Ayiesha Dukes
OKC,OK
Summary
Accomplished Registered Nurse (RN) with 18+ years of experience in long term care, Home Health and Hospice, including significant leadership as a Director of Nursing. Proven expertise in clinical oversight, quality assurance (QA), and utilization review to ensure medical necessity and regulatory compliance. Expert in managing interdisciplinary teams and complex care coordination within remote and hybrid environments. Seeking to leverage deep clinical judgment and operational leadership in a remote Case Management, Triage or Utilization Management role.
Overview
26
26
years of professional experience
1
1
Certification
Work History
RN/Director of Clinical Services - Hybrid position
1st Choice Home Health and Hospice
OKC
08.2023 - Current
- Direct clinical operations for a multidisciplinary home health and hospice team, managing an average of 180 patients. Ensuring 100% adherence to state and federal regulatory standards.
- Conduct comprehensive clinical documentation audits and Quality Assurance (QA) reviews to validate medical necessity and optimize resource utilization.
- Organize Case conference for RN’s, LPN’s, HHA’s, Physical and Occupational therapist, MSW, Chaplain. Ensuring that each patient meets CMS guidelines, to prevent ADR’s and improve/maintain star rating.
- Lead telephonic triage and clinical assessments, utilizing evidence-based protocols to determine appropriate levels of care and reduce hospital readmissions.
- Manage complex care transitions and discharge planning, collaborating with providers to ensure seamless patient care across the continuum.
Quality Assurance (QA) RN |100% Remote
Progressive Home Health
12.2022 - 08.2023
- Provided clinical oversight and quality assurance for Oasis and skilled nursing notes, for home health documentation, ensuring adherence to Medicare, state regulations, and company policies.
- Audited electronic medical records (EMR) remotely, focusing on accurate OASIS documentation and compliance to improve patient outcomes, star rating, and billing accuracy.
RN/Clinical Supervisor (100% Remote)
Select Home Care
OKC
01.2020 - 08.2023
- Managed a high-volume caseload in a 100% remote capacity, consistently meeting productivity and quality benchmarks.
- Performed remote utilization reviews of clinical records to ensure compliance with Care Plan requirements and Medicare/Medicaid guidelines.
- Served as a primary clinical resource for field staff, providing remote guidance on complex case management and intervention strategies.
- Facilitated virtual interdisciplinary group meetings to coordinate care for high-risk patient populations.
RN/Case Manager
Alpha Home Health and Hospice
OKC
04.2017 - 01.2020
- Provided clinical care and case management for 3-40 homebound patients, focusing on chronic disease management and end-of-life care.
- Coordinated with physicians, social workers, and therapists to develop and execute comprehensive individualized care plans.
- Educated patients and caregivers on disease processes, medication management, and symptom control to improve health outcomes.
RN/Case Manager
Alpha Home Health and Hospice
OKC
04.2017 - 01.2020
- Case managed up to 40 patients, Completed Start of Care, Recertification, supervisory, and discharge visits which included multi system assessments, medical record and medication profile review to create care plans, and coordinate multi disciplinary care.
RN/Oasis Coder
Expediting Coding management
OKC
02.2015 - 12.2015
- Audited skilled nursing charts, and accurately coded OASIS following CMS guidelines.
RN/Case Manager then promoted to Director of Nursing
Oklahoma Heritage Home Health
OKC
02.2011 - 02.2015
- Directed and coordinated all nursing care for an agency with over 400 patients.
- Completed billing daily, cutting cost where needed.
- Created teaching plans and developed nursing guides to educate the entire nursing staff and provide tools to teach patients during skilled nursing visits.
Licensed Practical Nurse
Abiding home health
OKC
06.2007 - 10.2009
- Provided skilled nursing visits in patients home following a care plan created by the physician and registered nurse/case manager. Assessment included multi system assessments, monitoring disease processes, diet, medication, and pain management, teaching where deficits existed.
LPN - Licensed Practical Nurse
OU Children's Hospital
OKC
12.2005 - 06.2007
- Assisted physicians during upper and lower gastrointestinal endoscopy procedures.
- Inserted naso gastric tubes prior to procedures.
- Completed physician orders for hospital admissions, scheduling procedures, appointments, and reordering medications.
- Phone Triage
Unit Specialist/Armorer
United States Army
Hanau, Germany
06.2000 - 02.2002
- Ordered and Issued Supplies to the company as needed including but not limited to weapons, ammunition and vehicles.
- Prepared various companies for training and combat during Iraqi Freedom.
Education
Associates of Applied Science - Nursing
Oklahoma State University
Oklahoma City, OklahomaSkills
- Clinical Operations: Medical Necessity Review, Utilization Management (UM), QA/OASIS Review, Triage
- Care Coordination: Case Management, Discharge Planning, Interdisciplinary Team (IDT) Leadership
- Compliance: HIPAA, CMS Regulations, Joint Commission Standards, HEDIS, ICD-10, CMS, and medicare guidelines
- Technology: Remote Collaboration (Teams/Zoom), EMR Systems: Kinnser/Wellsky, MS Office Suite
- OASIS fluent,
- IDG management for hospice
- Ensured consistent regulatory compliance by maintaining a deficiency-free documentation record through multiple unannounced CMS and State surveys
Certification
Basic Life Support (BLS): American Heart Association
Timeline
RN/Director of Clinical Services - Hybrid position
1st Choice Home Health and Hospice
08.2023 - Current
Quality Assurance (QA) RN |100% Remote
Progressive Home Health
12.2022 - 08.2023
RN/Clinical Supervisor (100% Remote)
Select Home Care
01.2020 - 08.2023
RN/Case Manager
Alpha Home Health and Hospice
04.2017 - 01.2020
RN/Case Manager
Alpha Home Health and Hospice
04.2017 - 01.2020
RN/Oasis Coder
Expediting Coding management
02.2015 - 12.2015
RN/Case Manager then promoted to Director of Nursing
Oklahoma Heritage Home Health
02.2011 - 02.2015
Licensed Practical Nurse
Abiding home health
06.2007 - 10.2009
LPN - Licensed Practical Nurse
OU Children's Hospital
12.2005 - 06.2007
Unit Specialist/Armorer
United States Army
06.2000 - 02.2002
Associates of Applied Science - Nursing
Oklahoma State University