Kassandra Fitzgerald
Stonewall,LA
Summary
Goal driven Registered Nurse and Certified Case Manager with 25+ years working within multi-disciplinary healthcare teams in acute care, psychiatric, rehabilitation and post-acute care settings. Dedicated to optimizing patient outcomes and organizational growth. Offering proficiency in regulatory compliance, utilization review, revenue management as well as data collection and analysis and the ability to successfully oversee human resources, budgeting, supply management and patient services. Proven record of developing and implementing new programs to meet the needs of the Health System and community served.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Post-Acute Care Management Coordinator
Willis Knighton Health System
Shreveport , Louisiana
06.2006 - Current
- Educated and evaluated care management, utilization review and support staff regarding care quality management regulations and standards of care.
- Interpreted regulations to identify patient care requirement criteria to be monitored and establish systems to achieve compliance.
- Worked with providers to define quality metrics and outcome reporting process.
- Collected and aggregated data to identify problems or trends and develop new programs to meet post-acute care needs of aging population under changing regulations.
- Oversaw evaluation of patients for admission to acute inpatient rehabilitation program and 3 skilled nursing and rehabilitation facilities.
- Oversaw acute inpatient psychiatric unit utilization review department, utilization review for acute inpatient rehabilitation unit and 3 skilled nursing and rehabilitation facilities
- Worked with insurance carriers to obtain authorization approvals for inpatient rehabilitation, skilled nursing services and post discharge needs such as medications, supplies and equipment.
- Negotiated single case agreements with insurance carriers for rehabilitation and skilled nursing services.
- Oversaw coordination post-discharge care by case management staff for acute inpatient rehabilitation unit and subacute rehabilitation skilled facility
- Completed weekly scheduling and monthly department reports for case managers.
- Conducted literature and coding reviews to adhere to state and federal standards.
- Spearheaded and implemented new projects to expand scope of engagement.
- Managed application processes for facility certifications with Department of Health and Hospitals and The Centers for Medicare and Medicaid Services.
- Recruited, hired and coached employees to offer high-quality, cost-effective care to all clients.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
Physical Medicine Case Management Coordinator
Willis Knighton Health System
Shreveport, Louisiana
05.2001 - 06.2006
- Managed and monitored program activities and evaluated quality for improvement recommendations.
- Created care plans that addressed clinical and financial challenges, family requirements and facilitated patient quality of life.
- Served as case coordinator, assuming responsibility for complex, high-volume assignments and guiding endeavors to successful completion.
- Structured standardized case management processes to comply with regulatory agency statutes and standards.
- Collaborated with multidisciplinary teams to facilitate client care and reduce case management barriers.
- Devised and implemented cost-control plans to enhance department operations.
- Reviewed and developed intake and discharge planning strategies to encourage client engagement and retention.
- Served as corporate resource for compliance and audits to facilitate legal process and appeals.
- Oversaw implementation of inpatient rehabilitation facility prospective payment system, collaborating with management to achieve smooth operations and maximize resource utilization.
- Successfully appealed three million dollars in Medicare denials recovering 78 percent of rehabilitation claim denials from Trispan Fiscal Intermediary through administrative law judge level.
Assistant Director of Nursing
Progressive Care Center
Shreveport , Louisiana
04.1996 - 06.1999
- Established and monitored infection control programs to provide safe, sanitary environment to prevent transmission of disease and infection.
- Established new policies and updated existing policies to improve standard of care for patients.
- Collaborated with staff, management and external groups to coordinate patient care.
- Planned and assigned workload to nursing staff to direct patient care.
- Performed rounds to observe care and interview staff, residents and families.
- Developed positive employee relations, incentives and recognition programs to promote teamwork and mutual respect.
- Identified department issues to recommend corrective actions.
- Participated in management team meetings to discuss resident status, census changes and resident complaints or concerns.
- Evaluated work performance of nursing personnel to determine wage increases and implement discipline.
- Successfully negotiated client contract renewals to create increased revenue.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Successfully implemented changes to workflow and skilled patient care processes to maximize resource utilization with implementation of skilled nursing facility prospective payment system.
Assistant Director of Nursing
Live Oak Retirement Center
Shreveport, Louisiana
05.1995 - 04.1996
- Established and monitored infection control programs to provide safe, sanitary environment to prevent transmission of disease and infection.
- Established new policies and updated existing policies to improve standard of care for patients.
- Collaborated with staff, management and external groups to coordinate patient care.
- Planned and assigned workload to -person nursing staff to direct patient care.
- Complete Minimum Data Set Patient Assessment Instruments as required by regulatory agencies on all residents.
- Identified department issues to recommend corrective actions.
- Participated in management team meetings to discuss resident status, census changes and resident complaints or concerns.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
Registered Nurse
Willis Knighton Health System
Shreveport, Louisiana
01.1995 - 04.1995
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Managed care from admission to discharge.
- Provided direct patient care, stabilized patients and determined next course of action.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
- Monitored patient reactions to drugs and carefully documented findings.
- Reviewed post-operative orders and continuously monitored patients' post-operative vitals, set up PCA and fluids and oriented patients to unit.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Education
Bachelor of Science - Nursing
Northwestern State University of Louisiana
Natchitoches, LA05.2019
Associate of Science - Nursing
Northwestern State University of Louisiana
Natchitoches, LA12.1994
Skills
- Financial Operations Oversight
- Service Utilization Improvements
- Process Implementation
- Risk Management
- Employee Supervision
- Interdepartmental Functions Coordination
- Policy and Program Development
- Employee Training Program
- Rehabilitation Programs
- Performance Monitoring
- Medicare Compliance
- Utilization Management
Accomplishments
Organizer and Presenter: Prospective Payment System Across the Continuum of Care For Case Management, Social Services, Utilization Management and Administrative Personnel Willis Knighton Health System, Shreveport, LA -3 hour seminar December 2002
Presenter: Success under Inpatient Rehabilitation Facility Prospective Payment System
American Physical Therapy Association Combined Sections Convention, Tampa, Florida-2 hour seminar February 2003
Organizer and presenter: Haynesville Shale 101: A Public Education Forum
City of Shreveport-4 hour Seminar June 2008
Represented 52 households in successfully resolving dispute regarding gas drilling rights and land owner protections and in Desoto Parish neighborhood 2008-2010
Participant: Haynesville Shale Documentary 2008-2009
Development of Willis Knighton Extended Care Center Subacute Rehabilitation and Willis Knighton Post-Acute Care Management Department.
Certification
Certified Case Manager
Timeline
Post-Acute Care Management Coordinator
Willis Knighton Health System
06.2006 - Current
Physical Medicine Case Management Coordinator
Willis Knighton Health System
05.2001 - 06.2006
Assistant Director of Nursing
Progressive Care Center
04.1996 - 06.1999
Assistant Director of Nursing
Live Oak Retirement Center
05.1995 - 04.1996
Registered Nurse
Willis Knighton Health System
01.1995 - 04.1995
Bachelor of Science - Nursing
Northwestern State University of Louisiana
Associate of Science - Nursing
Northwestern State University of Louisiana