LaRhonda Conte

• Support the Case Management office with an emphasis on smooth transitions from care setting, e.g. in-basket messages, schedules follow-up KP center appointments for our members and our community services patients seen by KP physicians. Referral entry. Support Nursing staff with follow-up calls. Support nursing staff with trouble shooting services issues discovered during follow-up calls.
• Develops and maintains relationships with and among co-workers, external agencies and providers and various internal departments as they relate to the functioning of the referral management process as they relate to accessing services and coordination of care across transition. Support the nursing staff with the SNF and home care placement process. Copy and fax charts.
• Revises the hospital census reports from the previous and current day, and follows departmental procedures to expedite data entry/integrity and the discharge of our members across various care setting. Entry of inpatient hospital authorizations. (Including NICU). Arrange ambulance services for transport.
• Informs the hospital, facility, agency and business office of any member eligibility or coverage issues.
• Varies member eligibility and benefit coverage for various referral services. Determines applicability of coordination of benefits and ensure all appropriate payers sources are billed that includes Medicare, Workers Compensation, and co-coverage issues.
• Reviews with the manager and staff, eligibility or benefit clarification discrepancy.
• Serve as a contact person for obtaining and maintaining member information specific to transitional care services and communicates all relevant information to all required and coordinating within KP.
• Prepares and maintains data daily in the Health Care to report to facilities accurately hospital, e.g. RWB reports.
• Provides continuous telephone and clerical coverage for the CM office.
• Prepares and generate standardized or individual letters, memorandums, forms and materials associated with authorization and processing of hospital and referral services as needed under the direction of the Nurse.
• Participates in the orientation of new providers and staff regarding the referral management process.
• Keeps abreast of Kaiser Permanente and organizational policies and procedures which impact departmental operations, interprets and communicates them to physicians and other who are involved.
• Maintains current knowledge about, understands and follows state regulation requirements regarding benefits administration, case management and the use of specific guidelines and protocols.
• Perform other related duties as directed.

• Facilitates care of members in collaboration with Kaiser Permanente of the Mid-Atlantic States (KPMAS) staff, Mid-Atlantic Permanente Medical Group (MAPMG), Network, contracted and non-contracted providers.
  • Provides technical and professional support for the KPMAS, and Hospital Services Management (HSM) offices.
  • Coordinates health care services for our members in affiliated and non-affiliated service delivery systems.
  • Follows local, state and federal jurisdictional regulations on applicable activities and projects to ensure regulatory compliance.
  • Verifies membership eligibility regionally and inter-regionally to coordinate health care services for members.
  • Facilitates meeting KPMAS Utilization Management targets by routing authorizations electronically to appropriate reviewer.
  • Resolves rejected authorizations in the claims processing system.
  • Performs other related duties as directed

Assists pharmacists in obtaining patient specific information as appropriate for safe medication management.
Under direct supervision, participates in the exchange of information with appropriate healthcare professionals and staff.

Ensures that medications are selected and procured based on departmental criteria.
Demonstrates a working knowledge of the formulary list and the formulary process.
Adheres to policies and procedures regarding the procurement of non-formulary medications.
Adheres to policies and procedures that address medication shortages, outages, emergency and disaster situations.
STORAGE
Ensures that medications are properly and safely stored throughout the hospital.
Stocks or stores only approved routine and emergency medications and adheres to appropriate par levels
Stores medications under conditions necessary to ensure stability
Secures medications in accordance with the hospital’s policy and law and regulation
Stores controlled substances in such a manner to prevent diversion in accordance with state and federal laws and regulations
Appropriately labels all medications and chemicals used to prepare medications with contents, expiration dates and appropriated warnings
Abides by recommendations from regulatory and advisory groups regarding safe medication principles, including look alike, sound alike and high alert drugs
Routinely inspects all medication storage areas according to hospital’s policy

