Jackie Higgins OTR/L
Middletown,NJ
Summary
Dynamic and results-oriented Occupational Therapy professional with a proven track record at United Healthcare and extensive experience in rehabilitation management across various settings. Excelled in case management and effective team collaboration, significantly enhancing patient care and departmental efficiency. Expert in home health regulations and adept at fostering multidisciplinary team collaboration.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Home Health Coordinator
United Healthcare
01.2022 - Current
- Review OASIS documentation and clinical notes from providers and utilize InterQual criteria to determine medical necessity and appropriate authorization for home health services
- Understand and apply CMS Chapter 7 guidelines for home health
- Follow up with providers as necessary for clarification of clinical documentation of patients’ status
- Compete reviews into clinical documentation system and update authorization timely
- Collaborate with the medical director regarding CMS and managing authorizations
- Utilize effective communication skills to coordinate with healthcare providers
- Actively engage in quarterly meetings with the Business Analysis Team for clarification and questions on workflow and complete various projects
Skilled Inpatient Care Coordinator
Navihealth
01.2019 - 01.2022
- Coordinated and provided assistance through engagement with our members, their families, and providers in order to transition our members to the appropriate next level of care at the right time
- Assisted with management and orientation to our nH predict tool to new skilled nursing facilities and new colleagues
- Facilitated conflict resolution in managing challenging facilities, provided education and realistic goals to succeed
- Collaborated effectively with medical directors, nurses, case managers, social workers, and therapy departments to ensure that a safe and appropriate discharge plan has been implemented
- Utilized clinical skills, experience, and the nH predict tool to perform assessments and complete authorizations for members
- Participated in weekly rounds with the medical director and clinical team to discuss members' progress, goals, and discharge plans
- Attended Medicare meetings at skilled nursing facilities to closely monitor members' care and ensure that their goals and care needs were being met
- Recorded timely and accurate documentation in the CM Tool application
- Assessed and monitored patients' continued appropriateness for skilled nursing facilities, setting according to guidelines
- Identified possible barriers and initiated discharge planning discussions at the time of admission
- Conducted on-site visits to skilled nursing facilities to promote engagement and relationships with members, interdisciplinary teams, and families
Home Care Occupational Therapist
Hackensack Meridian Health at Home
03.2016 - 12.2018
- Responsible for scheduling, coordinating care and providing occupational therapy to patients in their home environment
- Completed comprehensive therapy assessments and reassessments for assigned patients
- Provided hands-on therapy and training, including but not limited to ADL/IADLs, the use of assistive devices and adaptive techniques, transfers, therapeutic exercise, home safety, establishing a home exercise program, patient education, and caregiver training
- Completed appropriate, timely medical record documentation consisting of evaluation, care plan, obtaining physician orders, and treatment notes
- Collaborated with the rehabilitation team to ensure coordinated and effective care
- Knowledge of Oasis/Home Care
- Case management of assigned patients
Rehabilitation Manager: Continuing Care Retirement Community (CCRC)
Erickson Living – Seabrook
10.2012 - 10.2015
- Responsible for effective administration of Therapy for Physical, Occupational, Speech and Personal Training services for entire continuum of care for sub-acute, long term living, assisted living and out-patient
- Consistently and appropriately responded to the needs and concerns of residents, families and visitors in a pleasant respectful, and courteous manner
- Oversaw 7 day week program for sub-acute unit
- Responsible for monthly analyses and reporting on departmental business lines
- Partnered with various departments such medical center, wellness center, CHH, admissions, and marketing
- Provided Occupational Therapy duties as needed
- Quarterly rotation for weekend manager
Director of Rehabilitation
Care One at Wall
06.2004 - 05.2012
- Manager of Rehab services for 138 bed facility consisted of 68 sub acute beds
- Coordinated rehabilitation service delivery in a cost-efficient manner
- Responsible for appropriate rehab staffing levels, daily scheduling and coordination of services for 7 day a week program
- Managed productivity and efficiency to meet financial and clinical goals.
- Effectively communicated and coordinated departmental functions with other disciplines
- Communicated effectively with the Administrator and the Regional Rehabilitation Director regarding department programs, problems, and successes
- Generated rehab management reports on a weekly and monthly basis, with an analytic review and strategic plan implemented to meet financial and clinical goals
- Attended and contributed to weekly care conference, utilization's review and rehab team meetings
- Assisted with rehabilitation-specific marketing efforts
- Supervised the affiliation of students with staff and oversaw the student program, thus resulting in the hiring of two therapists
- Evaluation and treatment of patients requiring occupational therapy services
- Coordinated all aspects of the opening and growth of the rehab department in the new facility
Education
Master of Arts Degree - Behavioral Sciences
Kean University
Union, NJPost Baccalaureate Major - Occupational Therapy
Kean University
Union, NJBachelor of Arts - Special Education: Teacher of the Handicap
Kean University
Union, NJSkills
- Case management
- Collaborative Team Engagement
- Effective Problem Resolution
- Prioritization Skills
- Strong Organizational Abilities
- Proficient Active Listening
- Documentation proficiency
- Multidisciplinary team collaboration
- Knowledge of CMS regulations for SNF and home health
- Customer service
- Provider outreach
- Ability to work independently and as part of a team
- Patient-centered approach to care
- SME for DSNP patients for RI
Certification
- Medicare & Retirement Professional Level 3 for UnitedHealth Group
- Active NBCOT
- Active Occupational Therapy License in NJ
Timeline
Home Health Coordinator
United Healthcare
01.2022 - Current
Skilled Inpatient Care Coordinator
Navihealth
01.2019 - 01.2022
Home Care Occupational Therapist
Hackensack Meridian Health at Home
03.2016 - 12.2018
Rehabilitation Manager: Continuing Care Retirement Community (CCRC)
Erickson Living – Seabrook
10.2012 - 10.2015
Director of Rehabilitation
Care One at Wall
06.2004 - 05.2012
Master of Arts Degree - Behavioral Sciences
Kean University
Post Baccalaureate Major - Occupational Therapy
Kean University
Bachelor of Arts - Special Education: Teacher of the Handicap
Kean University
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