1. Bridget Keyes, RN, BA, BSN, CCM, MPA
4 Paula Way, Berkeley Heights, NJ 07922
Email: nina.keyes@hotmail.com
Phone: 917-658-8959 - cell
Professional Summary
Manager of Case Management –RobertWood Johns University Hospital,New BrunswickNJ
April 2013- Present
 OverseesUtilizationManagementactivitiesof the case managersinsuringsystemsforefficient
provisionsof clinical reviewsutilizingappropriate criteriasuchasMillimanandInterqual
 Providesorientation,educationandsupervisionrelatedtoscreeningandassessmentof patients
 Conductsmonthlyauditstoensure staff isincompliance withCMSguidelines
 Works directlywiththe physicianadvisorsensuringappropriate patientstatus
 Rounddailyon all observationpatientstoensure theyare convertedordischargedina timely
manner.
 WorkedcollaborativelywithdifferentdepartmentsonLeanCommitteesandparticipatesin
quality andcost initiativesasneeded
 Participatedinthe 2 midnightcommitteetoensure all documentationwascorrect
 Meetwithdifferedphysiciangroupstoeducate about Medicare guidelinesandworktowards
decreasingtheirlengthof stay.
 Overseesadministrativestaff andhome care coordinators.
 Workeddiligentlywithmedical staff toformcollaborative workingrelationships
 Work withthe social workers andnursesto trouble shootdifficultdischarges
 Works directlywithbedmanagementtoensure transfersare appropriate
 Utilizesinternalandexternal resourcesandsystemstoeffectivelymeetpatientandfamily
needs. Supportsclinical decisionmakingprocessesbyutilizingexistingprotocolsandpractice
logicor scientificprinciples,qualitativeandquantitative outcome evidence
Case Manager Float Position-MemorialSloan Kettering CancerCenter,NY 2006-2013
 Manage on a dailybasisall facetsof care coordinationforassignedpatientpopulationacross
the healthcare continuum. Workcloselywiththe medical team, insurancecompanies,patient
and patientrepresentativesaswell asinterandintradepartmentalstaff toexpedite discharges
on a dailybasis.
 Excellentworkingknowledge of all payersystems/healthplansincludingMedicare,Medicaid
and private insurances.

2.  Interface withinsurance carriersand hospital billingdepartmenttoinitiateappealsandobtain
authorizationsfortreatment.Whennecessary,contactpatientsbenefitoffice tonegotiate
paymentforuncoveredservices.
 Coordinate familymeetingstodiscusscare objectivesandplans,workingcloselywithall
membersof medical teamaswell apatients andfamiliestobringplanto fruition.
 Identifyprocessfailuresandissuesusingasystematicproblemsolvingapproachtoanticipate,
assessandresolve problemsonadailybasis.
 ConductutilizationreviewandmanagementforassignedpatientpopulationutilizingInterqual
criteria.Determine whencasesneedescalationtoPhysicianadvisorandassistwithgathering
facts neededtojustifyidentifiedissuetothe payer.
 Developandestablishand understandingof regulatoryrequirementsanddisseminate the
particularsof these requirementstostaff
 Preparationandpresentationof educationalofferingstostaff
 Excellentworkingknowledge of computersystemapplicationsforcase management,aswell as
excel,powerpointandword.
 Serve aspreceptorfor newlyhiredcase managers.
 Work collaborativelywithothercase managerstoidentifyandimplementperformance
improvementinitiatives.
Case Manager Neurosurgery/Neurology –MemorialSloan Kettering CancerCenter,NY 2002-2006
 Assessdischarge planningneedsspecificforneurosurgical andneurological patientsand
coordinate home care services,outpatientphysical andoccupational therapy,andacute and
sub-acute placementforappropriate patients
 WorkeddirectlywithDepartmentChaironqualityinitiativesanddecreasinglengthof inpatient
stay
 CreatedPowerPointpresentationstoeducate staff andpatientsonthe expectationsof the
hospital stayandthe discharge process
 CollaboratedwithClinical NurseSpecialisttocreate a fact card to educate patientson
chemotherapyanditsside effects
 Performregularconcurrentutilizationreviewsonall patients
 Communicate withNeurosurgeonsandNeurologiststoformulate appropriate treatmentplans
for patientsthatrequiredongoingradiationorchemotherapytreatments
Experience
Clinical Nurse II-Neurology/NeuroObservationUnit/Orthopedics-MemorialSloan Kettering Cancer
Center,NY 1998-2002
 Providedcomplete range of RN servicesandexpertise includingchemotherapyadministration,
acute symptommanagementandpost-operativecare tosurgical patients

3.  Provide nursingcare toNeurostep -downpatientswithresponsibilitiesincludingbutnotlimited
to; telemetry,ICPmonitoring,neurological emergencies,sepsisandventilatormanagement
 Actedas charge nurse,withresponsibilitiesincludingcoordinatingadmissionsanddischarges;
reinforcingnursingparticipationinmultidisciplinaryrounds,maintaining unityandcohesiveness
on the floorand mandatingadherence toprimarynursing
Oxford HealthPlan – TeamcoordinatorforMedical Delivery Systems 1994-1996
 Responsible forMedical database
 Interactedwithvariouslevelsof healthcare providers
 Participatedinclaimsmanagementdecisions
Education
 Executive MPA
NewYork University,WagnerGraduateSchoolof PublicService Graduate May, 2012
Capstone
The focus of the capstone project was to decrease the length of stay (LOS) for
robotically assisted prostatectomies while maintaining high patient satisfaction
scores on Baker 15, a short stay surgical unit at NYP, Cornell.
 Bachelor of Science/Nursing 1996-1998
NewYork University
 Bachelor of Arts
Manhattan College 1991-1995
Committees
Nursing Quality Assessment and Performance Improvement Committee. Lean Committees,
Kaizan workgroups. Patient Flow committee.
Certifications/Credentials
 NJS RN License 2010- present
License # 26NR14911800

4.  NYS RN License 1998-present
License # 499207
 CertifiedCase Manager 2004-present
Cert# 0078328
 Chemotherapycertified
 PRI and screenedcertified
 ProficientinWord, Excel,and Power Point
References Available Upon Request