Donna Walker RN
Little Rock,Arkansas
Summary
Compassionate Case Manager accustomed to treating diverse patient needs while managing dynamic conditions. Collaborative professional possessing excellent clinical knowledge and judgment combined with strong documentation and problem-solving abilities. Well-versed in managing emergent cases with poise. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
16
16
years of professional experience
Work History
Case Manager
Elite Home Health Care
Little Rock, AR
02.2018 - Current
- Monitored client progress through regular follow-up contacts.
- Maintained accurate case records and documentation according to agency guidelines.
- Assessed clients' needs, developed service plans and monitored progress towards goals.
- Developed individualized care plans with input from clients and their families.
- Provided referrals to appropriate health care providers or other community resources.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Conducted home visits to assess the safety of living environments for clients.
- Participated in interdisciplinary team meetings to discuss treatment options.
- Coordinated transportation services for clients who lacked access to reliable transportation.
- Collaborated with medical professionals to coordinate treatment plans for clients.
- Reviewed treatment plans against individual goals and healthcare standards.
- Supported family members by providing information on local support groups.
- Provided case management services including intake, assessment, crisis intervention, advocacy, referral and monitoring of families.
- Counseled clients on available resources within the community that could help meet their needs.
- Facilitated communication between clients, families, caregivers, social services and other agencies to ensure client needs were met.
Home Health Nurse
Kindred Home Health
Little Rock, AR
02.2016 - 05.2018
- Developed personalized care plans for patients based on individual needs.
- Provided home health care services such as wound care, medication administration, and IV therapy.
- Educated patients and families about disease management, lifestyle changes, nutrition, and preventive healthcare measures.
- Instructed family members in basic nursing skills including wound care, injections, catheterization, and other treatments as ordered by the physician.
- Maintained accurate records of all visits made to patients' homes along with any changes in their conditions or treatments prescribed by physicians.
- Monitored vital signs such as blood pressure or pulse rate to detect any changes in a patient's condition.
- Adhered strictly to infection control protocols while caring for clients in their homes.
- Completed initial assessments of patients and family to determine and address individual home care needs.
- Administering medications according to physician orders and monitoring side effects of medications.
- Performed assessments of the patient's physical condition to determine their level of function and need for assistance with activities of daily living.
- Assessed patient health by conducting physical examinations and evaluating medical histories.
- Addressed patient care needs, collected vitals, dressed wounds and managed catheters.
- Coordinated patient discharge planning with physicians, social workers, case managers, therapists, pharmacists and other healthcare professionals involved in the patient's care plan.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Participated in interdisciplinary team meetings to discuss the progress of each patient's treatment plan.
- Administered prescribed medications and started intravenous fluids to address patient symptoms and underlying etiologies.
- Answered patient calls, identified issues and determined how best to provide assistance within parameters established by facility and supervisor.
- Initiated referrals to appropriate community resources when needed.
- Attended continuing education courses related to home health nursing practices.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Administered oral, IV and intra-muscular medications and monitored patient reactions.
Home Health UR and Home Health Coder
Care IV Home Health
Little Rock, AR
08.2013 - 05.2016
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Collected documentation and clarified ambiguous patient care statements by contacting providers.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Accurately assigned codes using software and official print copy of code book.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained high accuracy rate on daily production of completed reviews.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Maintained positive working relationship with fellow staff and management.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
Patient Care Manager Weekend Option
Gentiva Home Health
Little Rock, AR
08.2010 - 08.2013
- Resolved customer complaints regarding patient care services in a timely manner.
- Conducted regular meetings with clinical staff to review cases and discuss strategies for improving outcomes.
- Collaborated with interdisciplinary teams to coordinate discharge planning and post-discharge follow-up activities.
- Developed strategic initiatives aimed at increasing efficiency while maintaining high standards of quality patient care.
- Utilized well-developed communication, active listening, and interpersonal talents when interacting with people on daily basis.
- Protected patient data confidentiality in alignment with HIPAA protocols.
- Evaluated staffing patterns against current census data to ensure adequate coverage at all times.
- Provided guidance and support to staff members on various aspects of patient care management.
Utilization Review Nurse and Home Health Coder
St Vincent VNA
Little Rock, AR
12.2007 - 08.2010
- Assessed patient medical records to determine the appropriateness of requested services and procedures.
- Served as a resource for staff members seeking guidance on utilization review matters.
- Evaluated clinical documentation for accuracy and completeness in order to make decisions about coverage determinations.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Maintained up-to-date knowledge of health plan benefits, policies, procedures, regulations, coding guidelines.
- Reviewed denial letters issued by insurance companies to ensure that they were appropriate and timely.
- Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
- Identified opportunities for improvement within the utilization review process through data analysis.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Collaborated with billing team to confirm no additional diagnosis codes available for LCD and NCD coverage.
- Reviewed clinical data from medical records to assign ICD, CPT, and HCPCS codes.
- Responded to coding questions from callers and other internal departments.
- Accurately assigned codes using software and official print copy of code book.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Maintained high accuracy rate on daily production of completed reviews.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
Education
Diploma in Nursing - Nursing
Baptist System School of Nursing
Little Rock, AR12-1986
Skills
- Discharge Planning
- Family Education
- Referral Coordination
- Community Outreach
- Care Coordination
- Case Management
- Health History Documentation
- Needs Assessment
- Client Advocacy
- Patient Support
- Regulatory Compliance
- Chronic Disease Management
- Utilization Review
- Treatment Planning
- Staff Management
- Positive Attitude
- Utilization Management
- Home Visits and Inspections
- Patient Needs Assessment
Timeline
Case Manager
Elite Home Health Care
02.2018 - Current
Home Health Nurse
Kindred Home Health
02.2016 - 05.2018
Home Health UR and Home Health Coder
Care IV Home Health
08.2013 - 05.2016
Patient Care Manager Weekend Option
Gentiva Home Health
08.2010 - 08.2013
Utilization Review Nurse and Home Health Coder
St Vincent VNA
12.2007 - 08.2010
Diploma in Nursing - Nursing
Baptist System School of Nursing