Summary
Overview
Work History
Education
Skills
Timeline
Generic

CARLA D. CARTER, BSN,RN

West Chester

Summary

Professional and dedicated Registered Nurse with experience ensuring high standards of culturally competent care for a variety of patients with diverse needs.

Overview

31
31
years of professional experience

Work History

Care Manager

The Christ Hospital Health Network
01.2023 - Current
  • Enhanced patient care by developing and implementing individualized care plans.
  • Improved patient satisfaction through effective communication and collaboration with interdisciplinary healthcare teams.
  • Reduced hospital readmission rates by providing comprehensive discharge planning and follow-up support.
  • Promoted patient self-management by providing education on chronic condition management and healthy lifestyle choices.
  • Managed complex caseloads, ensuring timely assessment, intervention, and documentation for optimal care outcomes.
  • Collaborated with insurance providers to secure authorization for necessary services, maximizing patients'' benefits coverage.
  • Conducted thorough assessments to identify patients'' needs, strengths, and barriers to achieving optimal health outcomes.
  • Monitored patient progress closely, adjusting care plans as needed to promote ongoing improvement.
  • Developed strong rapport with patients and families through empathetic listening and compassionate communication techniques.
  • Maintained up-to-date knowledge of community resources by networking with local organizations and attending professional development opportunities.
  • Served as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals for seamless care coordination efforts.
  • Utilized electronic health records systems proficiently for efficient documentation of clinical information according to regulatory standards.
  • Prioritized time management effectively balancing competing demands within dynamic fast-paced healthcare environments.
  • Participated in interdisciplinary case conferences fostering teamwork collaboration sharing best practice insights to optimize patient care outcomes.
  • Educated clients and families on community resources, treatment options and health care services to better manage conditions.
  • Participated in team meetings and trainings to stay updated on best practices and new developments in care management.

Ambulatory Clinical RN Operations Supvr-Education

UC Health
09.2021 - 12.2021
  • Ongoing Supervision of the Ambulatory Education Program
  • Direct supervision for Ambulatory Staff Educator
  • Create, revise, and update Ambulatory Policies, Standard of Practice and Competencies for Medical Assistants and Licensed Practice Nurses
  • Oversees, created, and conducts Ambulatory MA/LPN/RN New Hire Orientation with Competency Checkoffs, Annual MA/LPN Skill Competency Checkoffs, and skill remediation sessions
  • Finalizes New Hires “Clear to Start List”
  • Initiated/co-developed/perform electronic checkoffs for the Ambulatory MA/LPN competencies
  • Creates/maintains/updates various Excel Spreadsheets for Ambulatory MA/LPN New Hire onboarding/Orientation
  • Coordinated Ambulatory MA/LPN/RN New Hire Orientation Point of Care Training (POC)
  • Co-created/updates/conducts various MA/LPN trainings
  • Co-created/updates/conducts virtual MA Preceptor Trainings for new MA Preceptors and MA Preceptor Refresher courses
  • Assist with uploading of competency modules in myKnowledge/One Touch for staff as needed
  • Maintains/updates orientation power point slides
  • Ongoing communications with the HR-TA, EPIC Team/Trainers, UCMC Educators, POC Trainers
  • Prep for 2-day New Hire Orientation
  • Initiated/co-developed/perform electronic checkoffs for MA/LPN competencies
  • Monitors MA/LPN Skills Fair Competency Excel Spreadsheet
  • Monitors MA/LPN myKnowledge Training Transcripts/One Touch for various competencies
  • Maintenance of the various Ambulatory Education Audiences in myKnowledge/One Touch competencies
  • Coordinates and conducts in-person and virtual training for Specialty Clinics for Nasopharyngeal and Anterior Swabbing with Fit Testing
  • Provided Covid Testing in Ambulatory Clinics
  • Coordinates the scheduling of the Specialty Clinics, TEAMS meetings and onsite competency trainings for NP/Anterior Swabbing & Fit Testing
  • Ongoing communication with Employee Health regarding Fit Testing and supplies
  • Inventory/ordering of supplies & equipment for Fit Testing, and skills training/testing
  • Maintenance/Updating of the Weekly Team Meeting Ambulatory Education MA/LPN Power Point presentations
  • Assign and create Oracle Training assignments for the Ambulatory Division
  • Facilitates Bi-weekly Ambulatory Education/Director/Manager Workgroup Meetings
  • Creates Ambulatory Education power point slides for Ambulatory Core Huddle Meetings; Director/Manager Meetings
  • Create/facilitate/collaborates other meetings as needed
  • Responds to various emails from Directors/Managers, Staff
  • Assumes other responsibilities as assigned


