Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Conducts timely and accurate Quality Assurance Reviews of waivers, residency agreements, Quarterly Centralized Complaint Intake Program and Justice Center Abuse/Neglect cases. Provides clinical feedback and recommendations.
Monitors and processes Transitional Adult Home Waivers in timely manner. Effectively communicates between DOH, Office of Community Transitions and Adult Care Facilities. Issues letters of determination and maintains log of dates received and dates processed.
Monitors and provides reviews, routing and responses to multiple Bureau Mail Logs.
Prepares and accurately processes documentation and written correspondence within the agency and with outside providers.
Actively participates and provides clinical expertise and input with updates and revisions of policies and procedures. Serves as an Inspection Review Process panelist.
Responsible for independent review of medical records and evaluations of submitted documentation to determine Medicaid Disability Determination.
Utilized department guidelines, New York State Regulations and Policy and Procedures to process Medicaid cases.
Collected, analyzed electronic medical records and documented medical evidence and data to designated formate.
Professional Registered Nurse with 40 years of clinical experience/expertise Excellent work ethics and function in many diverse health care settings Collaborate and motive as team member and effectively function individually