Alexandria Barger
Pueblo West,CO
Summary
Results-driven Home Health Care Coordinator with extensive experience at naviHealth/Optum, recognized for exemplary multidisciplinary team collaboration and strong ethical judgment. Achieved a flawless InterQual score while leading initiatives that boosted utilization management and drove a remarkable 58% increase in EBITDA. Proficient in discharge planning and process improvements, leveraging a solid nursing background to enhance patient care outcomes. Aiming to further optimize healthcare delivery through innovative strategies and teamwork.
Overview
23
23
years of professional experience
Work History
Home Health Care Coordinator (HHCC)
navihealth/Optum
02.2022 - Current
- Contributed to the team during the new launch as a member of Team Arkansas.
- Home Health was a new launch and new line of business for both United Health Care and naviHealth/Optum
- Primary objective, of this position is to meet the patient’s needs, execute utilization management using CMS regulations and your clinical judgement as a primary resource, understand InterQual as a guiding tool and meet the productivity and financial goals for navihealth/Optum
- Achieved a perfect score on InterQual annual test and all chart audits.
- Expertly applied CMS regulations, audited clinical notes, managed utilization effectively, and utilized ICUE system and NOMNC process.
- I have been able to work as a resource for agencies to encourage the use of social services for patients in need, further education of Chapter 7 guidelines while still making the appropriate NOMNC/IDN decisions when a patient is not meeting skilled care under CMS Chapter 7 based on the clinical information submitted
- Utilized Interqual to evaluate skilled needs.
- My responsibilities include the following: reviewing and auditing Oasis and visit note documentation for medical necessity, understanding and applying CMS Chapter 7 guidelines for home health, and collaborating with agencies to teach appropriate clinical documentation that is required, medical necessity, and discharge planning.
- Achieved professional status with Level 3 certification in M&R.
- Ensured compliance with state regulations related to healthcare service provision.
- Actively participated in staff meetings discussing best practices in patient care coordination.
- Assessed safety risks associated with living environments or activities of daily living.
- Worked effectively in team environments to make the workplace more productive.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
Skilled Inpatient Care Coordinator (SICC)
naviHealth
05.2019 - 02.2022
- Strategized and executed new services in collaboration with Humana for efficient patient care.
- Joined forces with United Health Care and Colorado to enhance utilization management practices.
- Aimed to meet patient needs and build positive relationships with facilities.
- I consistently performed in the top 5 of my region (Colorado, New Mexico and Arizona), managed a weekly caseload of 30+ patients, cleared over 400 cases a quarter, met all my KPI’s and was a 'buddy' for new hires
- My responsibilities included the following: Performed SNF assessments using both clinical knowledge and nH Predict for appropriate levels of stay, completing concurrent reviews, collaborate with both patient and facility in their care and discharge plans, attend care conferences both in person and telephonically, and refer to appropriate area of Health Plan for high risk and community-based needs at time of discharge
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Communicated with patients with compassion while keeping medical information private.
- Assisted in the development of discharge plans for clients transitioning out of care programs.
- Worked with cross-functional teams to achieve goals.
- Assisted with customer requests and answered questions to improve satisfaction.
Regional Dir. Of Operations
Bridges Community Homecare
Wheat Ridge, CO
06.2017 - 05.2019
- Objective: To build and stabilize underperforming branches and teams, improve STAR ratings, patient satisfaction and meet productivity and financial goals
- Assumed clinical leadership and financial oversight of two underperforming Colorado branches, increased EBITDA by 58% and increased star rating from 3 to 4.5 over 2 years
- Passed four state audits with zero deficiencies.
- Designed comprehensive QAPI plan for targeted quality improvement to enhance patient outcomes and satisfaction.
- Delivered quarterly presentations on QAPI to illustrate branch performance.
- Provide training and guidance to two Branch Director direct reports.
- Partnered with the sales team to enhance customer base.
- Collaborated with senior management on strategic planning initiatives.
- Reviewed financial statements and sales or activity reports to measure productivity or goal achievement.
- Monitored performance metrics to identify areas of improvement in operational efficiency.
- Ensured compliance with applicable laws, regulations and industry standards.
Branch Director
Abode Home Health
Pueblo, CO
05.2016 - 05.2017
- Oversaw clinical and financial aspects of startup development.
