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Click here or scroll down to respond to this candidate900 Appian Way #11 Mount Pleasant, MI 48858PHONE PHONE NUMBER AVAILABLE EMAIL: EMAIL AVAILABLECandidate's Name
OBJECTIVESeeking a remote position to further my knowledge and experience of 24 years in the healthcare field related to psychiatric, behavioral and addiction problems.EDUCATION1995-1999Clarion University of PA, Clarion PABachelor of Science in Psychology, GPA 3.2WORK EXPERIENCE8/2022 8/2023Beacon Behavioral Hospital, Lacombe LA and Lutcher LAPosition: Utilization Review Coordinator (Remote Position)Responsible for daily pre-certifications and concurrent reviews for a 24 bed Geriatric facility and a 24 bed adult facility.Responsible for submitting appeals and retros with Medicaid, VA and Commercial insurances.Communicated with doctors if a peer to peer needed to be completed due to denial from insurance.Documented in EMR for billing department and nursing team days covered or denied and pertinent information and reasonings.Verified all insurances.Attended monthly meetings with corporate and other UR coordinators to discuss reasons for denials and to strategize on ways to get all days covered.Effectively communicating with the Psychiatrist, Charge Nurse, Administrator and Billing Department as needed and reporting covered and uncovered days for each patient on a daily basis.Successful in less than 5% in uncovered days.2/2019 8/2022Beacon Behavioral Hospital, Lacombe LAPosition: Admissions DirectorWorked remotely from 8/20 8/22Responsible for admitting patients to the 4 psychiatric hospitals for the company that are in Lacombe, New Orleans, Lutcher andBunkie LA for a total of 104 inpatient beds.Responsible for the daily activities in the admissions department for adults 18+ (PEC, CEC and FVA)Supervising 14 Intake Coordinators.Effectively communicating with the Psychiatrist, Charge Nurse, UR Nurse and Billing Department for each admission and providing all needed documentation in a timely manner.Manage hospital admissions policies, procedures and EMTALA log.Completing precertifications for 2 of the hospitals.2/2018 2/2019Northlake Behavioral Health Hospital-Mandeville, LAPosition: Admissions DirectorResponsible for completing all pre-certifications and verifying all insurances for each admission and had zero denied days. Coordinated closely with the Office of Behavioral Health with LDH to manage the Judicially Committed patients that needed to be admitted from the hospitals and/or jail along with coordinating with Central Louisiana State Hospital. Daily goal to maintain the census above 100.Responsible for the daily activities in the admissions department for 122 bed hospital. Licensed to admit adolescents, ages 12-17, and adults (PEC and JC).Supervising 1 RN, 5 LPNs, 6 Intake Coordinators, 1 Therapist and 2 ReceptionistsEffectively communicating with the Psychiatrist, Charge Nurse, UR Nurse and Billing Department for each admission and providing all needed documentation in a timely manner.Manage hospital admissions policies, procedures and EMTALA log.12/2016 2/2018Covington Behavioral Health Hospital-Baton Rouge, LAPosition: Admissions DirectorResponsible for restructuring the department to implement RNs, creating a more cohesive schedule, training and implementing the process to admit clients for the detox program, improving the pre-certification process that resulted in the hospital to have almost zero denied days and increase in revenue, increased the average daily census, went over budget with the number of admissions per month and the number of patient days.Responsible for the daily activities in the admissions department for 60 bed hospital to also include proper assessment for the increased demand of voluntary patients to determine the appropriate level of care for inpatient, detox or IOP.Effectively increased the average daily census from 40 to 52 which had the hospital at 86% capacity.Supervising 4 Intake RNs, 1 Intake LPN and 4 Intake Coordinators.Manage hospital policies and procedures.2/2015 12/2016Seaside Health Systems-Baton Rouge, LAPosition: Admissions and Marketing DirectorResponsible for the daily activities in the admissions department for 64 bed unit and marketing to the community to include ERs, private practices, group homes, outpatient clinics and treatment centers.Supervised 1 Marketer, 6 Intake RNs and 1 LPN.Effectively increased the average daily census from 40 to 57.9 that had the hospital at 90% capacity. Increased the total monthly admissions from 200 to 250.Responsible for taking crisis calls, verifying insurances, completing pre-certs, completing all needed consents, conducting client pre-admission screening and completing the admission process, obtains demographic and financial information and maintaining confidentiality.Manage hospital policies and procedures.Organized and presented at the Governing Council each month for the