Summary
Overview
Work History
Education
Skills
Affiliations
Certification
Professional Licenses
References
Timeline
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Deborah Jones

Deborah Jones

Jurupa Valley,CA

Summary

Hardworking and motivated Utilization Manager with 19 years of experience and record of success in the Healthcare industry. Solid history balancing team performance, customer service targets and business objectives. Decisive leader with good planning and organizational skills. Seeking a Directors position where my skills, education and experience can effectively contribute to a company’s growth and profit goals.

Overview

19
19
years of professional experience
1
1
Certification

Work History

Manager of Utilization Management

Kaiser Permanente Medical Center
Fontana, California
10.2019 - Current
  • Led and coached case managers, which contributed to the achievement of magnet status
  • Ensures cost effective and quality patient care by appropriate utilization of resources
  • Provides direction to staff, which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation, and others as assigned
  • Assist staff in reducing our average length of stay in rounds by discussing any discharge barriers to ensure that our patients have a safe, appropriate, and timely discharge plan
  • FMC has remained consistent with being at the top spot for readmission in reduction performance in SCAL
  • Our Patient Day Rate (PDR) has improved -8.39% from December 2022 to December 2023
  • Utilizing our alternative programs, such as AMACH and ECAH has assisted in reducing our PDR
  • Created and implemented outlines for staff to utilize when rounding face-to-face with their physicians to ensure that they are gathering the pertinent information regarding their patients discharge plan
  • In addition, created another outline for the case managers to utilize to ensure that they are knowledgeable regarding their patients when reporting during the CWD rounds
  • These outlines were implemented to ensure that our patients have a safe, appropriate, and timely discharge plan
  • Co-Lead of the Mobility Work Group. I collaborate with nursing leaders, physical therapists, and physicians to ensure that our patients are getting up to sit or walk. This group was created to aid in ensuring that our patients are being mobilized while in the hospital to prevent them from being discharged to a skilled nursing facility
  • Implemented the mobility tool to assess our patients’ mobility level
  • This tool was piloted at Fontana Medical Center and then implemented at the Ontario Medical Center
  • The outcome is that this tool is being utilized on the units to improve our patient’s mobility
  • Co-Lead of the Hospitalists and Case Managers’ Huddle Improvement Project
  • Implemented case manager and Hospitalist daily face-to-face in-person rounding and implemented the CWD newsletter that is distributed monthly
  • Implemented in-person rounds on Thursdays and Fridays with hospitalists, case managers, and the interdisciplinary team. These rounds have assisted in reducing our length of stay and have aided in building a relationship between the hospitalists and case managers
  • Significant improvement from April 2023-September 2023 in my people pulse scores. I was asked to be a mentor to managers who have received low scores
  • I have increased my engagement score by 6 points compared to my last score in March
  • My engagement score is higher than the average score in Southern California
  • A 100 % of my staff completed their people pulse survey
  • In all of the categories in the people pulse, I improved my score as high as 8 points than was scored in March.

RN Clinical Case Manager (Per Diem)

University of California Los Angeles Medical Center
Los Angeles, California
10.2018 - Current
  • Perform UR and discharge planning to assist patients who are on Medical Surgical, Oncology, ICU, Geriatrics, Pediatrics, and Orthopedic units
  • Utilize this position to keep myself informed of other trends in case management to improve my FMC team’s performance
  • Participated in performance improvement projects/processes and other duties as assigned
  • Chosen as a preceptor for new employees in my department.
  • Created strategies to help clients reach their goals through self-advocacy skills training.

Nurse Manager

Baylor Scott & White Medical Center
Sunnyvale, Texas
01.2018 - 09.2018
  • Successfully managed a team of 40, which included clinical nurses, assistant nurse managers, and patient care technicians on the Medical Surgical unit in a 70-bed hospital
  • Developed a mentorship program for newly hired assistant nurse managers, and mentored charge and clinical nurses
  • Through collaboration with my nursing staff and nursing leaders my departments HCAHPS scores significantly improved from 30% to 70% by implementing hourly rounding.
  • Promoted a positive work environment through effective communication with staff members.

Assistant Nurse Manager, Telemetry

University of Texas Southwestern Medical Center
Dallas, TX
04.2017 - 01.2018

· Managed a team 90, which was composed of clinical registered nurses and patient care technicians in a 751-bed facility.