- Collaborated in marketing campaigns to increase market share.
- Managed recruitment, training, and auditing of clinical charts for all branch staff.
- Implemented QAPI program to boost performance and patient outcomes.
- Performed patient visits to support the field staff and reviewed all OASIS documents
- Provided training and development opportunities to ensure staff meet goals and objectives.
- Reviewed financial reports to monitor budget adherence and expenditure levels.
- Increased efficiency and drove branch revenue by optimizing daily operations.
Regional Administrator
Encompass Home Health
Greenwood Village, CO
05.2015 - 05.2016
- Objective: To build and stabilize underperforming branches and teams, improve STAR ratings, patient satisfaction and meet productivity and financial goals
- Directed regulatory, clinical, and financial operations of all Encompass branches across Colorado.
- Conduct continual quality improvement committee meetings with active plans of improvement
- Contributed to creation and promotion of an innovative Dementia program for homes and ALFs.
- Designed and delivered content for both monthly and twice yearly review sessions.
- Executed change of ownership and community health accreditation partner surveys without any shortcomings.
- Participated in planning committees for special projects or events within the region.
- Facilitated staff meetings to convey policy changes and hear employee input.
- Assessed organizational performance against established standards and goals.
- Oversaw recruitment and selection processes for new employees in the region.
- Evaluated existing services within the region and identified areas of need or improvement.
Regional Administrator
Encompass Home Health
Greenwood Village, CO
03.2014 - 05.2015
- Objective: To build and stabilize underperforming branches and teams, improve STAR ratings, patient satisfaction and meet productivity and financial goals
- Managed all aspects of regulatory, clinical, and financial operations across three Northern Colorado branches.
- Spearheaded active planning sessions for quality advancement.
- Surpassed EBITDA goals by 57%, securing best branch ranking within the company over two years.
- Achieved a 58% growth in patient count in twelve months.
- Achieved two state surveys without deficiencies.
- Helped design and establish an initial orthopedic BPCI initiative for Home Health in Colorado.
- Contributed to development, training, implementation, and marketing of ALF program.
- Recognized among the 'Top 100 Places to Work in Colorado' for three consecutive years.
Assistant Regional Administrator
Encompass Home Health
Denver, CO
01.2014 - 03.2014
- Led clinical operations and managed financial performance for two Denver branches.
- Support development and growth of two Branch Director direct reports through mentorship.
- Assumed interim leadership of a key Denver branch.
- Oversaw recruitment and selection processes for new employees in the region.
- Prepared reports summarizing regional accomplishments, challenges.
- Ensured that all staff members are adhering to safety protocols at all times.
- Analyzed data related to program outcomes, effectiveness, utilization.
- Responded promptly to customer complaints or inquiries regarding regional services.
- Assessed organizational performance against established standards and goals.
- Facilitated staff meetings to convey policy changes and hear employee input.
- Conducted regular meetings with staff to discuss operational issues, performance goals, and strategies for improvement.
Branch Director
Encompass Home Health
Pueblo, CO
06.2012 - 01.2014
- Oversaw clinical operations and managed financial aspects of new Pueblo branch.
- Ensured effective team dynamics through comprehensive recruitment, training, and mentorship.
- Supported field staff through patient visits.
- Achieved a 30% growth in patient population within eighteen months.
- Achieved top performance in company by exceeding 2013 earnings target by 21%.
- Reviewed financial reports to monitor budget adherence and expenditure levels.
- Provided training and development opportunities to ensure staff meet goals and objectives.
- Increased efficiency and drove branch revenue by optimizing daily operations.
- Supported outside sales force in servicing and obtaining new business.
- Checked payroll, vendor payments and other accounting disbursements for accuracy and compliance.
- Conducted regular performance reviews for staff, providing feedback and guidance on areas of improvement.
- Recruited qualified personnel for key positions within the branch organization.
- Worked cross-functionally to plan and establish branch goals, supporting strategic objectives.
Care Coordinator/Branch Director
Professional Home Health
Colorado Springs, CO
09.2011 - 06.2012
- Oversees and directs daily branch activities.
- Expertly implements essential procedures based on agency's strategic plan.
