Haley Caldwell
Ellwood City
Summary
Dynamic Registered Nurse Case Manager specializing in case management and care transitions. Demonstrated success in enhancing patient outcomes through comprehensive discharge planning and effective communication strategies, ensuring seamless coordination between healthcare providers and patients.
Overview
1
1
Certification
5
5
years of professional experience
Work History
Care Transition Coordinator
WeCare Facilities
Remote
10.2025 - Current
- Coordinated patient care transitions between hospital and home settings.
- Facilitated communication among healthcare providers and patients, enhancing discharge planning effectiveness.
- Collaborated with healthcare teams to ensure quality care standards.
- Reviewed patient medical records for accuracy and ensured compliance with regulations.
- Analyzed clinical documentation for completeness and clarity.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Maintained up-to-date knowledge of regulatory changes affecting reimbursement practices.
- Performed pre-certification reviews to determine coverage eligibility for services.
- Evaluated appeals submitted by providers on denied claims and recommended appropriate action.
- Coordinated with team members to resolve conflicts and manage difficult situations.
Registered Nurse Case Manager
AHN Healthcare at Home
Warrendale
01.2025 - 10.2025
- Provided comprehensive case management services to a diverse patient population, including assessment of patients' needs and development of individualized care plans.
- Monitored patient condition and treatment plan adherence through regular follow-up calls and visits, ensuring timely interventions.
- Engaged in interdisciplinary meetings to discuss complex cases and support decision-making on patient care strategies.
- Communicated effectively with patients, families, and healthcare providers to ensure understanding of care plans and address concerns.
- Established strong working relationships with other departments within the organization to ensure seamless coordination of care.
- Utilized critical thinking skills when making decisions about patients' care plans or referral sources.
Registered Nurse
UPMC Passavant
Cranberry
06.2023 - 01.2025
- Provide direct patient care and treatment for up to 6 patients per shift in the ED and med-surg units.
- Managed IV therapy to maintain patient hydration and facilitate timely medication delivery.
- Coordinated patient discharges and admissions to streamline workflow and reduce wait times.
Licensed Practical Nurse
Lutheran Senior Life
Zelienople
09.2021 - 11.2022
- Experience working with Dementia and Alzheimer's patients.
- Monitored patient status and updated physician on new symptoms to ensure timely medical intervention.
- Supported patients by voicing their needs and ensuring their concerns were acknowledged. by thoughtfully addressing their concerns.
- Ability to work in a high-stress, fast-paced environment.
Education
ADN Program -
Community College of Beaver County
PA, USPA, US
Licensed Practical Nurse -
Lenape Practical School of Nursing
PA, USPA, US
Nursing Prerequisites -
Butler County Community College
PA, USPA, US
Skills
- Care coordination strategies
- Discharge planning
- Transition planning
- Case management
- Utilization management
- Pre-certification processes
- Utilization assessment
- Clinical record reviews
- Healthcare Regulations
- Patient Safety Protocols
- Triaging
- Medicare
Certification
- BLS
- PALS
- ACLS
- Licensed Registered Nurse
Timeline
Care Transition Coordinator
WeCare Facilities
10.2025 - Current
Registered Nurse Case Manager
AHN Healthcare at Home
01.2025 - 10.2025
Registered Nurse
UPMC Passavant
06.2023 - 01.2025
Licensed Practical Nurse
Lutheran Senior Life
09.2021 - 11.2022
ADN Program -
Community College of Beaver County
Licensed Practical Nurse -
Lenape Practical School of Nursing
Nursing Prerequisites -
Butler County Community College