· Coached and trained staff how to care for patients on the Pulmonary Hypertension and Cystic Fibrosis unit.

Implemented hourly rounding, which improved our HCAHPS scores

Assistant Nurse Manager, Care Coordination

University of Texas Southwestern Medical Center
Dallas, TX
03.2016 - 04.2017
  • Worked together with patients and their families to facilitate discharge planning
  • Collaborated closely with social workers and to ensure that home health, SNF, or DME was ordered for our patients when discharged
  • Led daily rounds with physician and interdisciplinary team on the Pulmonary Hypertension and Cystic Fibrosis unit.

Inpatient RN Case Manager

Texas Health Presbyterian
Rockwall, Texas
12.2014 - 01.2018
  • Performed Discharge planning and Utilization review on Medical Surgical and Orthopedic unit in a 60-bed facility
  • Chosen as a preceptor for new employees in my department.

Hospice RN, BSN, PHN

Heartland Hospice
Hurst, Texas
07.2013 - 09.2016
  • Cared for patient who have been diagnose with 6 months or less to lives to ensure that they are comfortable and are receiving quality end of life care
  • Provided symptom management, educated families regarding the dying process, and provided support of comfort.

High-Risk Outpatient RN Care Manager

Baylor Scott & White Medical Center
Dallas, Texas
08.2013 - 12.2014
  • Developed the curriculum for training new employees during their orientation and employment
  • Chosen as a preceptor for new employees in my department.

Home Health Hospice and Palliative RN/PHN

Kaiser Permanente
Downey, California
03.2009 - 07.2013
  • Provided individualized care based on each patient unique needs focusing on their comfort and quality of life
  • Served as a committee member of the Labor/Management Partnership
  • Chosen as a preceptor for new employees in my department.

Operating Room Nurse

Saint John’s Health Center
Santa Monica, California
01.2009 - 03.2009
  • Worked as a circulating nurse for Urology, Vascular, Colorectal, Thoracic, Robotic Prostatectomy, and Kidney Transplants in a 266-bed facility
  • This facility has 12 operating rooms suites
  • Assisted the anesthesiologist with positioning the patient for intubation.

Operating Room Nurse

Cedar Sinai Medical Center
Los Angeles, California
09.2005 - 11.2008
  • Chosen as a Charge nurse that houses 40 operating room suites
  • Worked as a circulating nurse for Urology, Vascular, Colorectal, Thoracic, Robotic Prostatectomy, and Kidney Transplants in a 915-bed facility
  • Chosen as the lead preceptor for new employees in the operating room

Telemetry/Medical Surgical Nurse

Kaiser Permanente
Bellflower, California
11.2004 - 08.2005
  • Performed my nursing duties, which entailed nursing head to toe assessments, administered medication safely utilizing nursing principles, and performing real time documentation.

Education

Doctor of Education - Option - Education & Leadership in Healthcare

Nebraska Methodist College
08.2019

Master of Science in Nursing - Option - Nursing Administration

California State University - Los Angeles
03.2015

Associate of Arts in Nursing -

Mt. Saint Mary’s College
12.2007

Associate of Arts in Liberal Arts -

Mt. San Antonio Community College
06.2004

Bachelor of Science in Nursing -

California State University - Los Angeles

Skills

UM Department Manger

Manager with 5 years’ experience in Utilization Management overseeing a department of 70 employees Manages the day-to-day operations of the Utilization Management Department in a tertiary teaching facility, which is the biggest service area in Kaiser Manage RN case managers, Travelers, and FMC clerical staff

FMC UBT Co-Lead

Reached Level 5 status, which is the first in Fontana Medical Center (FMC) Unit Based Team's (UBT) History Our UBT was selected to present our Medicare Meals project in the DA meeting Our project was Medicare Meals Our goal was for our case managers to improve the referral rate of ordering these meals from 53% to 70% When we finished our project, our referral rate was 100% Our UBT was selected to present our Medicare Meals project in the DA Meeting

Team Excellence Award Enhanced Care at Home

Team Excellence Award for our Enhanced Care at Home (ECAH) program This program’s goal was to provide an alternative for patients appropriate for skilled nursing facility (SNF) care The patients in this program are managed in the comfort of their home, and SNF related risks, such as infection, are reduced and allows for patients who need higher acuity to receive care in the SNF An estimated total of 54 million dollars has been saved from SNF diversion This also allows for decreased SNF discharge rate for SBC allowing lower acuity patients to be rehabbed at home, opening SNF bed capacity for higher acuity patients This program was started in SBC

