Kristin Wrubel
Pinellas Park,FL
Summary
Highly-motivated employee with desire to take on new challenges that will expand and build upon previous experiences with Utilization Review and Level of Care Determination and Coordination. Bringing strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Proficient in Medicare skilled level of care criteria and associated regulations with over 20 years experience. Knowledgeable of a multitude of software platforms.
Overview
17
17
years of professional experience
Work History
MDS Director
The Springs of Boca Ciega Bay
South Pasadena, FL
12.2022 - Current
- Managed comprehensive, interdisciplinary assessments for patient admissions and concurrent reviews to determine and deliver appropriate level of care as well as determine appropriate transition points to lesser or higher levels of care.
- Compiled reports from various systems regarding utilization review outcomes and quality indicators as requested by management staff.
- Analyzed clinical data using statistical tools to identify informational trends.
- Adjusted data into necessary formats by using categorization and classification software such as EHR, PCC, Interqual, Matrix, and Simple LTC, Availity, Anna, Patient Keeper and others.
- Maintained an effective working relationship with all levels of internal staff as well as external partners.
MDS Coordinator
Signature Healthcare-Gulfport rehabiliation
South Pasadena, FL
04.2020 - 11.2022
- Responsible for the timely coordination and completion of the MDS/RAI and care planning processes
- Determine if continued skilled stay criteria is met through ongoing assessment and clinical updating. Sole decision maker for approving skilled services and the subsequent termination of skilled services. As well as the timely Issuance of Notice of Medicare Non-Coverage and detailed explanation letters.
- Participated in discharge planning recommendations for post skilled services as warranted.
- Responsible for management of the quality measures and data integrity program. In my first 6 months of managing this process I have improved the quality measure star rating from 2 to 4 stars and am on target to hit the 5 star mark at the end of the next quarter.
Regional Nurse Consultant
Wellcare consulting and management-MICHIGAN
03.2015 - 04.2020
- Provided clinical operational support for three Long Term Care Nursing Facilities
- I was responsible for clinical oversight and direction of the skilled services units; Including policy development, auditing and education, survey readiness, as well as supervision and management over the RAI/MDS departments to ensure Medicare skilled criteria and Insurance contractual agreements were being upheld and adhered to. Utilized EHR, PCC, Matrix, and Interqual programming.
- My responsibilities included ensuring compliance with clinical services delivery, correct and complete documentation, reimbursement processes and practice while also serving as the risk management and mitigation officer
- With my leadership, the RAI/MDS departments ran deficiency free through four years of regulatory visits and audits, and the overall star rating improved an average of two points across all three locations
- Under my management, we successfully introduced, implemented and transitioned to the use of an electronic health record at all Wellcare locations.
- Collaborated with local healthcare providers to identify gaps in care delivery systems and develop solutions.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Maintained open communication with team members and stakeholders, resulting in successful project outcomes.
RN HOME HEALTH
Ameriflex home health
Macomb, MI
09.2016 - 05.2018
- Provided home health nursing services to post-acute care patients with a variety of skilled care needs
- As lead admission nurse, I was responsible for accurate assessment and plan of care development, as well as complete and timely documentation utilizing both Oasis and Interqual Criteria to determine level of care needs.
- After my initial 90 days, ALL of my documentation was deemed successfully submitted and accepted at 100% and I was invited to obtain additional hours by auditing plan of care claims prior to submission for other visiting nurses.
mds coordinator/DON
caretel Inns-michigan
08.2010 - 03.2015
- Hired in as the MDS Coordinator for a 60 bed subacute rehab unit where I was charged with the coordination and completion of the RAI/MDS and care planning processes
- After two years I was promoted to the position of Director Of Nursing Services
- In this role, I was successfully responsible for directing and managing daily clinical operations for a nursing community that was comprised of 60 subacute beds as well as 40 assisted living beds.
regional mds coordinator
11.2006 - 08.2010
- Verified quality of assessments in accurately reflecting physical, mental and psychosocial status of each resident.
- Performed data entry functions associated with entering information into computer systems used for tracking and monitoring purposes.
- Followed standard operating procedures to perform quality control audits.
Education
RAC-CT -
AANAC 2010, 2014, 2019 And Relias 2022
06-2022
Registered nurse -
07.2019
Registered nurse -
03.2000
Bachelor of science in nursing -
01.2000
Skills
- Certified in patient assessment
- Extensive experience with and knowledge of Medicare A and CMS regulatory compliance
- Proficient with level of care determination utilizing Medicare A and CMS Regulation
- Notice of Medicare Non-Coverage and Detailed Explanations experienced
- Able to work with multiple software systems including microsoft applications, DOS, PCC, Matrix, Oasis, Interqual, Availity, Anna, Patient Keeper
- Able to work independently
- Workflow Coordination Expert
- Records Management Experience
- Over 14 years of Utilization Review and Utilization Management experience within diverse post acute care settings
Personal Information
Title: RN, BSN
References
- Lesli Wade Springs, BOM, The Springs, 813-679-8817
- Amy Riley, Admistrator, Gulfport Rehabilitation, 630-853-7975
- Shazad Yousif, Administrator, Amerflex HHC, 248-910-1727
- Jackie Steffen, Administrator, Wellcare, 248-770-6487
- Jody Seal, therapy director, Caretel, 313-408-0605
Timeline
MDS Director
The Springs of Boca Ciega Bay
12.2022 - Current
MDS Coordinator
Signature Healthcare-Gulfport rehabiliation
04.2020 - 11.2022
RN HOME HEALTH
Ameriflex home health
09.2016 - 05.2018
Regional Nurse Consultant
Wellcare consulting and management-MICHIGAN
03.2015 - 04.2020
mds coordinator/DON
caretel Inns-michigan
08.2010 - 03.2015
regional mds coordinator
11.2006 - 08.2010
RAC-CT -
AANAC 2010, 2014, 2019 And Relias 2022
Registered nurse -
Registered nurse -
Bachelor of science in nursing -
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