- Fulfilled branch performance benchmarks determined by corporate leadership.
- Assisted with financial planning and branch administration.
- Handled client admissions and intake processing.
- Oversees timely execution of certification and re-certification activities related to patient care.
- Conduct interviews, hire staff, and provide orientation.
- Assesses the performance of staff in the field.
- Delivered essential training sessions to field personnel.
- Coordinated various aspects of quality assurance encompassing OBQI, QRR, and QA log.
- Facilitated nursing, care team, and therapy meetings.
- Monitored staff adherence to all relevant rules and guidelines for regulatory compliance.
- Collaborated with interdisciplinary teams to provide comprehensive patient-centered care.
RN Case Manager/Preceptor
Professional Home Health
Pueblo, CO
11.2008 - 09.2011
- Provided comprehensive in-home nursing care to patients.
Conducted health assessments and administered treatments.
Ensured proper medication management and patient education. - Delivered healthcare services in patients' homes, precepting new hires clinically and administratively.
- Demonstrated extensive knowledge of Rebif medication protocols.
- Referred patients to specialized health resources or community agencies to furnish additional assistance.
- Attended continuing education seminars relevant to case management practices.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Partnered with Seronto Pharmaceuticals to provide statewide education on administering Rebif and understanding its side effects and indications.
- Trained new employees across the organization in skills assessment and computer documentation.
- Provided support across branches in quality assurance.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
- Provided direct nursing care such as wound dressing changes, IV therapy, medication administration and patient education.
LPN II Field Nurse
Professional Home Health
Pueblo, CO
04.2002 - 11.2008
- Offered comprehensive physical and emotional care to patients and families.
- Collected and documented vital signs to track current patient conditions.
- Administered prescribed medications or started intravenous fluids, noting times and amounts on patients' charts.
- Facilitated communication between patients, family members, and healthcare professionals.
- Communicated concerns regarding patients' status, care and environment to nursing supervisors, clinical care supervisors and case managers.
- Directed implementation of improved patient care and documentation methods and procedures to achieve quality objectives.
- Reported findings on patient condition directly to physicians.
- Evaluated effectiveness of interventions implemented based on patient responses or feedback from family members.
- Provided emotional support during difficult times such as end-of-life decisions or family disputes over treatment options.
- Observed, charted, and reported developments in patient health conditions for nursing supervisor.
- Answered patients' calls to determine how to assist.
- Coordinated with interdisciplinary team members such as doctors, nurses and social workers to ensure quality patient care was provided.
- Instructed patients and their families about disease prevention, proper nutrition, medication management and other health related topics.
Education
BSN -
University of Phoenix
Phoenix, AZ10.2020
ASN -
Otero Jr. College
La Junta, CO08.2008
LVN -
Grant Adult School
Sacramento, CA08.1999
Certified Home Health Aide -
Benicia Adult School
Benicia, CA11.1991
Skills
- Multidisciplinary team collaboration
- Discharge planning
- Nursing background
- Medical terminology understanding
- Database coordination
- Documentation
- Organizational skills
- Ethical judgment
- Conflict resolution
- Process improvements
- Team collaboration
- Problem-solving
Degree
BSN, RN
References
References available upon request.
Timeline
Home Health Care Coordinator (HHCC)
navihealth/Optum
02.2022 - Current
Skilled Inpatient Care Coordinator (SICC)
naviHealth
05.2019 - 02.2022
Regional Dir. Of Operations
Bridges Community Homecare
06.2017 - 05.2019
Branch Director
Abode Home Health
05.2016 - 05.2017
Regional Administrator
Encompass Home Health
05.2015 - 05.2016
Regional Administrator
Encompass Home Health
03.2014 - 05.2015
Assistant Regional Administrator
Encompass Home Health
01.2014 - 03.2014
Branch Director
Encompass Home Health
06.2012 - 01.2014
Care Coordinator/Branch Director
Professional Home Health
09.2011 - 06.2012
RN Case Manager/Preceptor
Professional Home Health
11.2008 - 09.2011
LPN II Field Nurse
Professional Home Health
04.2002 - 11.2008
BSN -
University of Phoenix
ASN -
Otero Jr. College
LVN -
Grant Adult School
Certified Home Health Aide -
Benicia Adult School
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