| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateAndrewTBlack,Jr.,MHA,MSN,CMSRNStreet Address
Tel: PHONE NUMBER AVAILABLE E-mail: EMAIL AVAILABLEProfileSelf-motivated Registered Nurse leader with excellent interpersonal and organizational abilities, creative and performs effectively in a collaborative atmosphere or independently. Competent in disseminating standards related to policy and procedure adherence. Resourceful in utilizing acquired leadership skills in the role of nurse manager, compliance program specialist, staff development liaison, shared governance representative and MDS assessment coordinator. Communicates in an efficient, positive manner and exemplifies the accountability and responsibilities inherent in professional nursing practice.EducationPfeiffer UniversityMaster's of Science Degree in Health Administration 2011GPA (4.0 Scale): 3.9Master's Project: Implementation of Epidemiological Services inCanada's Community Care Access CentreCompletion of greater than 130 practicum hoursWinston Salem State UniversityBachelor's of Science Degree in Nursing 2005Cum LaudeLivingstone CollegeBachelor's of Science Degree in Biology 2002Magna Cum LaudeWork ExperienceNovant Health Thomasville Medical CenterUtilization Review Nurse 2012 Oct.Proactively analyze information submitted by providers to make timely medical necessity review determinations based upon evidence based clinical criteria and standards within governmental and contractual guidelinesIdentify and present cases of possible quality of care deviations, questionable admissions and prolonged lengths of stay to the Medical Director for further determinationCollect accurate data for system input by using correct coding of diagnoses and/or proceduresProcess authorization requests via phone queue according to internal departmental processes.Perform selected provider calls to address post-hospital discharge services, redirection to in network providers for appropriate steerage, durable equipment usage and utilization of other medical services and/or procedures and other telephonic follow-up as identified by the UM Nurse, the Medical Management Clinical Supervisor or Medical Management Director. Maintain documentation of all contacts with providers for health management activities to meet all regulatory and contractual requirementsRegistered Nurse Assessment Coordinator 2008 Oct.Facilitate timely and accurate completion of the minimum data set (MDS) and transmit data to the State as defined by Centers for Medicare & Medicaid Services (CMS)Certify the need for skilled care, considering cost awareness, length of stay and discharge requirementsServe as a resource for residents, family members, social workers, direct-care staff, business office and records personnel regarding Medicare regulationsReinforce organizational and departmental procedures compliance and vigorously participate in Data Entry/Analysis and Quality Assurance activitiesWake Forest University Baptist Medical Center -Community PhysiciansClinical Compliance Specialist 2008 JuneDevelop, maintain and revise policies and procedures related to State and Federal regulations and standards complianceMaintain patient care protocols and standards, ensuring adherence to State and Federal policies, regulations, and guidelines for operations in physicians' practice; establish and coordinate quality improvement, safety and infection prevention programsPlan, implement and evaluate clinical activities in the practice setting related to infection prevention, occupational health, safety, laboratory and new employee orientationCollaborate with the Chief Medical Officer, Physicians, Practice Managers, Clinical staff and others in regards to clinical practice and quality improvement matters, continually measuring progress against objectivesWake Forest University Baptist Medical CenterUnit Based Educator 2007 JuneModel excellence in nursing practice through the utilization of advanced concepts in areas of assessment, diagnosis, planning, implementation and evaluation of problems in a variety of patient populationsProvide clinical education expertise for compliance with professional and regulatory standards and orient novice nursesCollaborate with Staff Development to identify educational opportunities designed to assist nursing professionals in providing optimal patient careStaff Nurse II 2005 Jan.Create a nurturing environment for patients, families by identifying needs and priorities while utilizing the components of the nursing process to meet these needsDevelop and revise individualized plans of care to assure positive outcomes and collaborate with multidisciplinary team members to evaluate care outcomesUtilize the nursing process to ensure high quality patient care is rendered throughout the episode of carePERSONAL AND RELEVANT ATTRIBUTESProven record of passion and innovation for obtaining positive financial resultsStrong record of financial improvement in facility reimbursementCapable of coordinating interdisciplinary involvement in clinical care amongst multiple disciplinesExtensive experience initiating and managing Medicare and Medicaid billingEffective enforcer of policy, procedure and regulations in the clinical and long term care settingsCapable of resolving challenging issues resulting in positive facility outcomesProfessional and Personal References Available Upon Request |
