Experience

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  Kindred healthcare

  Jun 2013 - Dec 2014

  As a member of the interdisciplinary team (IDT), participate in the management of care rendered to patients, present appropriate interventions to members of the IDT. Schedule, manage and complete MDS assessments required by federal and state laws as well as for reimbursement purposes in a 92-bed facility. Assess all patients at least quarterly, including physical function, nutrition, and skin. Provide staff in-services as needed to ensure quality and accuracy in documentation. Create and maintain ICD-9 codes. Show less Per diem position. Coordinate patient care as liaison between insurance, other healthcare entities, patient, family/responsible party and facility. Principal goal to ensure that patient receives all necessary services and that their stay adequately equips them to safely discharge to the community or the most appropriate level of care. Duties include arranging for specialized equipment, making referrals as needed, communicating patient's progress and expected length of stay with parties, initiate patient/family teaching, and together with social worker arrange a seamless discharge. Show less

  • Assessment Coordinator

    Nov 2010 - Dec 2014

  • Case Manager

    Jun 2013 - Aug 2014
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  Ncphs

  Aug 2014 - Apr 2017

  Mds coordinator

  Managed all aspects of Minimum Data Set (MDS) schedule for non-skilled and skilled patients including Medicare and HMO payer sources. Work closely with therapy manager to schedule PPS (prospective payment system) ARD (assessment reference date) to most accurately capture rendered level of care. Prepared and provided patients with appropriate Medicare documents to comply with requirements of patient end of coverage notification and corresponding education on appeal process. Managed CMS appeals and served as patient liaison with QIO Livanta. Provided support to nursing team including teaching of nursing skills to new staff members, efficient documentation, and care planning. Show less

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  Contra costa county

  May 2017 - Jul 2024

  Quality manager

  Provide improvement and regulatory support to various departments. Hospital and Ambulatorycredentialing visits roles as survey escort, scribe, supporting the command center in potential findings investigation, document and policy fulfillment. Post survey visits coordinating and organizing plans of correction efforts and documentation. Quality support for Utilization Review Case Management Dept. aimed at promoting efficient workflows transitioning manual processes to electronic or automated, educated staff on CMS and TJC documentation requirements, track performance and developed and reported Quality Improvement Department Measures to Leadership. As Facilities Dept. Quality Manager perform several monthly Environment of Care Rounds to all licensed areas under CCRMC license including clinics, mobile units, and school-based clinics to help maintain a survey ready status with accompanying sustainability plan for identified deficiencies. As CCRMC Core Measure Lead Abstractor oversee and provide ongoing training of 2+ nurse abstractors. Well versed and experienced in abstraction of inpatient psychiatric, inpatient medical, and outpatient CMS and TJC Core Measure completion, submission, validation and performance improvement guidance. Peer review nurse for physician departments, General Surgery, specialty surgical groups, Detention, Diagnostic Imaging, ED, Pediatrics, and Psychiatry. Supporting peer review included chart review of referred cases as well as reviewing reports to identify cases warranting review. Show less

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  Contra costa health

  Jul 2024 - now

  Utilization review coordinator