KERRY LECHLEIDER MSN, RN, CCM
Hampton Bays,New York
Summary
Certified Registered Nurse with over 34 years of experience in ED/CC/Acute Case Management & Utilization Review, Appeals, Quality Management, Peri Operative Services, and Acute Care. Proficient in SORIAN, SUNRISE, Care Port, & Word. Ten years expertise in nursing supervision, management, and leadership. Efficient and succinct communicator. Highly successful in physician and staff relations, interdisciplinary collaboration, and patient relations. Excellent team builder and motivator.
Overview
34
34
years of professional experience
3
3
Certification
Work History
RN Case Manager
Northwell Health - Peconic Bay
10.2019 - Current
- Identified diagnosis and supporting data appropriate for IP v. OP status
- Successfilly completed Utilization Reviews and communicated with insurance companies to ensure optimal fiscal outcomes
- Optimized resource utilization by identifying opportunities for cost containment while maintaining quality of care.
- Effectively communicated with physicians and interdisciplinary team members to streamline discharge planning processes, ensuring a smoother transition to the next level of care
- Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
Emergency Department Case Manager & Utilization RN
Northwell Health, Huntington Hospital
07.2014 - 10.2019
- Work closely with ED physicians in assessing patients for admission & appropriate level of care using Milliman Care Guidelines
- Aid in detection of unjustified admissions through ED
- Actively monitored special populations to prevent readmission.
- Facilitate partnerships with multidisciplinary teams and healthcare members across continuum to establish safe, patient-centered outcomes.
- Work with Physician Advisor managing internal audits & billing modification for Medicare short stay & commercial insurers
RN Case Manager, Per Deim
Northwell Health-Flex Staff
01.2017 - 01.2019
- Case Management Duties in acute care hospitals
- Some experience in Appeals, Denials, and DPU
Patient Navigator/Total Joint Coordinator
Peconic Bay Medical Center
04.2011 - 04.2014
- Expertly planned, coordinated, and directed all operations of JC recognized TJR Center of Excellence
- Managed PI data for quality reporting, Pre Admission Screen to expedite safe discharge / Reduce LOS Case Management / PRI Assessor for TJR patients
- Coordinated with surgeons and nursing leaders to develop care paths for TJR program Patient-physician liaison & hospital representative for the community 24/7
Assistant Director of Peri Operative Services
Peconic Bay Medical Center
04.2007 - 04.2011
Acute Care, Peds, Oncology, Peri Op Services RN
Central Suffolk Hospital / Peconic Bay
05.1990 - 02.2007
Education
Masters of Science in Nursing - Health Care Systems Management
Loyola University
Bachelor of Science - Nursing
University of Phoenix
Associate of Applied Science - Nursing
Suffolk Community College
Skills
- Certified Case Manager
- SORIAN, SUNRISE, CARE PORT
- Milliman Guidelines
- Medical Necessity Assessment
- Case Review Expertise
- Critical Thinking
- Interpersonal and written communication
- Acute & Critical Care
Timeline
RN Case Manager
Northwell Health - Peconic Bay
10.2019 - Current
RN Case Manager, Per Deim
Northwell Health-Flex Staff
01.2017 - 01.2019
Emergency Department Case Manager & Utilization RN
Northwell Health, Huntington Hospital
07.2014 - 10.2019
Patient Navigator/Total Joint Coordinator
Peconic Bay Medical Center
04.2011 - 04.2014
Assistant Director of Peri Operative Services
Peconic Bay Medical Center
04.2007 - 04.2011
Acute Care, Peds, Oncology, Peri Op Services RN
Central Suffolk Hospital / Peconic Bay
05.1990 - 02.2007
- NYS Registered Nurse #424646-1
- Certified Case Manager #4212773
- New York State PRI & NYS SCREEN Certification
- ACCM, CMSA & CMSALI Member
Masters of Science in Nursing - Health Care Systems Management
Loyola University
Bachelor of Science - Nursing
University of Phoenix
Associate of Applied Science - Nursing
Suffolk Community College
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