Tiffany Baker
@tiffanybaker1
RN case manager with 20+ years in healthcare, driving remote care transitions, population health, and utilization optimization.
United StatesWhat I'm looking for
I’m an experienced, credentialed RN Case Manager with 20+ years in healthcare and 14+ years as a licensed Registered Nurse. I focus on remote and field-based case management, population health, and care transitions across Medicaid, Medicare, and commercial plans—always centered on patient-centered outcomes and utilization optimization.
In my current role with Blue Cross Blue Shield of Kansas City, I manage complex ACA, MA, and commercial cases, including oncology and transplant. I also serve as a lead RN preceptor, provide daily clinical support for new care managers, contributed to UAT testing and software updates (GuidingCare/Altruista), and support SOP development while training staff on high-cost and ER-use programs.
Previously at Optum/UnitedHealthcare, I handled Medicaid dual-eligible cases in northwest Missouri and coordinated appointments and in-home services, linking members to housing, food, and transportation resources. Before case management, I built strong clinical depth through oncology infusion care, home health and hospice (including supervision of an LPN and telehealth lab/symptom follow-up), and cardiac surgery/transplant units—covering CVICU and LVAD patient care.
Experience
Work history, roles, and key accomplishments
Managed complex care for ACA, MA, and commercial members, including oncology and transplant cases. Served as lead RN preceptor and contributed to UAT testing and software updates while supporting UM tasks with NCQA and CMS compliance.
RN Case Manager (Remote/Field)
Optum / UnitedHealthcare
Sep 2018 - Dec 2020 (2 years 3 months)
Handled Medicaid dual-eligible case management in northwest Missouri with phone-based coordination and limited field visits. Coordinated appointments and in-home services, worked with behavioral health and social services, and linked members to housing, food, and transportation resources.
Registered Nurse
Saint Luke's Cancer Institute
Jan 2016 - Sep 2018 (2 years 8 months)
Administered cancer medications in a 16-chair infusion center connected to a medical oncology clinic, including iron infusions and blood products. Provided central line care, covered charge nurse duties, and trained new nurses on infusion center operations.
RN Case Manager
Saint Luke's Home Care & Hospice
May 2014 - Jan 2016 (1 year 8 months)
Oversaw home health care for up to 40 patients and coordinated supply orders, medication setup, and surgical wound follow-ups. Supervised an LPN for daily visits and used remote telehealth systems for lab draws and symptom reporting.
RN (Heart Institute)
Saint Luke's Hospital of Kansas City
May 2009 - May 2014 (5 years)
Provided care across cardiac surgery and transplant units, including CVICU and LVAD patients. Participated in care planning for heart failure and post-transplant monitoring and gained specialized experience working with ventricular assist devices (LVAD).
Registration Clerk (Radiology/ER)
St. Mary's Medical Center
Jul 2004 - Mar 2011 (6 years 8 months)
Registered patients for the ER and radiology, verified insurance, and entered intake data. Supported nurse and technician workflows with patient scheduling, chart transfers, and pre-visit information, and maintained daily patient volume logs.
Education
Degrees, certifications, and relevant coursework
Saint Luke's College of Health Sciences
Bachelor of Science in Nursing, Nursing
Grade: Cum Laude
Earned a Bachelor of Science in Nursing (BSN) from Saint Luke's College of Health Sciences in Kansas City, Missouri, graduating cum laude.
Longview Community College
Associate of Science, Science
Earned an Associate of Science at Longview Community College in Lee's Summit, Missouri.
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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