Bridget Keyes has over 20 years of experience in nursing and case management, currently serving as the Director of Case Management at East Orange General Hospital where she oversees various departments and initiatives to reduce costs and improve outcomes. Prior to this role, she held several case management positions with increasing responsibilities at major hospitals in New York and New Jersey. She has extensive leadership experience, education, and certifications in nursing, case management, and healthcare administration.

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
Director of Case Managementat East Orange General Hospital April,2015-Present
 Oversight of system utilization review, case management, social services and denials
and appeals management.
 Leaderof Provisionof Care ChapterforNursingforPreparationforJointCommission.
 Workedon decreasingdenialstofrom30% to under9%
 Work closelywithphysicianstoreduce LOS
 Leaderof LOS committee
 Leader of Utilizationcommittee
 Work closelywithrevenue cycle todecrease frontendandbackenddenials
 ProvidesCEU’sforstaff withoutside vendors
 Workedcollaborativelywithall departmentstosee EOGHthroughthe acquisitionwithProspect
Medical Group
 Workedcollaborativelywiththe TransitionalCare Teamtoreduce the readmissionrate to fewer
than 10%. Community and system development with outside facilities to support initiatives
and lessened lengths of stay and readmission.
Manager of Case Management –RobertWood Johnson University Hospital,New BrunswickNJ
April 2013- Present
 DirectsUtilizationManagementactivitiesof the case managersinsuringsystemsforefficient
provisionsof clinical reviewsutilizingappropriate criteria.
 Providesorientation,educationandsupervisionrelatedtoscreeningandassessmentof
patients.
 Conducts monthlyauditstoensure staff compliance to CMSguidelines.
 Assists physicianadvisorsensuringappropriatepatientstatus.
 Conducteddailyrounds onall observationpatientstoensure theyare convertedor discharged
ina timelymanner.
 Workedcollaboratively inmultidisciplinary LeanCommitteesandparticipated inquality andcost
initiativesasneeded.
 Participatedinthe “2” midnightcommitteetoensure correctdocumentation.
 Provide educationto physiciangroupsabout Medicare guidelineswithagoal towards
decreasingtheirlengthof stay.

2.  Overseesadministrativestaff andhome care coordinators.
 Formed a collaborative workingrelationship withphysicians.
 Assistssocial workersandnursesin trouble shootingdifficultdischarges.
 Utilizesinternalandexternal resourcesandsystemstoeffectivelymeetpatientandfamily
needs.
 Supportsclinical decision-makingprocessesbyutilizingexistingprotocolsandpractice logicor
scientificprinciples,qualitativeand quantitative outcome evidencebasedpractice.
 Assistsdirectlywithbedmanagementtoensure transfersare appropriate.
Case Manager Float Position-MemorialSloan Kettering CancerCenter,NY 2006-2013
 Manage on a dailybasisall facetsof care coordinationforassigned patientpopulationacross
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.
 Interface withinsurance carriersandhospital billingdepartmenttoinitiateappealsandobtain
authorizationsfortreatment.Whennecessary,contactpatientsbenefitoffice tonegotiate
paymentforuncoveredservices.
 Coordinate familymeetingstodiscusscare objectivesandplans,workingcloselywithall
membersof medical teamaswell apatients andfamiliestobringplanto fruition.
 Identifyprocessfailures andissuesusingasystematicproblemsolvingapproachtoanticipate,
assessandresolve problemsonadailybasis.
 ConductutilizationreviewandmanagementforassignedpatientpopulationutilizingInterqual
criteria.Determine whencasesneedescalationtoPhysicianadvisorandassistwithgathering
facts neededtojustifyidentifiedissuetothe payer.
 Developandestablishandunderstandingof 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

3.  CreatedPowerPointpresentationstoeducate staff andpatientsonthe expectationsof the
hospital stayandthe discharge process
 CollaboratedwithClinical NurseSpecialisttocreate a fact card to educate patientson
chemotherapyandits side 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
 Provide nursingcare toNeurostep -downpatientswithresponsibilitiesincludingbutnotlimited
to; telemetry,ICPmonitoring,neurological emergencies,sepsisandventilatormanagement
 Actedas charge nurse,withresponsibilitiesincludingcoordinatingadmissionsanddischarges;
reinforcingnursingparticipationinmultidisciplinaryrounds,maintainingunityandcohesiveness
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 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

4. 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
 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