| Candidate Information | | Title | Quality Assurance Case Manager | | Target Location | US-NY-Ronkonkoma |
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Click here or scroll down to respond to this candidateMission To utilize acquired professional nursing skills to advocate, facilitate, and provide compassionate caring nursing healthcare to the communityCatholic Homecare CHHA agency November Street Address to April 2023Street Address
Performance Improvement Coordinator/Educator August 2018 to April 2023Evaluate, assess, audit staff and agency performance in multiple areas of care including documentation. Monthly audits performed to evaluate compliancy, efficiency, performance, and documentation of care provided to patients with wounds, foleys, UTI and hospitalizations, oxygen usage, pleurex catheters, HHA services, and advanced directives. Utilization of MIDAS program to evaluate agencys performance of medication error, intravenous related problems, and infection for both staff and/or caregiver/patient incidents. Organizer of maintaining agencys complaint log. Coordinator of monthly utilization chart reviews thus identifying any under/over utilization of services provided to patient. Quarterly reports presented to management with audit outcomes and explanations as required. Record keeping of teams performances on dashboard reports in areas of communication, overall performance, census, re-hospitalization, fall incidents, HHA supervisions, oasis functional categories including pain, transferring, healing of surgical wounds, med errors via SHP reporting program. Coordinated audit concerning staff compliancy with flu vaccine or wearing of surgical mask. Assist with reviewing 485s and set up for outside vendor (QIRT) to review for accuracy. Audits recorded with utilization of Excel, Word, MIDAS. Results discussed with management and individual assigned teams. Monthly team meetings conducted monthly with team manager, care manager, and team staff members to discuss outcomes and agency recommendations for improvement of care. In addition, participant in Huddle meetings to inform and be informed of daily happenings within the agency and on clinical teams. Attendance at Performance and Compliance Meetings with participation in providing audit results. Attend PI meetings as arranged by department manager. Can be assigned to clinical SN visits to patients if understaffed.Care Manager August 2016- August 2018Facilitate appropriate skilled care provided to patients by review of documentation including oasis responses including initial visit functional responses, interpreting the CMI for individual teams. Also, monitor LUPA rate and educate staff concerning effects of oasis responses and CMI/Lupa rates. Conduct interdisciplinary team meetings to discuss patient care and issues. Assist in providing authorization for managed care patients, and actively write appeal letters to counter denials from insurance companies.Team Manager February 2013- August 201630-Member Interdisciplinary Team of RN/ LPN/REHAB/MSWs to ensure interpretation and delivery of homecare services within the guidelines of Medicare/Medicaid and Managed Care insurances. Ensure cost effectiveness and optimize quality care. Also accountable for education, performance evaluation, staff hiring and termination process Coordinate staff scheduling, facilitate transition of patient to home from various facilities. Communicate with patients and family members concerning positive and negative feedback and issues. Conduct monthly team meeting to communicate and update staff on agency/homecare policies/procedures. Interdisciplinary team meetings held weekly to discuss select patients and their care issues.Facilitate appropriate usage and allocation of skilled visits via authorization process for managed care insured patients.Committee Member:oAllscripts - monthly trouble shootingoWound Care - redesign documentationoEnvironmental - establish internal green procedures.oSandata Program pilot testing of Home Health Aide plan of care documentationCongestive Heart Failure Hospital/Homecare Program discuss post discharge of CHF patients status with hospital CHF coordinator to ensure continuity of care and prevent rehospitalizationNursing Team Supervisor April 2005 to February 2013Catholic Homecare Farmingdale, NYAdministration, management, education, evaluation of 16 member nursing teamAssistant Nursing Care Coordinator June 2004- March 2005Catholic Homecare Farmingdale, NYAssistant to Nursing Team SupervisorRN Field Case Manager November 2000 - June 2004Catholic Homecare Farmingdale, NYPerform skilled nursing care for caseload patientsDirector of Nursing/ Quality Assurance June 2016 December 2019SCOPE Healthcare Melville, NY-Supervision of field RNs, coordinator of staff education-TBI population-Quality Assurance coordinatorCommunity Health Nurse, October 1999-November 2000Brookhaven Memorial Hospital Homecare Agency Brookhaven, NYNursing Case Manager for 25 patient caseloadField Nurse (per diem), December 1998-September 2000Self-Help Communities Homecare Services Levittown, NYPerformed skilled nursing visits and evaluations.Supervision of HHA and PCA personnel.Participant in Oasis Studies, Denver Colorado.Instructor for training classes for aides.Field Supervisor, May 1998-August 1999Personal Touch Homecare Agency Garden City, NYField supervisor of HHA and PCA employees.Conducted field visits to patients including teaching of disease, medications, and diet.Field Rehab Nurse, December 1995-August 1997Crawford Disability Management Company Uniondale, NYInterview, assess, and pursue injured employees to return to work . Coordinate care required to facilitate successful recovery return to work.Coordinate and review IME reports, peer reviewsCommunity WorkHEALTHY SUNDAYS Catholic Health Service Community Program provide preventative screening for blood pressure, seasonal vaccines, and blood glucose testing.Host Family Program at SUNY @ Stonybrook (2007-2010) provide international students with acclimation to the U.S. and its culture and educational systemEducation:Adelphi University, Bachelor of Science in Nursing 79; Sigma Theta Tau Honor SocietyContinuing Education Courses:1.EMR Garnett Education ., Nurse.com Oct 20122.Cognitive-Communication Disorders Assessment and Treatment of Neurological Impairments. Pesi Healthcare Oct 2011The Nurses Health Study II participant Harvard School of Public Health and the Channing Laboratory at Brigham and Womens Hospital. 1999-2009.Technical Expertise includes: MicroSoft Word, Outlook, PowerPoint, Allscripts/NetsmartPersonal Interests: soapmaking, gardening, baking, willing to re-locate. |
