic
University of South Florida 2000
Bachelor's in Nursing
Eastern Michigan University
Certifications
State of Florida Registered Nurse (RN2598542
Skills
Nursing
2020
18
Triage
2000
6
Utilization Review
2016
6
Health Services Administration
2020
5
Home Health
2020
5
Audit
2020
4
Medicare
2020
4
HEDIS
2020
3
ACLS
1992
2
ER
1992
2
Appeals
2008
1
Case Management
0
1
Cerner
0
1
e-Clinical Works
0
1
Program Management
0
1
Registered Nurse
0
1