| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
An Experienced, Accomplished Nursing and Compliance Professional42048 Farm Lane Court, Sterling Heights, Michigan 48313 EMAIL AVAILABLEPHONE NUMBER AVAILABLEOBJECTIVETo obtain a position in using my nursing expertise and be an integral part of the Clinical team to assist an organizations continuing pursuit of effective and efficient patient care. HIGHLIGHTS OF SKILLS 20 Years of direct patient care experience Detail Oriented and able to manage multiple tasks and deadlines Exceptional Patient Advocate. A consistent role model of the Compliance and Ethics Program to foster trust critical to the foundation of the organization as well as fostering relationships with patients and families. Clinical experience includes, but not limited to, CVICU, ED, Trauma, Hospice, Home Heath (ventilator case management), skilled nursing/subacute units in both staffing and management. PROFESSIONAL EXPERIENCEDepartment of Corrections, Woodland Correctional Center Whitmore Lake, Michigan Corrections Registered Nurse 2024-PresentResponsible for the management of inpatient prisoners with acute and long term psychiatric disorders.Responsible for admissions, management plans and suicide risk assessments for new intakes as well as inmates with changes in mental status.Responsible for physical assessments and determining disposition for inmates who require a higher level of medical management.Document and refer inmate grievances and Prisoner Rape Elimination Act reports. McLaren Health Care Grand Blanc, MichiganRegional Compliance Director February 2021-2023Regional Compliance Director for the Central Region of McLaren Health Care.Assisted in the development of contract templates and managing contract process for assigned subsidiariesMember of the Contract Subcommittee, External Access SubcommitteeSelected to be a member of the Institutional Review BoardInvestigate and document compliance concerns.Maintain McLarens Corporate Compliance objectives and work plan and completed the work plan every year.Monitor compliance hotline and actively respond to inquiriesResponsible for all compliance and HIPAA investigations and remediation of identified non-compliant areasAssist with policy and procedure review and developmentChair all subsidiary Corporate Compliance CommitteesActively participate in UR/UM, 340B and other committeesReviewed clinical documentation frequently to address compliance concerns and/or ensure compliance with Medicare/Medicaid/Medicare Advantage billing rules/regulations. REDLANDS COMMUNITY HOSPITAL, Redlands, CaliforniaCompliance Director November 2017 to February 2021 Responsible for the development, implementation, and maintenance of a robust compliance program for a 229-bed acute care hospital.Established, implemented, and maintained a Contract Management SystemResponsible for managing over 800 contracts and the contracts management systemEstablished a new Integrity Line SystemEstablished conflicts of interest reporting with 99% compliance for physiciansEstablished conflicts of interest reporting for employees and volunteersImplemented a new web-based policy and procedure management systemAssisted in the creation of a newly established workplace violence protection programImproved the recall management system to ensure recalled items are quickly logged in a central data baseEstablished a more robust auditing and monitoring programEstablished investigation processesReviewed, revised, and established policies and procedures for the Compliance ProgramCoordinated the reconfiguration of the Institutional Review Board to bring the Board into complianceReviewed clinical documentation for appeals and compliance with billing.Responsible for all compliance and HIPAA investigations and remediation of identified non-compliant areasWorked as an ED RN during height of COVID pandemic at the hospital to assist with staffing shortages. HEALTH QUALITY MANAGEMENT GROUP, INC., Encino, California General Counsel /Director of Legal & Regulatory Affairs / Compliance Officer (2010-2016) Contract services July 2016 to July 2017.A post-acute care healthcare management company, managing over 700 beds.Handled all typical duties of General Counsel and worked extensively with outside counsel in drafting and responding to pleadings to contain costsManaged all administrative law issues including OSHA compliance, handling administrative and Medicare appealsManaged outside claims and litigation resulting in lower deductibles and lower amounts paid per claim because of risk and compliance programs establishedHandles IDR, CRC, and ALJ administrative appeals, and successfully took to trial Double-A Citations.Reduced overall litigation costs and payouts resulting in lower GL/PL and workers compensation premiums resulting from risk management and compliance programsAssist with insurance appeals including Medicare and Medi-calEstablished risk management program and risk safety teamsActed as the company Privacy officer and HIPAA/HITECH consultantCreated companys corporate compliance program, meeting all