Summary
Work History
Education
Skills
Certification
Timeline
SeniorSoftwareEngineer

KATHLEEN M. MEEHAN

Louisville,KY

Summary

Experienced with patient care, clinical assessments, and medical documentation in many work settings. Utilized strong interpersonal skills to foster patient trust and enhance care delivery. Track record of maintaining accurate health records and implementing effective care strategies.

Work History

Quality Compliance Assistant

FLOYD MEMORIAL HOME HEALTH CARE
1993 - 1997
  • Assisted in conducting compliance audits to ensure adherence to regulations and company policies.
  • Supported development and implementation of compliance training and infection control programs for staff.
  • Monitored regulatory changes and assessed impact on organizational practices and procedures.
  • Collaborated with cross-functional teams to identify compliance risks and recommend mitigation strategies.
  • Wrote and implemented infection control policies and procedures.

Home Health Nurse

Floyd Memorial Hospital
1991 - 1993

Telephone Triage RN

OPTUM HEALTHCARE
01.2023 - 12.2024
  • Worked as Telephone Triage RN. Took incoming calls for a hospital system in Pennsylvania to triage patients' symptoms and guide them to the appropriate level of care. Handled call for both adult and pediatric patients. Utilized Epic and Cerner medical record programs to access medical records, communicate with physicians and office staff, schedule appointments.

Covid Nurse

CHANGE HEALTHCARE
06.2022 - 01.2023
  • Became full time employee of Change Healthcare, after working for them as a temporary employee – see last listing for Signature Staff Resources.

Covid Nurse

SIGNATURE STAFF RESOURCES
01.2021 - 06.2022
  • Hired as temporary employee working for the New York City Department of Health. Telephonic outreach program to deal with COVID 19 questions, encourage testing and vaccinations. Made 50-75 outreach calls daily in a 12-hour shift. Took incoming phone inquiries about COVID and provided telephone triage and advice.

Telephonic Case Manager

CAREWISE HEALTH
01.2017 - 12.2019
  • Started as a temporary employee and hired full-time after 3 months. Interacted with multiple clients to teach and support lifestyle changes. Provided education about new and changed disease processes to maximize compliance with medical plan of care. Utilizing InterQual, reviewed and authorized transplants of all kinds, serving as department liaison with transplant centers.

Hedis Review Nurse

WELLCARE
02.2016 - 05.2016
  • Performed chart review for HEDIS data collection in a temporary position.

Rapid Response Case Manager

PASSPORT HEALTH PLAN
01.2011 - 05.2015
  • Responded to urgent/emergent needs of plan members ranging from medication problems to DME needs. Managed some members for compliance, arranging transportation and home health services. and navigating a path through the system to meet the member's needs.

Medical Review Nurse

NATIONAL GOVERNMENT SERVICES
06.2002 - 10.2010
  • Performed pre-pay and retrospective medical record audits to trigger fraud and abuse investigations and determine compliance with Medicare regulations. Educated healthcare providers and their staff, facilitating improved billing practices and timely payment. Initiated recoupment of payments not supported by medical records. Performed inter-rater reliability audits with peers.

Clinical Manager

VISITING NURSE ASSOCIATION
05.1999 - 06.2002
  • Managed nurses and personal care attendants providing private duty home care. Performed intake assessments and periodic updates. Managed payroll data to ensure timely and correct payment for staff. Taught orientation classes and provided periodic updates. Served as contact for patients and families to coordinate care.
  • Oversaw office operations for six-month period while Director was on medical leave.
  • Supervised office staff of five and clinical staff of more than thirty.

Case Manager

HUMANA INC.
09.1997 - 05.1999
  • Coordinated care and services for health plan members telephonically while hospitalized. Supported delivery of quality, cost effective and medically appropriate health care. Maintained close and effective working relationships with hospital discharge planners.

Staff Nurse

JEWISH HOSPITAL
01.1985 - 01.1991

Education

Associate Degree - Nursing

Bellarmine University
Louisville, KY
01.1984

Skills

  • Health education
  • Clinical evaluation skills
  • Discharge planning coordination
  • Case management proficiency
  • HEDIS data analysis
  • Medical audit execution
  • Quality assurance
  • Utilization review
  • Electronic health records management
  • Proficient in Microsoft Office Suite

Certification

  • Certified Case Manager

Timeline

Telephone Triage RN

OPTUM HEALTHCARE
01.2023 - 12.2024

Covid Nurse

CHANGE HEALTHCARE
06.2022 - 01.2023

Covid Nurse

SIGNATURE STAFF RESOURCES
01.2021 - 06.2022

Telephonic Case Manager

CAREWISE HEALTH
01.2017 - 12.2019

Hedis Review Nurse

WELLCARE
02.2016 - 05.2016

Rapid Response Case Manager

PASSPORT HEALTH PLAN
01.2011 - 05.2015

Medical Review Nurse

NATIONAL GOVERNMENT SERVICES
06.2002 - 10.2010

Clinical Manager

VISITING NURSE ASSOCIATION
05.1999 - 06.2002

Case Manager

HUMANA INC.
09.1997 - 05.1999

Staff Nurse

JEWISH HOSPITAL
01.1985 - 01.1991

Associate Degree - Nursing

Bellarmine University

Quality Compliance Assistant

FLOYD MEMORIAL HOME HEALTH CARE
1993 - 1997

Home Health Nurse

Floyd Memorial Hospital
1991 - 1993

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KATHLEEN M. MEEHAN