Experienced nursing professional bringing demonstrated clinical expertise, leadership skills and technical knowledge. Proficient in reviewing charts for accuracy and completeness and working with multidisciplinary teams to optimize patient care. Quality-driven and efficient with strong interpersonal abilities.
Overview
1
1
Certificate
Work History
Regional Dir. of Clinical Services & Reimbursement
Grace Healthcare, acquired by Portopiccolo Group
2019 - Current
Participate in developing plans of correction.
Reviewed medical records for accuracy and completeness.
Provided training and coaching to DONs and MDS Coordinators.
Crafted and initiated development of strategy-based plans, allowing organization to exceed objectives and achieve goals, such as increasing the 5 Star Score.
Partnered with nurse managers to raise standards of practice by developing and implementing performance improvement projects.
Monitored quality assurance initiatives in order to improve patient outcomes.
Improve policies and procedures through development, implementation, revision and evaluation of new protocols.
Utilized active listening and interpersonal communication skills to build professional relationships with patients, clinical staff and other stakeholders.
Developed tools for improving facility process efficiency, such as a Morning Meeting Workbook in Excel and a PDPM Resource Guide.
Participated in risk management through incident and investigation review for facility events, including facility reportable incidents.
Created custom templates in the electronic medical record system.
Active participant in facility Emergency Preparedness, Water Management, and Infection Control Committee's.
Regional Director of Clinical Reimbursement
Grace Healthcare Clinical Support Partners
2016 - 2019
Reviewed medical records to ensure accurate diagnosis coding, MDS assessment completion, transmission, and billing.
Participated in performing unannounced team mock survey's in facilities.
Provided education and coaching regarding the MDS process, Quality Measures, and clinical reimbursement payment systems.
Completed auditing, preparation, and follow-up for the company's annual Corporate Integrity Agreement with CMS. This included completing on-site facility preparation and support before and during the Independent Review Organizations inspection visit, followed by preparing the charts to be submitted for auditing. Next, would implement the teaching required based on the findings of the annual review by presenting and educating to the facilities in my region, and then following up with quarterly audits to ensure understanding of the education as evidenced by MDS and billing accuracy.
Participated in corporate QAPI meetings to monitor company performance, identify areas for improvement, and develop strategies.
Monitored facility performance in CMS quality measure outcomes, analyzed for accuracy and opportunities for improvement, and worked with facility team to develop a plan.
Multiple Roles
Grace Healthcare of Three Rivers
2011 - 2016
RN: Started working as an RN providing direct care to residents. Completed assessments, medication administration, wound care, IV management, enteral nutrition, and dementia care.
Unit Manager: Transitioned to Unit Manager and completed resident risk assessments, incident investigation, at-risk interdisciplinary meetings, care plan updates, infection reports, new chart reviews, QAPI committee participant, and collaborated almost daily with the physicians.
ADON: Transitioned to Assistant Director of Nursing and became the unit manager for the skilled, rehab unit. In addition, was the staff development coordinator, back-up MDS Coordinator, and participated in writing and implementing POCs. Also took lead in researching current best practice guidelines as acuity changed in our resident population and provided the education to staff as needed to safely and appropriately care for the residents.
MDS Coordinator: Transitioned to MDS Coordinator and led all MDS processes, ICD-10 diagnosis coding, insurance certifications, referral reviews, and weekly utilization review meetings.
As the ADON in the first year and and then the MDS Coordinator in the third year of the company's Corporate Integrity Agreement, I was the lead facility staff member, working with the corporate team, through the Independent Review completed on-site.
Education
Bachelor of Science in Nursing -
Grand Canyon University
03-2016
Associate Degree in Nursing -
Glen Oaks Community College
05-2011
Skills
Quality Improvement
Clinical Leadership
Interdisciplinary Collaboration
PDPM Reimbursement System
Infection Preventionist
ICD-10 Coding
Level 3 Access for NHSN
Certification
RAC-CTA from AAPACN
DNS-CT from AAPACN
Positive Approach to Care Certified Trainer
Certified Nursing Home Infection Preventionist from the CDC
Timeline
Regional Dir. of Clinical Services & Reimbursement
Grace Healthcare, acquired by Portopiccolo Group
2019 - Current
Regional Director of Clinical Reimbursement
Grace Healthcare Clinical Support Partners
2016 - 2019
Multiple Roles
Grace Healthcare of Three Rivers
2011 - 2016
Bachelor of Science in Nursing -
Grand Canyon University
Associate Degree in Nursing -
Glen Oaks Community College
References
Renee Warner, Nursing Home Administrator, (269)906-1065
Ava Green, Director of Clinical Services, (816)679-4548
Kylee Knapp, Director of Nursing, (269)506-1644
Miki Schrader, MDS Coordinator, (269)506-7826
References
Renee Warner, Nursing Home Administrator, (269)906-1065
Ava Green, Director of Clinical Services, (816)679-4548
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