Ali Deena Williams, RN,MSN,CCM

Aged, Blind & Disabled/ LTSS Program

• Provide case management services, including intake, assessment, advocacy, and referrals to appropriate medical, mental health, and social services.
• Assist members with Medicare/Medicaid in setting realistic goals and developing action plans.

Medicare Case Management

• Provide telephonic case management services to Medicare high-risk patients and provide safe transitions of care to patients discharged home from the emergency room and hospitalization.

Managed Long Term Services & Services (MLTSS)

• Provide Care management services in person and telephonically to members including but not limited to community referrals/resources.
• Fill in as a utilization management nurse during staffing shortages to determine medical necessity and authorization of services.

DCP&P (formerly DYFS) Child Health Program

• Assess the child’s health care needs, develop a plan of care, integrate the health plan into the child welfare service plan to ensure safety, permanency and wellbeing, and intervene and advocate to ensure continuity of care and improved health care outcomes.

Personal Injury Protection Dept

• Determine the medical necessity of services for automobile injured clients utilizing NJ Care Paths, Decision Point Reviews and Pre-certification Standards

Case review utilizing Medicare review criteria

• Assist physicians in denial or approval of requested Medicare services. Provide verbal and written notification with medical rationale to beneficiaries, insurance companies and providers

• Provided hands on care for nursing home residents and skilled nursing facility patients. Provide supervision to Licensed Practical Nurses and Nursing Assistants.

• Coordinated in-home skilled nursing care to patients with diverse physical needs and conditions.

Cord Blood/Stem Cell Program

• Supervise Licensed Practical Nurses and phlebotomists
• Conduct chart reviews and risk assessment questionnaires with research participants. Perform stem cell collection from placental umbilical cord, Prepare slides/venipuncture on donors

Pediatrics, Neonatal Intensive Care Unit, Post Partum Units

• Provide direct care to patients in above units