Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Personal Information
Credentials
Additional Information
Work Availability
Work Preference
Timeline
AdministrativeAssistant

Donna Jo Smith

Summary

Summary of Experience: Epic, Microsoft Excel, Citrix, Outlook, Utilization Review using InterQual , MCG, and Milliman, E-prescribing software, Electronic Health Care Records among others as well 22 years management-Including House Supervisor for 210 bed hospital (7years), ED Director (6 years), Medical Director (2 years), Mother-Baby Director (1.5 years), ADON (8 years) 7 years ICU/CCU, 10+ years ER, Med/Tele, Travel Nurse, Teaching EKG readings, held AHA instructor 12 years Case Management includes EPIC, Outlook, Microsoft Excel, Citrix, virtual employee orientation, SME-subject matter expert, UR using InterQual ICD9 and ICD 10, Milliman, Telephonic assistance for insurance coverage for needs of specialty treatment, partnered with clients, families, and PCPs for best outcome, coordinate patient care utilizing clinical nursing skills and knowledge of resource management and clinical care requirements for post hospitalization disease specific care. Acute Care knowledge. Inpatient Care knowledge. End of Life discussion, hospice education. Work from home 6 years. 20+ years of budget achievement and successful director, UR, QA, Policy \Procedure\Protocols, including nursing care plans and treatments plans, Infection Control, RM, and QA state review preparation. JCAHO preparation, including chart review and abstraction for testing and outcome desires as ADON of Rural Hospital, also JCAHO ED remodel 38 bed ED, Accreditation Medical Manager for Boys' Residential Program for Juvenile Detention to direct supervision of nursing staff, Medical Provider, Psychiatrist, development of case management and treatment plans. Controlled budgeting of medical department, staff competency, staff ADA guidance/injury documentation and assessment, and teaching. Completed three state reviews and achieved Accreditations for the State of FL in which FL modeled other residential juvenile programs as this program.

Overview

39
39
years of professional experience
1
1
Certification

Work History

Administrative Assistant

Gospel Outreach Church
03.2023 - 12.2023
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
  • Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
  • Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.
  • Coordinated office supply inventory management, proactively ordering necessary items before depletion to avoid workflow disruptions.
  • Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents.
  • Assisted in onboarding new employees, providing training materials, and coordinating orientation schedules to ensure a smooth integration into the team.
  • Optimized calendar management for executives by scheduling appointments strategically while considering priorities and minimizing conflicts.
  • Assisted coworkers and staff members with special tasks on daily basis.
  • Built and maintained excellent customer relationships through timely response to inquiries and going above and beyond to accommodate unusual requests.
  • Continually sought methods for improving daily operations, communications with clients, recordkeeping, and data entry for increased efficiency.

Utilization Review Care Manager

Insight Global
02.2022 - 06.2022
  • Contract position for UM review of records for admission, CCR, OBS patient using MCG
  • Review of records 14 to 20 plus daily
  • New company contract
  • Assessed clients and developed plans to meet needs.

RN Case Manager

Affinity Hospice
08.2021 - 01.2022
  • Full time position as RN Case Manager for 18-25 patients home visits
  • Manage care for CAD, HTN, CHF, Cancer, COPD and other diseases or co-morbidities
  • Supervise care function of LPN and HHA
  • Produce Care Plan, Wound Care Plan
  • Use Home Care Home Base system to record patient visit, outcomes, Admission/Discharge/Deaths, Enclara for E-prescriptions and Tiger Text for team discussions and updates
  • Research treatment options and/or new exploration of medications/treatments
  • Other duties as needed/assigned
  • On Call volunteer as needed
  • Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
  • Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
  • Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
  • Educated patients and families on available community resources, facilitating access to necessary support services.
  • Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
  • Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
  • Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
  • Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
  • Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
  • Conducted thorough assessments of patients'' needs, enabling more accurate diagnoses and targeted interventions.
  • Mentored new nursing staff, facilitating a faster learning curve and increased overall team efficiency.
  • Facilitated multidisciplinary team meetings to discuss patient care, fostering collaborative approach to healthcare.
  • Educated family members and caregivers on patient care instructions.
  • Evaluated patient histories, complaints, and current symptoms.
  • Provided skilled, timely and level-headed emergency response to critically-ill patients.

