Skilled professional offering 3+ years' experience in reviewing compliance standards and auditing charts. Knowledgeable in medical data gathering and analysis. Self-motivating professional promoting attention to detail and the drive to resolve issues effectively. Calm and poised in the most stressful environments. Seeking the opportunity to join new organization in the role of Utilization Review Clinician.
Overview
1
1
Certification
28
28
years of professional experience
Work History
Performance Outcomes Clinician
Community Health Center
Johnstown, NY
01.2020 - Current
Managed the OASIS process to ensure quality measures are completed in a timely manner for all disciplines.
Daily evaluation of Strategic Healthcare Programs (SHP) as primary audit tools to evaluate OASIS integrity
Ensure Plan of Care is reflective of patient diagnosis with oversight of the coding process to ensure regulatory compliance.
Communicate OASIS/POC/Documentation inconsistencies, omissions and/or discrepancies through direct contact with clinicians.
Utilized strong assessment skills to determine necessary patient care.
Developed and implemented evidence-based care plans.
Assessed healthcare needs of patients by conducting PT admissions.
Used Healthwyse to update electronic medical records with relevant and accurate patient information collected during patient admissions, recertification's, ROC's and discharges.
Serves as a clinical resource for OASIS education.
Physical Therapist
Visiting Nurse Service Of Northeastern New York
Schenectady, NY
01.2007 - 12.2019
Primary of role of Admission Clinician
Evaluated and assessed patients to establish measurable goals and promote restoration of functional abilities.
Incorporated clinical expertise, patient values and best evidence to drive clinical practice.
Maintained organized documentation and patient files.
Rendered highest quality of care when interacting with patients and families.
Identified and properly documented patient goals, evaluated progress and planned reevaluation.
Reviewed physician referrals and patient medical records to formulate accurate diagnosis and best course of treatment.
Designed treatment program to achieve established goals.
Directly supervised 2 physical therapy aides and managed caseload of 20-30 including PTA patients.
Physical Therapist
Sunnyview Rehabilitation Hospital
Schenectady, NY
06.1998 - 01.2007
Orthopedic Team leader from 2003-2007 with direct supervision provided to 4-5 team members.
Built work schedules and staff assignments, taking workload, space and equipment availability into consideration.
Maintained communication and transparency with governing boards, department heads and medical staff.
Collaborated with multi-disciplinary staff to improve overall patient care and response times.
Trained new staff members and completed Performance Appraisals on all team members
Met with team members monthly to provide program and departmental updates.
Performed evaluations and treatments on various patient populations including , but not limited to, Total Joint Replacements, CVA and various neurological conditions, TBI, Amputee, SCI, Cardiopulmonary, Ventilators, and Aquatics.
Evaluated effects of treatment at various stages, adjusting treatments to achieve maximum benefits.