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Yvonne
ygprudhomme@gmail.com
713-315-1136
Eunice, LA 70535
Telephonic Case Manager
5 years experience
W2
0
Recommendations
Average rating
32
Profile views
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
Remove Skill
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
Record has not been verified.
Bachelor's in progress
Nursing- University of Louisiana at Lafayette
Record has not been verified.
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