Case Manager

Piedmont Mountainside Hospital
10.2016 - 08.2021
  • Full time position in ED as Case Manager as well as Floater for CM to various positions within the case management department such as UR, PLC, ED, DCP, CM and fill in SW
  • Currently make rounds with physicians and discuss DCP- As CM in the ED I perform UR and complete commercial, Medicare, and Medicaid reviews, fax needed clinical information and converse with insurance CM as needed, Medicaid GHP documentation, discuss with MD as needed for orders and/or changes in orders to accommodate needed treatments or inpatient to OBS or OBS to inpatient as needed, review ED preadmission needs, Milliman and InterQual review for admission and observation, and discuss with ED physician, Cardiologist, Pulmonologists as needed for orders of admission or transfer
  • Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
  • Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
  • Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
  • Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
  • Advocated for client rights when interacting with external agencies or institutions, ensuring fair treatment at all times.
  • Provided crisis intervention support for clients experiencing emergencies, using appropriate techniques to de-escalate situations safely.
  • Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
  • Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
  • Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
  • Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
  • Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
  • Trained new case managers, raising team's overall competency and service delivery standards.
  • Collaborated with mental health professionals to address psychological needs of clients, supporting their holistic recovery.
  • Enhanced team collaboration by leading regular case review meetings, promoting unified approach to client care.
  • Managed crisis situations with empathy and professionalism, ensuring client safety and continuity of care.
  • Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.

Telephonic Case Management RN

Humana, INC
10.2011 - 06.2016
  • Worked independently at home via internet connection with Humana, INC and telephonic to clients
  • Patient education including Care Plan creation, updates, and education of disease process
  • Decision making ability consistent with medical protocols
  • SME (subject matter expert) for team including new computer programs, policy and procedures, monitor Super User chat room daily for updates to be reported to team in ever changing environment
  • Provided supervision during manager vacations
  • Provided diverse case management to clients with HTN, DB, CVA, A-Fib, PAD, CAD, PTSD, assisting in authorizations for care, treatments, surgery, medication as needed/indicated
  • Computer programs such as Outlook, Microsoft, and Citrix used daily, with multiple navigation pages opened for review and assistance
  • I also operated as point person for team when manager was unavailable, and I was assigned as the team leader for orientation via virtual computer conference
  • Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
  • Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
  • Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
  • Developed strong relationships with patients'' families, providing emotional support while addressing concerns or questions about care plans.
  • Educated patients on disease management and self-care techniques, promoting lifestyle changes for improved health.
  • Served as a liaison between physicians and patients'' families to facilitate clear communication regarding treatment options and progress updates.
  • Mentored new nursing staff, contributing to a supportive work environment and improved retention rates.
  • Provided emotional support to patients during challenging times, fostering a sense of trust and rapport that contributed to better overall wellbeing.

