Elizabeth McCusker
Halifax,USA
Summary
I am seeking a position, that will allow me to make a difference, help others, and fulfill my passion as a nurse.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Clinical care coordination and care planning-LPN
Commonwealth Care Alliance (CCA)
04.2024 - Current
- Responsibilities in this role include Assisting CCA members navigate the healthcare system, ensuring they understand how to access services and receive needed care specific to their needs
- Create member-centered care plans and access support from the care team
- Communicate with members to provide engagement, build trust, and address concerns in a timely fashion
- Coordinate outgoing referrals
- Provide administrative support to the care team, including data entry, correspondence, filing, and scheduling of assessments needed
LPN visiting nurse
Norwell VNA
11.2023 - Current
- As a LPN my responsibilities as a visiting nurse include but not limited to Taking and monitoring patient vital signs
- Wound care
- Maintaining accurate patient records
- Assist doctors and registered nurses
- Collaborate with teams for patient care
- Health assessments
- Monitor patients throughout their treatment
- Administers medication and intravenous infusions, catheter care
- Helping with rehab exercises and routines
- Managing emergency medical situations
- Preparing patients for transfers or discharge
- Supporting RNs and physicians on rounds
Utilization Review Nurse
Commonwealth Care Alliance (CCA)
Boston, MA
11.2021 - 11.2023
- Long term support services (LTSS) Utilization Management nurse conducting reviews for initial authorizations, reauthorizations and continuation of service requests for LTSS services: Personal Care Agency, Homemaker, Adult Foster Care, Group Adult Foster Care, Assisted Living Services, Adult Day Health, Day Habilitation, Laundry and Home Delivered Meals
- Remaining compliant per MassHealth regulations and CCA Medical Necessity Guidelines, following standards of practice and strong clinical judgement to establish medical necessity for services when completing reviews
- Gathering information from MDS, Service coordinator Assessments and Time for task tool (TFTT) reviewed for supporting clinical documentation of the medical necessity guidelines
- Collaboration with CCA Care Team and Medical Directors and initiating case conferences with care team for any adverse determinations to prevent under or over-utilization of member's services
LPN
Royal Rehab
Braintree, MA
08.2007 - 11.2021
- 2007 staff nurse- medication administration/wound treatments/documentation
- 2008 supervisor for the facility
- 2009 promoted to unit manager on both LTC Unit and subacute unit.
- Caring for patients anywhere from acute illnesses, post surgical, psych, drug dependence, to geriatric, Alzheimer's and hospice care.
- 2017 promoted to Case manager. My duties in this role included but were not limited to collaborating with insurance case managers, our team, patient to determine a plan for transition back into the community safely with necessary supports at home.
- Managing appeals if/when needed.
- Patient advocate
- Worked with social workers, physical therapists and speech therapists to assess patient needs, plan and adjust plans of care and actualize nursing interventions to promote and restore patient health.
- Provided emotional support during difficult times such as end-of-life decisions or family disputes over treatment options.
- Care planning as a team between nursing, rehab, and social services to ensure residents safety and best outcome. Navigating through challenging situations while being proactive to ensure a successful discharge/and or plan of care. Strategizing with care team and having open communication with patients/family/team which helps to alleviate stress on both patient and family.
- Taking on different roles during COVID 19 pandemic including staff development. Assisted and educated staff with the ever-changing protocol changes including frequent in-services/training staff on PPE, testing, new guidelines, assisting DNS with reporting to DPH/ Epidemiologists, tracking both staff and patients all while maintaining my caee manager position.
LPN
South Shore Medical Center
10.2008 - 02.2009
- While still working at Royal Rehab per diem I worked at South shore medical center in the internal medicine dept
- Left South Shore medical center for a better opportunity at Royal Braintree
LPN
John Scott House
Braintree, MA
01.2007 - 08.2007
- John Scott House was my first nursing job
- I was a primary staff nurse for a LTC floor
- I left John Scott House for a better opportunity at Royal Rehab Braintree
Education
College in LPN - Nursing Licenses PN
Quincy College
Quincy, MA06.2006
Skills
- LPN
- Staff Nurse
- Alzheimer's Care
- Social Work
- Hospice Care
- Dementia Care
- Laboratory Experience
- EMR Systems
- Tube Feeding
- Medication Administration
- Vital Signs
- Medical Imaging
- Crisis Intervention
- Critical Care Experience
- Home Care
- Caregiving
- Patient Care
- Infection Control Training
- Microsoft Excel
- Computer literacy
- Microsoft Word
- Phlebotomy
- Experience Administering Injections
- Epic
- Medical Coding
- Management
- Transcription
- Case management
- Supervising Experience
- Medical Billing
- Computer Networking
- Microsoft Windows Server
- Medical Records
- System Administration
- Attention to detail
- Multitasking
- Time management
- Team player
- Computer oriented
- IV certified
- Case management
- Documentation review
- Medical collection
- Utilization management
- Managed care
- SSH
- Negotiation
- Microsoft Office
- Clinical documentation improvement
- Medicare
- Utilization review
- ICD-10
- MDS
- Medical office experience
Certification
- Dementia certified, 04/01/13, present
- Nursing License, MA, 11/2006
Personal Information
Authorized To Work: US for any employer
Timeline
Clinical care coordination and care planning-LPN
Commonwealth Care Alliance (CCA)
04.2024 - Current
LPN visiting nurse
Norwell VNA
11.2023 - Current
Utilization Review Nurse
Commonwealth Care Alliance (CCA)
11.2021 - 11.2023
LPN
South Shore Medical Center
10.2008 - 02.2009
LPN
Royal Rehab
08.2007 - 11.2021
LPN
John Scott House
01.2007 - 08.2007
College in LPN - Nursing Licenses PN
Quincy College