Rasheedah Haynes
Lansdale,PA
Summary
I am a dedicated Registered Nurse with two decades of experience in the healthcare field. I have built a foundational knowledge base that includes mental health, training, direct patient care, Medicaid and Medicare case management as well as leadership. Additionally, a team player, with a demonstrated record of accomplishment in aligning HR strategies with organizational goals and standards. Research-oriented and attentive with respectful and resilient approach. I am looking to secure a position within a health care organization that is driven to provide quality care to all communities.
Overview
15
15
years of professional experience
Work History
Long Term Service & Support Manager
AMERIHEALTH CARITAS
Philadelphia, PA
02.2019 - Current
- Manages and collaborates with a team of 95 direct reports
- Implement successful business strategies to increase revenue and target new markets
- Create detailed plans outlining timelines, goals, budgets, staffing needs and other requirements for projects
- Responsible for ensuring compliance measures and contractual requirements are met by direct reports within the Community Health Choices Waiver program
- Assist with the development and management of policies and procedures to ensure alignment with Medicare and Medicaid PA State and Federal requirements
- Develop and manage standard operations reporting required by the Office of Long Term Living
- Collaborate with consultants to improve the case management process, enhance member engagement and satisfaction by developing strategic methods and tools
- Participate in appeal hearings as an employee voter and decision maker regarding the approval or denial of LTSS benefits, medications, home modifications, and other Medicaid/Medicare requested services
- Develop workflows and desktop tools for use in departmental education and training
- Monitor market conditions and competitor activities to inform business decisions
- Negotiated agreements with external partners such as contractors or consultants.
Senior Clinical Trainer
HEALTH PARTNERS PLANS
Philadelphia, PA
04.2017 - 02.2019
- Develop comprehensive training programs to support health care management, including training materials, manuals and job aids for both clinical and non-clinical learners
- Deliver and develop training curriculums specific to the Medicare line of business
- Deliver training courses aligned with organization onboarding process
- Ensure curriculums adhere to the regulatory and standard processes required by
- Develop lesson plans for clinical curriculum
- Train existing and new employees on application systems such as CCMS, MHS, MACESS, OnContact, and RXNova.
Clinical Quality Audit Specialist
HEALTH PARTNERS PLANS
Philadelphia, PA
12.2016 - 04.2017
- Monitored and audited Medicare and Medicaid cases for quality to adhere to NCQA standards
- Trained colleagues on quality standards surrounding documentation
- Created training tools for Medicare based on outcomes of audits
- Collaborated with management to improve departmental standards.
RN - Care Coordinator
01.2014 - 01.2016
- Handled telephonic case management for members that have both Medicare and Medicaid benefits who are diagnosed with chronic diseases and mental health disorders
- Responsible for initiating, scheduling and moderating interdisciplinary care team meetings, formulating care plans and working with physicians to improve coordination of care
- Navigate internal processing systems such as CCMS, MHS ARGUS and MACESS
- Member of the leadership team, with primary responsibilities surrounding training new colleagues, monitoring and auditing cases for quality standards
- Created learning materials, educating staff on documentation quality standards, department procedures
- Collaborated with the management team to improve departmental standards.
Registered Nurse
DELAWARE PSYCHIATRIC CENTER
New Castle, Delaware
07.2012 - 01.2014
- Worked in a level 5 psychiatric prison and various other psychiatric units performing charge nurse responsibilities
- Daily chart auditing, administered medication, transcribed orders, delegated documentation
- Delivered patient education, treatment planning, daily treatment team meetings and wound care
- Completed annual staff evaluations, trained new nurses and continuously educated the team on new policies and procedures.
Registered Nurse (Psychiatric/Medical Surgical Unit)
ROXBOROUGH MEMORIAL HOSPITAL
Philadelphia, PA
06.2009 - 09.2012
- Hands-on direct patient care in an acute care setting with patients diagnosed with psychiatric disorders and other medical illnesses
- Provided medication administration, admission and discharge planning
- Delegated tasks to other staff, educating patients and family
- Preceptor for new graduates, treatment planning and wound care.
Registered Nurse
GIRARD MEDICAL CENTER
Philadelphia, PA
10.2009 - 10.2010
- Administered medication
- Handled discharge and treatment planning, thoroughly documenting records
- Facilitated nurse education groups for dual-diagnosed, long term care and acute care psychiatric patients.
Education
MSN/MHA, Online Program -
University of Phoenix
11.2018
BSN, Online Program -
University of Phoenix
11.2011
RN/BSN -
Roxborough School of Nursing
05.2009
Skills
- Human Resource Management
- Strategic Planning
- Systems Evaluation
- Training Program Development
- Organizational Development
References
Furnished upon request
Timeline
Long Term Service & Support Manager
AMERIHEALTH CARITAS
02.2019 - Current
Senior Clinical Trainer
HEALTH PARTNERS PLANS
04.2017 - 02.2019
Clinical Quality Audit Specialist
HEALTH PARTNERS PLANS
12.2016 - 04.2017
RN - Care Coordinator
01.2014 - 01.2016
Registered Nurse
DELAWARE PSYCHIATRIC CENTER
07.2012 - 01.2014
Registered Nurse
GIRARD MEDICAL CENTER
10.2009 - 10.2010
Registered Nurse (Psychiatric/Medical Surgical Unit)
ROXBOROUGH MEMORIAL HOSPITAL
06.2009 - 09.2012
MSN/MHA, Online Program -
University of Phoenix
BSN, Online Program -
University of Phoenix
RN/BSN -
Roxborough School of Nursing
Similar Profiles
Debra CaldwellDebra Caldwell
Independent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health ChoicesIndependent Contractor – Member Services at AmeriHealth Caritas Pennsylvania - Medicaid & Keystone First – AmeriHealth Caritas Pennsylvania Community Health Choices – Keystone First Community Health Choices
Timothy DetmanTimothy Detman
Manager, Business Systems Analysis at AmeriHealth CaritasManager, Business Systems Analysis at AmeriHealth Caritas
Tiesha ReidTiesha Reid
Personal Care Connector at AmeriHealth Caritas of DelawarePersonal Care Connector at AmeriHealth Caritas of Delaware
DAQUICE PEARSONDAQUICE PEARSON
Provider Enrollment Specialist at AmeriHealth CaritasProvider Enrollment Specialist at AmeriHealth Caritas
Daniel YuDaniel Yu
Sales Manager at Hair CoutureSales Manager at Hair Couture