Medical Director/Manager of Medical Department

Twin Oaks Juvenile Department of Justice
06.2009 - 10.2011
  • Manager of Medical Department for 50-70 bed residential boy's juvenile program
  • Case Management for each youth, Discharge planning upon completion of program, review of possible new residents for care and discussion with director for acceptance of need or ability to meet need of new resident before acceptance
  • Monitored and maintained all new Intakes with care plan implementation and medical record creation, scheduling of well visits and physicals, transfer coordination for special visits such as cardiology, assessment and treatment for sick call with implementation of protocols and procedures, managed staff of 5 with reviews, hiring and firing, orientation
  • Monitored non-medical staff including TB test status, illness, injury for workman's comp, drug testing
  • Staff competency teaching for program, CPR instructor, budget manager for medical program
  • Prepared medical department for yearly QA visits with passing and no recommendations, high accommodations from state of FL in which state adapted managerial ideas, forms, and insight from this program created by me
  • Creation of medical charts for each juvenile and computer record of immunizations, forms, and schedules, long-standing plan of care for each resident to reach goals of graduation and continue in post-graduation program for success with collaboration from all disciplines of the program
  • Supervised clinical staff, providing continuous professional development opportunities and training to maintain and strengthen competencies.
  • Conducted ongoing evaluations of medical practices, ensuring adherence to evidence-based guidelines and best practices.
  • Managed multidisciplinary teams, fostering collaboration between various healthcare professionals for optimal patient care.
  • Enhanced operational performance by identifying areas of improvement and implementing change management strategies.
  • Led quality improvement initiatives resulting in enhanced clinical service delivery across departments.
  • Oversaw and developed clinical departments through hiring, training and evaluating staff.
  • Improved patient care quality by implementing new clinical policies and procedures.
  • Drove significant improvement in achievement of goals related to health, safety and employee relations.
  • Mentored physicians and other medical staff, facilitating professional development through training programs.
  • Contributed to the growth and success of the organization by participating in regional and national conferences, sharing best practices with industry peers.
  • Developed quarterly and yearly objectives, goals and budgets in addition to devising suggestions to decrease spending.
  • Assessed performance of medical care, equipment, supplies and pharmaceutical drugs.
  • Ensured compliance with accreditation requirements through regular audits of facility operations and diligent record-keeping practices.
  • Negotiated contracts with vendors, securing cost-effective supplies while maintaining high-quality standards for equipment and materials used in patient care.
  • Focused on preventive care and proactive identification in care management of high-risk patients to lower costs.
  • Developed criteria for test orders and trained staff regarding data acquisition methods and escalation protocol.
  • Maintained compliance with local, national and federal requirements for staff education and certifications.
  • Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
  • Designed and introduced leadership development, coaching and team management model, resulting in promotion of employees into increased levels of responsibility.
  • Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.
  • Defined testing protocols, quality assurance initiatives and clinic policies and procedures.
  • Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
  • Communicated with patients, ensuring that medical information was kept private.
  • Scheduled surgeries, managed pre-certifications and verified insurance coverage.
  • Ordered all pharmacy supplies and kept check on inventory levels.
  • Maintained professional, organized, and safe environment for employees and patrons.
  • Cross-trained existing employees to maximize team agility and performance.

Assistant Director of Nursing

Calhoun-Liberty Hospital
09.1998 - 06.2009
  • ADON (assistant Director of Nursing): Infection Control review, Budget review for nursing and pharmacy, Utilization Review, Risk Management Review, Orientation of all new employees, Orientation class development for Med/Tele with cardiac rhythm teaching to all nurses, monitor/ward clerks, and lethal recognition to all CNAs
  • Monthly medical review meeting with physicians in which we discussed ideas and policy reviews, assisted in effective JACHO reviews as well as QA reviews
  • I also maintained orientation to employees for changes to any Policy or Procedure, was point person for 4 years to maintain and hold all emergency scenarios for hospital preparedness in such things as hurricane/tornado, bomb threat, radiation exposure, mass trauma with casualties as trained by national security team in continuing education program
  • Participated in management team meetings to discuss resident status, census changes, and resident complaints or concerns.
  • Collaborated with staff, management, and external groups to coordinate patient care.
  • Performed rounds to observe care and interview staff, residents, and families.
  • Managed nursing schedules and budgets, streamlining processes for cost savings while maintaining high-quality patient care.
  • Contributed to the accreditation process by maintaining compliance with state and federal regulations for nursing standards.
  • Mentored new nurses in clinical practice and procedures, fostering a supportive learning environment.
  • Assisted in developing policies and procedures for safe medication administration, minimizing errors within the department.
  • Served as a role model for nursing staff by demonstrating exceptional clinical skills, ethical behavior, and commitment to continuous learning.
  • Enhanced staff performance through regular training sessions and professional development opportunities.
  • Coordinated with physicians on complex cases, ensuring seamless communication among healthcare professionals involved in patient care.
  • Evaluated staff performance regularly, providing feedback and guidance for improvement when necessary.
  • Participated in quality improvement initiatives aimed at enhancing overall service delivery within the facility.
  • Implemented infection control measures, reducing hospital-acquired infections significantly over time.