program requirements and all company goalsRevised entire Medicare documentation system and corresponding nursing documentation to comply with Medicare guidelines for reimbursementImproved survey outcomes resulting from compliance and risk management systemsReduced worker compensation claims in total numbers and amounts paid resulting in lower insurance premiumsManaged companys human resources as it relates to compliance with labor lawsAnalyzed and interpreted state and federal regulations to maintain facility complianceResponsible for interpreting, educating, training and compliance of all state and regulationsWorked Hospice/Home Health on the weekends as an RN to maintain RN skills. CLARK HILL (FORMERLY MORRIS, POLICH & PURDY), Los Angeles, California (2014-2017) Of counsel representing/consulting with post acute care providers on regulatory, compliance and privacy issues. Represented clients with adverse licensing actions. TSW MANAGEMENT GROUP, INC., Anaheim, CaliforniaGeneral Counsel / Director of Health Care Operations / Compliance (2003-2010) Performed a variety of legal and consulting functions for seven post-acute care facilities comprising of more than 850 beds. Responsible for managing all healthcare operations.Handled all typical duties of General Counsel and worked extensively with outside counsel in drafting and responding to pleadings to contain costsManaged all administrative law (ALJ and MAC) issues including OSHA compliance, handling administrative and Medicare appealsManaged outside claims and litigation resulting in lower deductibles and lower amounts paid per claim and lowered the total number of claims for all seven entities combined to two (2) or fewer per yearResponsible for the oversight of contract management, drafted contractsOverhauled documentation system, greatly increasing nursing efficiency, while meeting all regulatory needsImplemented clinical competency programs, resulting in decreased litigation and improved patient outcomesCreated companys corporate compliance program, meeting all program requirements and all company goalsEstablished company risk management programPolicy and Procedure development and implementation for the organizationResponsible for interpreting, educating, training and compliance of all state and regulationsWorked weekends in Hospice and Home Health. Assisted in staffing as supervisor/charge nurse in times of staffing concerns.HURST CONSULTING GROUP, Chino, CaliforniaOwner/Chief Regulatory Consultant (2000-2021)Provided consulting services for long-term care providers within the region. Was responsible for managing daily company operations, consulting with clients, developing and implementing customized client risk management and compliance programs, monitoring program performance, developing plans of correction, providing in-services and other educational programs, providing forensic services for law firms, expert witness testimony, and client relations. Acted as Compliance Officer and Privacy Officer for three independent facilities. Assisted clients in regulatory compliance, educational programs, Cal-OSHA/OSHA programs, HR management to comply with state and federal labor laws and provided ongoing support for all regulatory matters. Did regularly assist one client with weekend staffing as an RN in both the SNF and distinct part with the ventilator/high acuity patients. Additionally assisted all clients with geriatric assessments and planning care for high acuity patients. EDUCATIONWHITTIER LAW SCHOOL, Costa Mesa, CaliforniaJuris DoctorGEORGE MASON UNIVERSITY, Fairfax, VirginiaMaster of Science in Nursing AdministrationPOINT LOMA NAZARENE COLLEGE, San Diego, California Bachelor of Science in Nursing DegreePROFESSIONAL CERTIFICATIONS AND ACCREDITATIONSR.N. License, State of Michigan (Active through 2025)Geriatric Board Certified Nurse (Active through 2025)R.N. License, State of California (Active through 2024)Michigan State Bar (Active through 2023)CLINICAL SUMMARY1986-1987 Charge Nurse/Supervisor for SNF1987-1989 St. Francis Medical Center started in Telemetry and went to ED and worked as ED nurse and MICN(obtained CEN at the time)1989-1993 Invoa Healthcare System CVICU Clinician IV Staff Nurse (Fairfax and obtained CCRN) and Manager of ICU (Arlington)1993-1997 Mercy Hospital (now Scripps Mercy) worked as a Trauma Coordinator (TNCC)/Hospital Supervisor1997-2019 Worked in some staffing capacity sporadically for TSW Management and Health Quality Management Group. During this time also worked Home Health (Case Manager for Ventilator dependent patients) and Hospice (Case Manager, Admission Nurse, On-Call Supervisor).2020 Worked in ED COVID pod for three weeks to help with staffing challenges.2000-2019 Hurst Consulting my consulting company for regulatory compliance but did fill in for clients as a charge nurse, nursing supervisor and provided other services such as IV nurse and providing assistance with immunizations.TECHNICAL SKILLSComputer knowledge: Windows OS, Word, Excel, PowerPoint, Adobe Acrobat, COMS Electronic Health Record and other systems. |
