Rebecca Moulden
Suffolk
Summary
Dynamic leader and forward-thinking problem-solver with a proven track record at Elevance, InforMed Medical Management and Hines & Associates as a successful Team Leader of Nurse Case Managers, known for strategic thinking and a hands-on approach, fostering a collaborative and inclusive environment. Specialize in staff training and analytical thinking, significantly improving project outcomes. Able to proficiently demonstrate professionalism and adaptability, achieving high-quality standards and developing strategies to improve efficiency and productivity. Pursuing a full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
33
33
years of professional experience
1
1
Certification
Work History
RN CASE MANAGER, SENIOR
Elevance
Indianapolis
09.2025 - Current
- Assess and educate patients/members on disease process, patient health, preventative management of chronic conditions
- Education on adherence to prescription medications
- Assessment of SDOH (Social Determinants of Health)
- Appropriate referrals to team professionals to assist the member with ongoing needs including pharmacist, SW, BH, Dietician, Exercise Physiologist and Respiratory Therapist
- Works in collaboration with Utilization Management to outreach to member inpatient and post-discharge for proactive engagement during member’s inpatient hospitalization and/or immediately following discharge.
- Collect and report cost-savings associated with case management interventions to the health plan
- Participate in interdisciplinary team meetings with the Medical Director for Rounds
Team Leader
Elevance
Indianapolis
01.2021 - 09.2024
- Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed for a team of approximately 25 nurses.
- Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
- Managed conflict resolution among team members, fostering a positive and collaborative work environment.
- Maintained an inclusive and diverse team culture, promoting respect and understanding among all members.
- Provided technological troubleshooting to team that utilized telephonic dialer technology, Electronic Medical Records, Microsoft Outlook and VPN.
- Facilitated quality chart reviews following NCQA guidelines and telephonic recording reviews to ensure quality and procedural adherence. Provided coaching, training as needed and escalated issues to manager as identified.
- Organized, led and provided documentation of interdisciplinary rounds with the Medical Director, manager and case managers
Telephonic Nurse Case Manager
Elevance
Indianapolis
01.2015 - 01.2021
- Collected and inputted case data in managed care system and timely and accurately generated required correspondence and review notification for management.
- Supported patients in developing effective coping strategies for managing the emotional impact of living with a chronic illness, promoting resilience and psychological wellbeing.
- Provided resources and referrals for patients seeking additional support services, such as mental health counseling or nutrition counseling.
- Maintained meticulous documentation of case management activities, facilitating accurate billing and compliance with regulatory requirements.
- Educated patients on self-management techniques to promote independence and improve quality of life.
- Managed caseloads of approximately 30-50 patients efficiently while prioritizing urgent cases requiring immediate intervention.
- Completed psychosocial evaluations and needs assessments.
Team Leader
InforMed Medical Management Services
Annapolis
01.2007 - 12.2014
- Organized 'start-up' case management with interviewing and hiring nurses, implementing orientation and on-going training of approximately 20-30 nurses
- Developed team members skills through targeted coaching sessions, resulting in improved individual performance.
- Collaborated with other department leaders to establish shared goals and ensure alignment across teams.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
- Assisted in recruitment to build a team of top performers.
- Built and maintained strong client relationships, leading to repeat business and referrals.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Evaluated customer needs and feedback to drive product and service improvements.
- Generated reports detailing findings and recommendations.
Telephonic Nurse Case Manager
Medical Management and Rehab Services (MMARS)
Baltimore
01.2006 - 12.2006
- Company Overview: InforMed Medical Management Services acquired a portion of MMARS nursing staff as a 'start-up' to their new company 1/2007.
- Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.
- Collaborated with other health care professionals regarding plan of care and variances in plan implementation to achieve outcomes.
- Utilized evidence-based practices to inform decision-making in the development and implementation of targeted interventions for each patient's unique needs.
- Educated patients on self-management techniques to promote independence and improve quality of life.
- Completed psychosocial evaluations and needs assessments.
- InforMed Medical Management Services acquired a portion of MMARS nursing staff as a 'start-up' to their new company 1/2007.
Team Leader
Hines & Associates Case Management
Elgin
01.2003 - 12.2005
- Evaluated team member performance against established objectives during regular reviews, offering praise for achievements or identifying areas requiring further development.
- Mentored junior staff members, helping them develop their leadership potential and advance in their careers.
- Increased customer satisfaction ratings by closely monitoring service quality standards and addressing any issues promptly.
- Provided ongoing support to direct reports, addressing concerns or questions promptly so they could remain focused on their tasks.
- Set performance expectations for the team of approximately 5 case managers, utilizing productivity analytics and monitoring progress towards goals and providing constructive feedback as needed.
- Assisted in recruitment to build a team of top performers by facilitating interviews and hiring new staff.
- Oversaw quality control measures by performing quality chart reviews on staff, maintaining high standards for all project outputs.
Telephonic Nurse Case Manager
Hines & Associates Case Management
Elgin
12.2001 - 01.2003
- Help patients navigate complex insurance processes, easing their financial burden while ensuring access to necessary treatments.
- Managed caseloads of approximately 30-50 patients efficiently while prioritizing urgent cases requiring immediate intervention.
- Collaborated with interdisciplinary teams to optimize patient-centered interventions and ensure continuity of care.