Nursing Supervisor

Fairview Park Hospital
06.1985 - 07.1998
  • Summary of duties include basic nursing care with IV therapy, computer charting, medication administration, notification to MD of change in condition if warranted, EKG and tele monitoring and treatment of rhythm as indicated, follow protocols and procedures for change in assessment of medical condition, update MD and family of change, address EOL when needed or indicated due to patient condition, maintain and monitor cardiac function, A-lines, CVP, vent-ICU/CCU
  • Summary of duties as Supervisor and Nurse Manager: Responsible for house staffing, arranging transfers, and responded to all emergencies throughout facility
  • This included codes, high risk C-Sections, high risk babies, code blue, fire, other emergencies, after hour pharmacy medication dispensing, medical records after hours, maintained all facility protocols, hiring and termination of nursing staff and supportive staff to ER and mother baby units
  • I conducted and prepared meetings and orientation to departments, maintained budget in units and prepared for JACHO, QA program passing each with Accreditation for Emergency Department

Education

Associate of Applied Science - Nursing

Middle GA College, University of GA
Cochran, GA

Skills

  • Epic
  • Microsoft Excel
  • Citrix
  • Outlook
  • Utilization Review using Interqual
  • MCG
  • Milliman
  • E-prescribing software
  • Electronic Health Care Records
  • Customer service
  • Care planning
  • Chronic disease management
  • Problem-solving
  • Basic life support
  • Staff development
  • Team leadership
  • Nursing management
  • Patient treatment planning
  • Data entry
  • Case assessments
  • HIPAA compliance
  • Case documentation
  • Clinical judgment
  • Staff training and development
  • Computer skills
  • Clinical documentation
  • Multidisciplinary approach
  • Active listening
  • Clinical quality improvement
  • Staff evaluation
  • Task delegation
  • Compassion and empathy
  • Privacy and confidentiality
  • Care coordination
  • Organization and multitasking
  • Medical documentation
  • Medication reviews
  • Home care management
  • Conflict resolution
  • Health promotion
  • Medical education
  • Recruiting and hiring
  • Electronic medical records
  • Microsoft Word
  • Medical chart documentation
  • Utilization review
  • Positive attitude
  • Behavioral health
  • Disease prevention education
  • Time management
  • Patient education
  • Email and telephone etiquette
  • Customer relationship management (CRM)
  • Ethical practice

Certification

  • Registered Nurse, MSL 1-203098
  • Massage and Reflexology Licensure, GA, 2017

Accomplishments

  • 2017, Nominated Daisy Award Winner
  • 2019, Awarded 360 Employee Award with Piedmont Systems

Personal Information

Title: Registered Nurse

Credentials

  • RN
  • ASN

Additional Information

Cell: 470-349-1803

Email: smith.donna77@yahoo.com

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference

Work Type

Full TimePart Time

Work Location

On-SiteRemote

Important To Me

Work-life balancePaid time offPaid sick leavePersonal development programsWork from home option401k matchStock Options / Equity / Profit Sharing

Timeline

Administrative Assistant

Gospel Outreach Church
03.2023 - 12.2023

Utilization Review Care Manager

Insight Global
02.2022 - 06.2022

RN Case Manager

Affinity Hospice
08.2021 - 01.2022

Case Manager

Piedmont Mountainside Hospital
10.2016 - 08.2021

Telephonic Case Management RN

Humana, INC
10.2011 - 06.2016

Medical Director/Manager of Medical Department

Twin Oaks Juvenile Department of Justice
06.2009 - 10.2011

Assistant Director of Nursing

Calhoun-Liberty Hospital
09.1998 - 06.2009

Nursing Supervisor

Fairview Park Hospital
06.1985 - 07.1998

Associate of Applied Science - Nursing

Middle GA College, University of GA

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Donna Jo Smith