Team Excellence Award Extended Length of Stay

Team Excellence Award for the strong work in reducing our extended length of stay (ELOS) Implemented daily follow-up on action items from CWD rounds and weekly ELOS meetings Implemented real time escalations Instructed case manager to escalate any issues in real time Worked with the interdisciplinary team, which resulted in an significant reduction from May 2023 to July 2023 in ALOS with an estimated 83 million dollars saved for SBC

Implemented On-site DME Hub

Partnered with Apria to implement a curbside pickup for COVID patients who needed oxygen when discharged When COVID was at its peak, this program allowed our patients and family members to drive up at curbside to receive their oxygen An Apria liaison would place the oxygen equipment in their trunk to aid in preventing the spread of COVID from person-to- person This partnership improved throughput and reduced DME delays from 1 week to 2 days

Kaiser Permanente Case Manager On-site Presence at St Mary’s Medical Center

Launched a new initiative that allows our Kaiser case managers to be on-site at Saint Mary’s to ensure that our patients have a safe and appropriate discharge plan This partnership has enabled Kaiser to have oversight over our patients’ care, ensuring that they are receiving quality care This partnership has also assisted in our reducing the length of stay and patient day rate (PDR) My role is to optimize discharge planning to decrease length of stay and eliminate discharge barriers by managing my staff efficiently

Advanced Medica Care at Home (AMCAH)

Collaborated with AMCAH Team in implementing the program at the height of COVID at FMC This program allows our patients to receive IV infusion in the comfort of their home instead of being discharged to a SNF Fontana Medical Center (FMC) did so well in implementing this program that the AMCAH template we used in SBC to launch this program is being utilized in all Kaiser medical centers

Managed members and non-members strike transfers when work stoppage was imminent in November 2021 Received acknowledgement from SBC senior leadership for critical performance in expatriating patients

Enhanced Rounds

Implemented Enhanced rounds to decrease our length of stay Our average length of stay has improved by- 522% December 2022 to December 2023 This was accomplished by increasing employee oversight and instructing staff to escalate in real time Implemented increasing the rounds frequency as well as doing sweeps has also assisted in decreasing our length of stay

Affiliations

American Nurses Association -#03371457

Certification

  • Certificate of Completion - Lean Six Sigma Yellow Belt
  • Certificate of Completion - Essentials of Supervision at UT Southwestern Medical Center

Professional Licenses

  • Registered Nurse - CA #646880
  • Public Health Nurse #74012

References

References available upon request.

Timeline

Manager of Utilization Management

Kaiser Permanente Medical Center
10.2019 - Current

RN Clinical Case Manager (Per Diem)

University of California Los Angeles Medical Center
10.2018 - Current

Nurse Manager

Baylor Scott & White Medical Center
01.2018 - 09.2018

Assistant Nurse Manager, Telemetry

University of Texas Southwestern Medical Center
04.2017 - 01.2018

Assistant Nurse Manager, Care Coordination

University of Texas Southwestern Medical Center
03.2016 - 04.2017

Inpatient RN Case Manager

Texas Health Presbyterian
12.2014 - 01.2018

High-Risk Outpatient RN Care Manager

Baylor Scott & White Medical Center
08.2013 - 12.2014

Hospice RN, BSN, PHN

Heartland Hospice
07.2013 - 09.2016

Home Health Hospice and Palliative RN/PHN

Kaiser Permanente
03.2009 - 07.2013

Operating Room Nurse

Saint John’s Health Center
01.2009 - 03.2009

Operating Room Nurse

Cedar Sinai Medical Center
09.2005 - 11.2008

Telemetry/Medical Surgical Nurse

Kaiser Permanente
11.2004 - 08.2005

Doctor of Education - Option - Education & Leadership in Healthcare

Nebraska Methodist College

Master of Science in Nursing - Option - Nursing Administration

California State University - Los Angeles

Associate of Arts in Nursing -

Mt. Saint Mary’s College

Associate of Arts in Liberal Arts -

Mt. San Antonio Community College

Bachelor of Science in Nursing -

California State University - Los Angeles
Deborah Jones