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Yvonne
ygprudhomme@gmail.com
713-315-1136
Eunice, LA 70535
Telephonic Case Manager
5 years experience W2
0
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Average rating
36
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Summary

  • Patient centered, detail oriented and compassionate Registered Nurse with a solid background in Case Management.
  • A seasoned hard working nurse driven to use all of my clinical expertise to compassionately promote health stabilization and proactively prevent the progression of disease.
  • Seeking a position in Clinical Review or Case Management.

Skills

  • Remote Telehealth
  • Discharge Planning
  • Motivational Interviewing
  • Wellness Coaching
  • Telephonic Case management
  • HEDIS Chart Abstraction
  • DME ordering
  • Quality Assurance
  • Care Coordination
  • EMR Super User
  • Quality & Risk Management
  • Prior Authorizations
  • Critical thinking
  • Medicare guidelines
  • Utilization Management
  • Clinical Review
  • Emotional Intelligence
  • Telephone Triage

Experience
Telephonic Case Manager
Information Technology
Jan 2017 - present
Eunice, LA

Remote

  • Provided telephonic Case Management and Care Coordination to members.
  • Developed goal based care plans using nursing diagnosis while incorporating therapeutic, preventive and rehabilitative nursing actions to maintain wellness and avoid hospital readmissions.
  • Identified knowledge deficits to prevent gaps in care and teaching and community resources.
  • Analyzed data from the various care providers to identify under/over utilization and improve resource consumption.x
Case Management Nursing Oncology Utilization Review
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Oncology Abstractor
Medical Devices
Aug 2017 - present
New York, NY
  • Performed accurate Hedis medical record data abstraction and clinical review for all measures of compliance specific to Oncology..
  • Prepared reports for management to utilize finding and trends to improve efficiency as well as customer satisfaction.
  • Maintained HIPAA regulations for consumer privacy and completed tasks in a timely manner to ensure compliance with NCQA, federal, state and other regulatory agency standards.
No skills were added
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Associate Case Manager
Information Technology
Jun 2019 - Nov 2019
Eden Prairie, MN

Remote

  • Monitored delivery of care to ensure all patient's needs were addressed.
  • Specialized in women's health, Makena injections, and high risk prenatal care.
  • Identified patient and family knowledge deficits and provided hands on teaching to improve patient outcomes and compliance
  • Efficiently created patient centered care plans that include measurable, clearly defined goals.
  • Performed telephone triage and used telehealth remote monitoring.
Compliance Triage
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Revenue Integrity Analyst
Medical Devices
Aug 2018 - Jun 2019
Houston, TX
Remote
  • Focused organizational efforts on the improvement of clinical quality performance measures.
  • Coordinated with various data sources and medical units to streamline billing processes.Drove compliance based on CMS guidelines to improve work processes, quality, and increase outcomes.
  • Guided quality improvement projects to review billing edits, modifiers and audit clinical documentation to ensure guidelines are followed with accuracy in CPT, ICD-10 diagnosis coding.
No skills were added
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Patient Educator
Information Technology
Aug 2016 - May 2019
Eden Prairie, MN

Remote

  • Effectively Case managed Medicaid members who were high risk pregnancies. Performed Home visits, including home safety evaluation, fall prevention, and diagnosis specific assessments.
  • Counseled members on hypertension, preterm labor, hyperemesis, gestational diabetes, hydration and IV infusion. Assisted in planning follow up care, teaching and prevention of worsening in condition.
  • Coordinated with hospital discharge planning to set up services and ensure safe discharge home.
  • Set up remote monitoring systems for members and performed daily checks on each enrollee to address any priority alerts and ensure health safety.
No skills were added
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Edit Skills
Non-cloudteam Skill
Education
Associate's in Nursing
Louisiana State University at Eunice 2008
Bachelor's in progress
Nursing- University of Louisiana at Lafayette
Certifications
Registered Nurse: Licensed in the State of Louisiana
Skills
Case Management
2021
3
Nursing
2021
3
Oncology
2021
3
Utilization Review
2021
3
Compliance
2019
1
EMR
0
1
HEDIS
0
1
Medicare
0
1
Registered Nurse
0
1
Triage
2019
1