Ambulatory Complex Care Manager Registered Nurse

TriHealth
03.2021 - 08.2021
  • Improved and increased appropriate utilization of healthcare such as ED visits, inpatient admissions and readmissions
  • Initiated care management interventions that increased patient self-management activities and improved quality of life
  • Managed minimally a panel of 36 enrolled patients monthly, using evidence based care such as Standards of Practice for Case Managers, NCQA Standards for Case Management, and program description
  • Utilized both clinical and claims reports, risk and predictive modeling reports to identify high risk patients that would benefit from enrollment
  • Developed collaborative individualized plan of care with patient, which included measurable long and short term goals, with monthly reassessment and updates
  • Ongoing collaboration with multidisciplinary team members across the continuum of care, such as Primary Care Specialty providers, Social Workers, Population Health Pharmacists, and Community Health Workers
  • Provided support services to PHO and all of it's value-based contract members
  • Completed all corporate and departmental assigned trainings and attended monthly meetings

Manager of Patient Services RN

Cincinnati Children's Hospital Medical Center
10.2018 - 03.2021
  • Provides daily ongoing operational management, supervision and clinical support to Psychiatric Division. Conducts daily shift Safety Huddles with Mental Health Specialists, and RN Nurse Huddles for daily reporting and operational updates of current patient census, patient flow maintenance and facility issues and concerns
  • Continual communication, collaboration and mitigation with interprofessional teams within Psychiatric Division and CCHMC multidisciplinary teams regarding patient placement and transport flow
  • Performs bed analysis and placement for psychiatric admissions to appropriate age milieu/unit with CCHMC ED Psychiatry Intake Response Coordinators (P.I.R.C.)
  • Escalates appropriate communication regarding any issues and concerns of operational maintenance, patient and family concerns , staffing issues to MPS Director, Clinical Managers, Unit Directors and Administrator on Call of the Division
  • Coordinates and mitigates with Staffing Office regarding staffing of personnel for nine inpatient and four residential units
  • Addresses any patient and family concerns with collaboration of Multidisciplinary teams throughout Psychiatry Division and CCHMC
  • Participates in various work flow and competency committees within Psychiatry Division and with other CCHMC interprofessional teams

Utilization Review RN Care Management Specialist

Mercy Health System - Mercy Fairfield Hospital
07.2018 - 10.2018
  • Collaboration with physicians and clinical staff in initiation, development, and integration of ongoing clinical assessment, patient care planning and education, assessment of patient progress through continuum of care and evaluation of discharge planning necessary for achievement of determined outcomes
  • Proactive and responsible for screening patients for appropriate level of care, for determination of medical necessity and for discharge planning needs
  • Acts as resource to medical staff and other health care disciplines regarding utilization or resources, quality of care, and clinical aspects of coding
  • Initiates review and correspondence in matter of denial payments and appeal process as appropriate
  • Functions as internal and external liaison for appropriate patient referrals within scope of discharge planning

Clinical Documentation Improvement Specialist, RN

Advocate Christ Medical Center
02.2016 - 06.2018
  • Responsibilities include improving overall quality and completeness of clinical documentation
  • Working knowledge of chart documentation, DRG payer issues, regulations, compliance requirements, and case finding strategies
  • Continuous collaboration with team members, Health Information Management(HIM) staff, and all members of healthcare team, to accurately reflect each patient's severity of illness
  • Participates in monitoring of quality indicators, and creates utilization issues for identified documentation deficiencies
  • Cerner and 3M/360 ICD 10 Systems documentation and tracking
  • Daily CDIS and coder DRG reconciliations
  • Self-directed with astute judgment skills. High level of personal accountability
  • Ensured HIPAA compliance. Ensured efficacy of treatments through monitoring of treatment regimens.

Clinical Documentation Improvement Specialists, RN

Metro South Medical Center
08.2015 - 01.2016
  • Responsibilities include improving overall quality and completeness of clinical documentation
  • Working knowledge of chart documentation, DRG payer issues, regulations, compliance requirements, and case finding strategies
  • Continuous collaboration with team members, Health Information Management(HIM) staff, and all members of healthcare team, to accurately reflect each patient's severity of illness
  • Provides ongoing documentation education for healthcare team through daily Rounds, Doctor's lounge information board, face-face and telephone discussions
  • Participates in monitoring of quality indicators, and creates utilization issues for identified documentation deficiencies
  • Cerner, HMS and 3M/360 ICD 9 & 10 Systems documentation and tracking
  • Make daily assignments in 360 and weekly work flow assignments
  • Performs daily Case Management Rounds, SICU, Med/Surg and Specialty Unit Rounds(Mother/baby; Special Care Nursery, Telemetry, & Observation)
  • Weekly CDI team telephone conference call with Corporate CDIS Director, with CFO and HIM Director
  • Bi-weekly CDI/Coder Round Table collaboration meetings
  • Access and run daily LOS/Outlier reports and Working DRG Reports for ongoing monitoring of extended LOS days and CDIS & coder DRG reconciliations
  • Run monthly 20D and Parking Meter(Query) tracking reports for assessment month end financial variances/impact
  • Self-directed with astute judgment skills. High level of personal accountability
  • Ensured HIPAA compliance
  • Ensured efficacy of treatments through monitoring of treatment regimens

