Jamie Hughes
Bowie,USA
Summary
Strategic-thinking individual experienced in turning low-performing organizations into top revenue producers. Offering an engaging and pleasant personality with expertise improving customer relationships. Seeking a Director role in the RN Case Management and Healthcare industry.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Director of Case Management
BridgePoint Healthcare
Washington, DC
09.2016 - Current
- Director of a 60 bed Long Term Acute Care Hospital tasks with the throughput of critically ill patients in the longterm acute care setting.
- Developed strategies to maximize reimbursement of patient with Medicare, Medicaid, and commercial insurance to ensure appropriate level of care had been optimized.
- Developed reports and kept logs of patient outcomes and discharge destinations for the CEO.
- Maintained policy and procedures set forth by the facility and those also required by federal and state entities.
- Managed staff with competancies and evaluations and provided education to better serve the department serving our facility.
- Continued with CDI efforts to maximize CMI throughout the insurance spectrum.
- Managed staff with competencies and evaluations and provided education to better serve the department serving our facility.
- Lead the Interdisciplinary Team meetings and provided guidance to physicians and staff alike.
- Performed other various duties as assigned.
Lead Clinical Documentation Specialist
MedStar Franklin Square Medical Center
Baltimore, MD
11.2004 - 09.2016
- Reviewed documentation for compliance with requirements and accuracy of information.
- Self-directed with astute judgment skills. High level of personal accountability.
- Investigated and reported issues relating to patient care or conditions that might hinder patient wellbeing.
- Initiated hospital-wide study to identify areas for process improvement.
- Recruited, hired, trained and coached on average of 6 new employees per year.
- Developed Clinical Documentation Program from the initialization to include processes and procedures related to improving documentation and increased maximum reimbursement.
- Worked closely with HSCRC in decreasing the Hospital Acquired Conditions within the facility. Turned a 2 million dollar deficit into a $500,000 overage.
- Developed and achieved financial and growth goals.
- Brought our facility rank up from worst (1) to middle level in facility reported hospital acquired conditions.
- Ensured HIPAA compliance.
- Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
- Established standards for selection, promotion and termination of staff.
RN Case Manager
MedStar Franklin Square Medical Center
Baltimore, MD
11.2004 - 09.2016
- Conduct comprehensive assessment of patients' physical, mental, and psychosocial needs.
- Develop care plans to prevent disease exacerbation, improve outcomes, increase patient engagement in self-care, decrease risk status, and minimize hospital and ED utilization.
- Utilize behavioral strategies help patients adopt healthy behaviors and improve self-care in chronic disease management. Promote self-management goals.
- Assist patients in navigating the health care system. Coordinate Specialty care, follow-up on test results and other care coordination needs.
- Follow-up with patients within 24 hours on inpatient discharge & within 48 hours of ED visit notification.
- Partner with external case management programs to coordinate care.
- Ongoing evaluation and documentation of patient progress/ risk status Document in EMR; communicate with care teams.
- Document in EMR.
ICU RN Charge Nurse
MedStar Franklin Square Medical Center
Baltimore, MD
11.2004 - 09.2016
- Partnered with team of registered nurses to achieve overall well-being of all patients.
- Worked closely with other medical staff, including physicians to determine individualized plans of care for each patient.
- Performed regular assessments on patients to evaluate their health conditions while they were in the ICU.
- Communicated with the patient and his or her family regarding care, tests and medications so that they were well-informed.
- Followed all policies and procedures and hospital regulations to ensure compliance and patient safety.
- Liaised between patients and physicians to ensure patient comprehension of treatment plans.
- Closely monitored acute conditions.
- Ensured safety and well-being of patients.
- Assessed patients and documented their medical histories.
- Evaluated patient care needs, prioritized treatment, and maintained patient flow.
- Developed and implemented nursing care plans.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Delegated staff nurse duties.
- Self-directed with astute judgment skills. High level of personal accountability.
Agency RN
Caresource
Essex, MD
01.1999 - 11.2004
- Developed patient care plans, including assessments, evaluations and nursing diagnoses.
- Self-directed with astute judgment skills. High level of personal accountability. Self led as temporary staff adjusting quickly in new hospital environment.
- Closely monitored acute conditions.
- Documented patient information obtained from interviews.
- Liaised between patients and physicians to ensure patient comprehension of treatment plans.
- Followed infection control procedures.
- Ensured HIPAA compliance.
Education
Master of Science - Leadership
Western Governors University
Salt Lake City, UTBachelor of Science - Nursing
Western Governors University
Salt Lake City, UTAssociate of Science - Nursing
Wor Wic Community College
Salisbury, MDSkills
- DATA MANAGEMENT
- MS OFFICE
- PROCESS IMPLEMENTATION
- WORD
- Case Management
- RN
- Utilization Review
- Care Management
- Hospital
- Utilization Management
- Acute Care
- Managed Care
- Documentation Review
- Nursing
- ICU Experience
- ICD-10
- Clinical documentation improvement
- Medicare
- DRG
- Care plans
- Strong verbal communication
- Team leadership
- Self-motivated
- Interpersonal and written communication
- Extremely organized
- Skilled in MS Office to include Excell, Word, and Power Point
- Public speaking
- Staff development
Certification
- CCDS, 04/01/17, 04/01/18, Certified Clinical Documentation Specialist
- RN, Registered Nurse
- BLS Certification, Basic Life Support Certification
Awards
Capstone Certificate of Excellence, 02/01/16, Awarded the Capstone Certificate of Excellence from Western Governors University for my Capstone Project; 'Post Operative Management of Patients at Risk for O.S.A.' Project was published by Western Governors University to be used as an example for new students.
Personal Information
Work Permit: Authorized to work in the US for any employer
Timeline
Director of Case Management
BridgePoint Healthcare
09.2016 - Current
Lead Clinical Documentation Specialist
MedStar Franklin Square Medical Center
11.2004 - 09.2016
RN Case Manager
MedStar Franklin Square Medical Center
11.2004 - 09.2016
ICU RN Charge Nurse
MedStar Franklin Square Medical Center
11.2004 - 09.2016
Agency RN
Caresource
01.1999 - 11.2004
Master of Science - Leadership
Western Governors University
Bachelor of Science - Nursing
Western Governors University
Associate of Science - Nursing
Wor Wic Community College