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@loissutherland
Certified RN Case Manager with 17+ years improving outcomes, reducing costs, and coordinating complex care.
I am a Certified RN Case Manager with over 17 years of case management experience across oncology, hospice, chronic disease, and transitions of care. I have a BSN (Cum Laude), multi-state RN licensure, CCM certification since 2016, and a track record of implementing cost-saving measures while maintaining high engagement and quality metrics.
I excel at remote work, EHRs, detailed care planning, and collaborating with multi-disciplinary teams to meet NCQA and NCCN standards. I consistently reduce readmissions, identify and close gaps in care, coach patients in self-management, and mentor team members to improve performance and wellbeing.
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Work history, roles, and key accomplishments
Managed a caseload of ~40–50 members across complex diagnoses and implemented cost-saving measures averaging $56,000 per case, contributing over $1M in total savings while exceeding engagement (84%) and quality audit (96%) targets.
Medical Rehabilitation Consultants
Jan 2021 - Jan 2024 (3 years)
Managed 30–50 client caseloads handling utilization review through disease management, achieving average cost savings of $27,000 per case and delivering monthly account reports to self-insured clients.
Managed chronic and transitions caseloads (35–120 members), reduced 30-day readmissions via timely outreach and medication reconciliation (82% completion), and identified/closed >10,000 gaps in care to lower utilization.
Community Nursing Services
Jan 2010 - Jan 2015 (5 years)
Provided home health and hospice case management for ~20 weekly clients, prevented over 500 hospital admissions, and coordinated interdisciplinary care while teaching complex clinical skills for patient self-management.
Degrees, certifications, and relevant coursework
Bachelor of Science in Nursing, Nursing
Grade: Cum Laude
Activities and societies: Inducted into Sigma Theta Tau Nursing Honors Society; named Carl G. Maeser Scholar
Bachelor of Science in Nursing (BSN), graduated Cum Laude and inducted into Sigma Theta Tau Nursing Honors Society.
Software and tools used professionally
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