- Provided empathetic emotional support for patients facing challenging health concerns, fostering trust and open communication.
- Supported patients in developing effective coping strategies for managing the emotional impact of living with a chronic illness, promoting resilience and psychological wellbeing.
- Educated patients on self-management techniques to promote independence and improve quality of life.
- Assisted patients in setting achievable health goals and monitoring progress to enhance motivation and adherence to care plans.
- Enhanced patient care by providing telephonic support and guidance to individuals with chronic illnesses.
Home Health RN Case Manager
Obici Hospital - Acquired by Sentara Hospital
Suffolk
01.1995 - 12.2001
- Managed complex caseloads of approximately 20-30 patients efficiently by prioritizing tasks, delegating responsibilities to support staff, and maintaining detailed records.
- Expedited wound healing using advanced wound care techniques such as negative pressure therapy or hydrocolloid dressings when appropriate.
- Reduced hospital readmissions through diligent monitoring of patient’s progress, open communication with physicians and timely interventions within the home settings.
- Improved medication adherence through education on drug administration, interactions, and potential side effects.
- Prevented complications from chronic illnesses like diabetes or heart failure through targeted patient education initiatives tailored to individual needs.
- Administered medications and treatments prescribed by physicians including IV therapy, chemotherapy, TPN and nutrition via PEG tube within the home setting.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
- Managed patients recovering from medical or surgical procedures.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Provided care to diverse patient populations/patient acuity including med-surg, chronic care/illness, pediatric, newborn and hospice care.
Home Health RN Case Manager
Interim Home Health
Virginia Beach
01.1994 - 01.1995
- Promote a safe living environment for patients by conducting thorough home safety evaluations and recommending necessary modifications or equipment upgrades.
- Managed complex caseloads of approximately 25-35 patients efficiently by prioritizing tasks, delegating responsibilities to support staff, and maintaining detailed records.
- Increased patient satisfaction by providing compassionate care, addressing concerns, and advocating for their needs.
- Empowered patients and their families to take an active role in care decisions, fostering a sense of self-efficacy and improving long-term health outcomes.
- Streamlined communication with physicians, ensuring accurate documentation and prompt updates on patient conditions.
- Improved medication adherence through thorough education on drug administration, interactions, and potential side effects.
- Administered medications and treatments as prescribed by physicians, including IV therapy, chemotherapy and TPN.
- Coordinated with other healthcare team members to support patient needs.
- Monitored vital signs, developed and implemented care plans, and documented patient progress.
Hospital Staff RN
Children's Hospital of the King's Daughters
Norfolk
01.1993 - 06.1994
- Utilized critical thinking skills to make quick decisions in high-pressure situations, prioritizing patient needs and addressing emergent issues promptly.
- Enhanced patient care by implementing evidence-based practices and individualized care plans on Transitional Care Unit - Long Term Care Unit for Ventilator Dependent infants, children and adolescents (up to age 18) with congenital anomalies, neuro-muscular diseases or pulmonary complications that render them ventilator dependent with tracheotomies.
- Monitored vital signs, lab results, and other indicators to detect changes in patients’ conditions promptly.
- Served as a preceptor for new nurses, sharing knowledge, expertise, and best practices to improve their skills and confidence.
- Participated in unit-based quality improvement initiatives focused on enhancing patient outcomes through process improvements.
- Promoted patient safety by adhering to infection control protocols and conducting regular health assessments.
- Administered medications accurately and safely, ensuring proper dosages were given by physician orders.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection and chest physiotherapy.
- Assessed physical, psychological, physiological, and cognitive status of patients.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
Education
Diploma - Nursing
DePaul Hospital Professional School of Nursing
Norfolk, VASkills
- Teamwork and collaboration
- Coaching and mentoring
- Overseeing daily activities
- Quality improvement
- Patient education
- Organizational skills
- Process improvement
- Effective communication
- Adaptability and flexibility
- Analytical skills
- Patient engagement
- professionalism
- Care plan development
- Chronic disease management
- Risk assessment
- Patient education
- Quality assurance
- Team leadership
- HIPAA compliance
- Discharge planning
- Patient advocacy
- Critical thinking
- Utilization review
Certification
Certified Case Manager, Commission for Case Management Certification, 00054671, 12/01/02, 11/30/27
Hobbies and Interests
- Gardening
- Playing the piano
- Thrifting at vintage antique stores
- Vacations in the mountains
Languages
English, Full Professional
Timeline
RN CASE MANAGER, SENIOR
Elevance
09.2025 - Current
Team Leader
Elevance
01.2021 - 09.2024
Telephonic Nurse Case Manager
Elevance
01.2015 - 01.2021
Team Leader
InforMed Medical Management Services
01.2007 - 12.2014
Telephonic Nurse Case Manager
Medical Management and Rehab Services (MMARS)
01.2006 - 12.2006
Team Leader
Hines & Associates Case Management
01.2003 - 12.2005
Telephonic Nurse Case Manager
Hines & Associates Case Management
12.2001 - 01.2003
Home Health RN Case Manager
Obici Hospital - Acquired by Sentara Hospital
01.1995 - 12.2001
Home Health RN Case Manager
Interim Home Health
01.1994 - 01.1995
Hospital Staff RN
Children's Hospital of the King's Daughters
01.1993 - 06.1994
Diploma - Nursing
DePaul Hospital Professional School of Nursing