Utilization Review Committee. Presented dashboards for average LOS, insurance breakdown, program breakdown, recidivism and total number of admissions and discharge for each month.3/2014 1/2015Baton Rouge Behavioral Hospital-Baton Rouge, LAPosition: Discharge PlannerResponsible for facilitating discharge planning for 30 bed unit for psychiatric and substance abuse patients while communicating with treatment team members on most appropriate level of care for discharge.Maintains open communication with facility staff, attending clinicians and physicians, patients, family members, referring agencies, group homes, rehabs, and insurance companies as needed to help determine best level of care upon discharge.Works closely with UR Nurse and Psychiatrist to track unfunded days by monitoring length of stay unfunded, payor mix, assigned doctor and any outlying issues.Completes assigned discharge paperwork and forwards referral packet to designated aftercare facility to have an aftercare appointment set for patient upon discharge.Build relationships with group homeowners, rehabs and IOP/PHP facilities to ensure a smooth transition for patients discharge.Participates effectively in multidisciplinary treatment plan reviews, demonstrating adequate preparation and understanding of patent issues, progress, areas of resistance, positive and negative strategies, etc.9/2013 3/2014Baton Rouge Behavioral Hospital-Baton Rouge, LAPosition: Admissions DirectorResponsible for the daily activities in the admissions department for 30 bed unit to include proper assessment for each patient by communicating with the nursing department and the Psychiatrist.Effectively increased the average daily census from 4 to 28 that had the hospital at a 93% capacity.Supervised 3 Admission Specialists, 1 Receptionist and 1 UR Nurse.Responsible for taking crisis calls, verifying insurances, completing pre-certs, completing all needed consents, conducting client pre-admission screening and completing the admission process, obtains demographic and financial information and maintaining confidentiality.Manage hospital policies and procedures.Organized and presented at the Governing Council each month for the Utilization Review Committee. Presented dashboards for average LOS, insurance breakdown, program breakdown, recidivism and total number of admissions and discharge for each month.9/2008 8/2013GeoCare/South Florida State Hospital-Pembroke Pines, FLPosition: Admissions CoordinatorCommunicates with receiving facilities and works with them to obtain the necessary admission information on referrals. Thoroughly reviews all referrals and works directly with the Clinical Director to set up civil and forensic admissions. Developing and maintaining excellent relationships with referral sources/receiving facilities.Manage hospital policies and procedures for the admissions department so that it is in conformance with state guidelines and joint commission.Keeps track of occupancy and vacancies for 341 bed hospital. Provides daily and monthly reports to the Department of Children and Families and county circuits.Knowledge of hospital criteria and legal aspects of admissions. Obtains general psychiatric and medical consents from patients, Guardian Advocates or Guardians. Organizes all legal paperwork in WFS system. (Electronic medical records system). Ensures accuracy and completeness of all information, forms and consents submitted and inputted at time of admission.Provides a presentation on a quarterly basis at the Stakeholders meeting to show the statistics for admissions and discharges, influx and reflux of referral packets comparable to current waiting time for admission and any issues that may obstruct the admission process.6/2007 - 9/2008GeoCare/South Florida State Hospital-Pembroke Pines, FLPosition: Recovery Plan SpecialistCoordinates, organizes, facilitates and monitors the provision and documentation of all treatment and rehabilitative services for 53 bed adult male unit.Completed initial recovery plan and update monthly, organize monthly treatment team meetings, review access to grounds monthly, review daily nursing reports and conduct special teams needed and document monthly team notes, special teams and discharge notes.9/03 - 6/07GeoCare/South Florida State Hospital Pembroke Pines, FLPosition: Rehabilitation Specialist IIConduct and direct therapeutic groups for the Engagement Phase that revolved around Role Recovery Theory.Develop issues and objectives for each individual.5/00 - 8/03Clarion Psychiatric Center, Clarion PAPosition: Assessment and Referral Associate (Admissions Department)Perform daily assessments for children, adolescents and adults to determine level of care needed for each individual.Determine nature of each crisis call and the most appropriate course of action for each call.Pre-cert insurances for each admission to the Partial Hospitalization Program, Dual Diagnosis and Acute Inpatient Center. |
