Christopher Grassi

• Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient’s provider benefits for their needs.
• Conducts and oversees concurrent and retrospective reviews for all patients.
• Act as a liaison between Medicaid reviewers and the staff completing required paperwork to facilitate the Utilization Review process.
• Collaborates with physicians, therapist and nursing staff to provide optimal review based on patient needs.
• Collaborates with ancillary services in order to prevent delays in services.
• Evaluates the UM program for compliance with regulations, policies and procedures.
• May review charts and make necessary recommendations to the physicians, regarding utilization review and specific managed care issues.
• Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation

• Develop and monitor individual treatment plans,
• Review and revise treatment objectives,
• Collaborate with Licensed Psychologist to insure services provided are of high quality and clinically necessary. Maintain clinical documentation
• Advised patients about in-home treatments and exercises to help ailments heal.
• Taught patients how to properly use exercise techniques.
• Guided clients in development of skills and cognitive behavioral therapy techniques.
• Documented client progress and maintained confidential records.
• Developed treatment plans to address individual client needs.
• Provided community resources and referrals to clients.4
• Quickly built trust and rapport with clients to facilitate growth.
• Provided community resources and referrals to clients.
• Maintained records of each patient and kept up-to-date on progress.

-Collaborates daily with leadership team to design and develop care managment in support of departmental goals and hospital and system vision. Assisting with day to day departmental operations, rotating on-call schedule to ensure support to the care management team

-Daily staffing allocation to ensure optuimal utilization of resources and coverage to hospital units

-Establish and maintain professional relationships within and outside the organization, regular communication with vendors and liaisons

-Manages a caseload according to care manager responsibilities as needed (approx. 3-5 times per week based on staffing needs)

-Evaluate staff development needs an provide opportunities for ongoing professional development, completing quarterly employee work validations and continued competency accorcing to the care manager responsibilities

• Educated and evaluated clinical and support staff regarding care quality management regulations and standards of care.
• Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
• Arranged transportation and documented details of discharge transition plans.

-Collaborate daily with the interdisciplinary team to ensure a safe discharge plan is devised for all patient identified to benefit from discharge planning services

-Complete assessments on patients in a defined caseload as warranted by conditions of participation

-Support quality care and service delivery to patients after discharge

-Provide input in treatment decisions and present treatment plans to the interdisciplinary team

-Collaborate with patients, family and others to determine appropriate goals for patients during the course of treatment

-Complete timely documentation in the medical record as applicable

-Lead and manage social services assistant when available

- Complete Resident assessments including care plans and orchestrate discharge plans as needed for short term residents

-Ensure emotional and social needs of residents are maintained on an individual basis as they relate to medical conditions and needs

-Provide excellent customer services through managing the resident greivance process

-Lead care plan meetings with the interdisciplinary team and ensure the resident and family are in agreement with care plan

-Ensure emotional and social needs of residents are maintained on an individual basis as they relate to medical conditions and needs

-Provide excellent customer services through managing the resident greivance process

-Lead care plan meetings with the interdisciplinary team and ensure the resident and family are in agreement with care plan

-Responsible for all admissions paperwork and assigned marketing and sales related activities to achieve occupancy and payor mix goals.

-Responsible for internal admissions process, party sources, concession ration, and other related revenue generating practices in conjunction with census development

-Responsible for intimate knowledge of market area competitors

-Maintain close relationships with the interdisciplinary to ensure appropriate treatment is available for all admitting residents

-Serve as fill-in for Social Services as needed

-Responsible for knowledge of payers and navigating payor benefits to ensure coverage for admitting residents

-Responsible for identifying qualifications for admissions to skilled nursing facilities as defined by CMS

-Served as Marketing Director for Scranton Healthcare Center- a sister facility of Dunmore Healthcare Center

-Manage and lead the Service Coordination team of 6 service coordinators for the Scranton Office covering 13 Counties

-Review care plans as completed the the service coordinators and collaborate to ensure appropriate service delivery prior to submission to the PA State office of Long Term Living (OLTL)

-Ensure appropriate caseload assignment and service area coverage for each service coordinator

-Conduct daily staff huddles to ensure timely delivery of updates to program information as delivered through the Office of Long Term Living

-Identifies and monitors the services provided to participants through the PA Waiver Programs and applicable regulations to determine quality of services provided and verifies whether the type, amount, scope, duration and/or frequency of services need to be adjusted.

-Completes all necessary forms enabling participants to continue to receive services in the timeframe established by program guidelines and with the Agency’s established standards.

-Prepares and completes all forms and documentation as required in state systems HCSIS and SAMS

-Manages a defined caseload as assigned by the Service Coordination Administrator

-Ensure timely home visits are completed on all participants