Director of Nursing/Alternate Agency Supervisor

Caring Hands Devotional Home Health Agency, Inc
08.2014 - 06.2015
  • Planned, organized, directed and evaluated operations of home health agency, to ensure appropriate nursing care services
  • Recruited, employed and retained personnel for staffing
  • Developed and conducted new hire orientations and continuing educational opportunities
  • Performed ongoing tasks of employee performance evaluations, Quality Assurance and utilization review monitors, in accordance with compliance of applicable laws and regulations
  • Overseen and managed 40+ clinical and support staff in patient care activities while maintaining high level of staff morale and professionalism
  • Ensured HIPAA compliance
  • Delegated staff nurse duties
  • Provided on-call nursing support at all times of day/evening
  • Developed and produced all office flyer notifications for important policy changes, office news and events
  • Maintained all confidential personnel files, license and CPR compliance records

Clinical Documentation Improvement Specialist, RN I

Rush University Medical Center
10.2012 - 07.2014
  • Responsibilities include improving overall quality and completeness of clinical documentation
  • Working knowledge of chart documentation, DRG payer issues, regulations, compliance requirements, and case finding strategies
  • Continuous collaboration with team members, Health Information Management (HIM) staff, and all members of healthcare team, to accurately reflect each patient's severity of illness
  • Provides ongoing documentation education for healthcare team
  • Participates in monitoring of quality indicators, and creates utilization issues for identified documentation deficiencies
  • EPIC, & 3M/360-ICD-9 & 10 Systems documentation and tracking
  • Self-directed with astute judgment skills. High level of personal accountability
  • Ensured HIPAA compliance
  • Ensured efficacy of treatments through monitoring of treatment regimens

Nurse Coordinator/Case Manager, Outpatient Pulmonary Medicine Department

Cincinnati Children's Hospital Medical Center
06.2004 - 08.2012
  • Responsibilities included case management of large patient base, as well as telephone triage of high call volume and continuous follow-up care for patient outcomes
  • Provided clinical nursing support within outpatient clinic setting
  • EPIC documentation and tracking (02/2008).
    Assessed need for, ordered, obtained and interpreted appropriate lab tests
  • Pharmacological and non-pharmacological management and treatment of various disorders and
    diseases
  • Self-directed with astute judgment skills. High level of personal accountability
  • Performed lab tests and communicated results
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans
  • Instructed patients and family members on proper discharge care
  • Closely monitored acute conditions.
    Ensured HIPAA compliance
  • Documented patient information obtained from interviews
  • Authorized drug refills and provided detailed prescription information to pharmacies
  • Collected blood, tissue and other laboratory specimens and prepared them for lab testing.
    Routinely retracted patient throat cultures and prepared for lab submission.

Clinical Nurse I, Emergency Department

Cincinnati Children's Hospital Medical Center
10.1995 - 06.2004
  • Provided emergent/urgent care in Emergency Department for over nine+ years
  • Duties included triage of ambulatory, squad, and helicopter transported patients, performing
    various types of clinical care and procedures
  • SANE(Sexual Assault Nurse Examiner)Nurse and unit preceptor
  • Charge nurse
  • Strong leader for nursing personnel assigned to unit/shift
  • Scheduled patient admissions and ER discharges.
    Routinely retracted patient throat cultures and prepared for lab submission
  • Assessed need for, ordered, obtained and interpreted appropriate lab tests
  • Counseled and educated patients about reproductive health issues and wellness
  • Primary care, assessment and evaluation of neonatal and pediatric patients
  • Overseen and managed 35+ clinical and support staff in patient care activities while maintaining a
    high level of staff morale and professionalism
  • Examined patients and dispensed contraceptives and other medications as needed
  • Pharmacological and non-pharmacological management and treatment of various disorders and
    diseases. Self-directed with astute judgment skills
  • High level of personal accountability
  • Effective counseling in health maintenance and disease management
  • Performed lab tests and communicated results
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans
  • Instructed patients and family members on proper discharge care
  • Closely monitored acute conditions
  • Demonstrated ability to lead and motivate outstanding healthcare teams in ER
  • Ensured HIPAA compliance
  • Ensured proper care for victims of domestic violence who presented to urgent care clinic
  • Documented patient information obtained from interviews
  • Performed basic physical assessments of newborns, infants, adolescent and young adults
  • Delegated staff nurse duties
  • Ensured efficacy of treatments through monitoring of treatment regimens
  • Followed infection control procedures
  • Performed pregnancy tests and sent specimens for laboratory testing
  • Assisted doctors with minor surgical and non-invasive procedures
  • Authorized drug refills and provided detailed prescription information to pharmacies.

Registered Nurse Case Manager

Integrated Comp, Inc
01.2000 - 01.2002
  • Provided case management and medical authorization of treatment for Ohio Bureau of Worker's Compensation and State of Ohio Department of Rehabilitation and Corrections
  • Pharmacological and non-pharmacological management and treatment of various disorders and
    diseases
  • Self-directed with astute judgment skills. High level of personal accountability
  • Effective counseling in health maintenance and disease management
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans
  • Instructed patients and family members on proper discharge care
  • Ensured HIPAA compliance.

Graduate Nurse

Cincinnati Children's Hospital Medical Center
10.1993 - 03.1995
  • Medical/Surgical Post-Operative Unit
  • Scheduled patient admissions and discharges
  • Collected blood, tissue and other laboratory specimens and prepared them for lab testing
  • Assisted patients with bathing, dressing, feeding, lifting and transferring
  • Measured urine and delivered specimens to lab
  • Monitored fluid intake and output levels
  • Assisted patients with daily functions
  • Followed infection control procedures
  • Performed basic physical assessments of newborns, infants, adolescent and young adults
  • Documented patient information obtained from interviews
  • Developed patient care plans, including assessments, evaluations and nursing diagnoses
  • Developed and implemented nursing care plans
  • Participated in unit-based Quality Assurance Program
  • Ensured HIPAA compliance
  • Closely monitored acute conditions
  • Instructed patients and family members on proper discharge care
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans
  • Performed lab tests and communicated results.
    Managed care for post-operative patients through discharge
  • Pharmacological and non-pharmacological management and treatment of various disorders and diseases
  • Primary care, assessment and evaluation of neonatal and pediatric patients
  • Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 8-10 patients per shift
  • Assessed need for, ordered, obtained and interpreted appropriate lab tests.


Education

Master of Science - Nursing Executive Leadership

Northern Kentucky University
Highland Heights, KY

Bachelor of Science - Nursing

College Of Mount St. Joseph
Cincinnati, OH
2008

Diploma of Nursing -

The Christ Hospital School Of Nursing With Cohort Program With Xavier University.
Cincinnati, OH
1993

Skills

  • Strong clinical judgment
  • Neurology awareness
  • Acute care expertise
  • Palliative care awareness
  • Preceptor
  • High level of autonomy
  • Problem resolution capability
  • Adept at prioritizing/managing deadlines
  • Sound decision maker
  • Calm under pressure
  • Fast thinking
  • Independent judgment and decision making
  • Promotes positive behavior
  • Quality improvement competency
  • Qualified critical care nurse
  • Hospice philosophy understanding
  • Multidisciplinary Team Collaboration
  • Operational Standards
  • Project Implementation
  • Creative Thinking
  • Healthcare Personnel Supervision

Timeline

Care Manager

The Christ Hospital Health Network
01.2023 - Current

Ambulatory Clinical RN Operations Supvr-Education

UC Health
09.2021 - 12.2021

Ambulatory Complex Care Manager Registered Nurse

TriHealth
03.2021 - 08.2021

Manager of Patient Services RN

Cincinnati Children's Hospital Medical Center
10.2018 - 03.2021

Utilization Review RN Care Management Specialist

Mercy Health System - Mercy Fairfield Hospital
07.2018 - 10.2018

Clinical Documentation Improvement Specialist, RN

Advocate Christ Medical Center
02.2016 - 06.2018

Clinical Documentation Improvement Specialists, RN

Metro South Medical Center
08.2015 - 01.2016

Director of Nursing/Alternate Agency Supervisor

Caring Hands Devotional Home Health Agency, Inc
08.2014 - 06.2015

Clinical Documentation Improvement Specialist, RN I

Rush University Medical Center
10.2012 - 07.2014

Nurse Coordinator/Case Manager, Outpatient Pulmonary Medicine Department

Cincinnati Children's Hospital Medical Center
06.2004 - 08.2012

Registered Nurse Case Manager

Integrated Comp, Inc
01.2000 - 01.2002

Clinical Nurse I, Emergency Department

Cincinnati Children's Hospital Medical Center
10.1995 - 06.2004

Graduate Nurse

Cincinnati Children's Hospital Medical Center
10.1993 - 03.1995

Master of Science - Nursing Executive Leadership

Northern Kentucky University

Bachelor of Science - Nursing

College Of Mount St. Joseph

Diploma of Nursing -

The Christ Hospital School Of Nursing With Cohort Program With Xavier University.

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CARLA D. CARTER, BSN,RN