Safely and accurately prepares sterile products using appropriate techniques.
Employs appropriate precautions when preparing hazardous medications and Chemotherapy medications
Orders and stocks supplies necessary for the preparation of compounded sterile products (CSPs).
Coordinates information between the nursing units and pharmacy necessary for the timely preparation and delivery of CSPs. Makes morning rounds when necessary.
Performs daily cleaning and preparation of the IV Lab.
Prints labels for CSPs using the pharmacy information system.
Employs techniques to assure accurate medication preparation.
Prepares medications in the most ready to administer form.
Prepares emergency carts and boxes for closure by pharmacist.
Fills stock exchange carts for OR, PACU, and IN & Out surgery.
Labels medications according to hospital policy, applicable laws and regulations, and standards of practice to ensure safe, accurate administration.
Labels medications for dispensing with the drug name, strength, amount expiration date, patient name, patient location, and directions for use.
Assists in dispensing medications in a safe manner.
Under supervision of pharmacist, prepares quantities that are minimally sufficient to treat patient’s needs safely.

Transports medication to patient units within established departmental standards for turnaround times. Assures accurate and timely delivery.

Adheres to all laws, regulations, and hospital policies regarding the management of recalled, discontinued, unused, expired, or returned medications.

Selects and fills medication to be dispensed by the automated distribution system. Removes discontinued medications from the units and ADMs.

Inspects returned medications for integrity before returning to stock. Segregates outdated or recalled medications from pharmacy stock.

Accounts for all unused, expired, or returned controlled medications according to the law. Checks pharmacy stock for expired medications.

MONITORING
Removes discontinued medications from the units and ADMs. Inspects returned medications for integrity before returning to stock. Segregates outdated or recalled medications from pharmacy stock.

Accounts for all unused, expired, or returned controlled medications according to the law. Checks pharmacy stock for expired medications.

Responds appropriately to medication occurrences.

Understands and takes appropriate action when a medication occurrence is identified

Complies with internal reporting requirements for medication occurrences using the Medication Occurrence Reporting System

Participates in the evaluation of the hospital’s medication management system for risk points and identifies areas to improve safety.
Participates in multi-disciplinary quality and service improvement teams.
Performs other related duties as assigned.

Greets members at reception area of behavioral health department, enters information into computer system, & receives co-payment as appropriate. Performs a variety of secretarial & administrative duties to support department.

Essential Functions:
• Greets patients & answers questions about benefits, services & programs.
• Verifies eligibility of patients & inputs patient data in computer system.
• Initiates the completion of required forms & receives co-payment from patient as appropriate.
• Retrieves mental health charts for use by provider; files providers' notes in patients' charts; maintains department files.
• Assists patients to schedule follow-up appointments & gives appropriate pre-appointment instructions.
• Types correspondence & other documents for providers.
• Coordinates meetings, interviews, & schedules for providers.
• Coordinates the transfer of patients to mental health facilities under direction of providers.
• Performs other related duties as directed.

Primary Duties and Responsibilities:

Operates telephone switchboard and routes calls to the proper area in the hospital.
Contact necessary persons involved in a code, Rapid Response, C-Port, or Stroke.
Provides general information to the public.
Places long distance calls for the hospital and assists patients with long distance requests.
Monitors all emergency alarm systems for the hospital.
Reports all telephone malfunctions.
Maintains paging services for organizations associated with the hospital.
Records daily “on call” rosters for all shifts.
Maintain cleanliness of the work area. Also does a weekly cleaning of the office in general. This task is done by the night shift. Night shift also checks all forms, tallies calls, checks supplies, cleans and stocks office, checks all equipment for paper, and replacement items.
Operate AMCOM PBX phone system. Must be able to access, and utilize all components involved with system.
Provides and maintains all the pagers used by hospital staff.
Maintains expired list of patients and reports this information to the Medical Records Department.
Records transfers to other hospitals and notifies appropriate personnel of the transfer.
Maintains monthly schedules for departments that are needed in the event of an emergency. Notified these departments as a reminder when schedules need to be updated.
Responds to requests as needed to contact the Operating Room, Recovery Team when needed.
Performs all other related duties as assigned.

As a pharmacy technician I Assist pharmacist with prescription set up, inventory, answering phones, labeling bottles, and computer input of insurance information, and ringing customers.

As a shift supervisor, I order low stock items, assist customers with issues, assist staff with problems, give change when needed, count down cash drawers at the end of shifts, travel back to make deposits or get change. Stocked shelves, placed or remove sale signs, assist with unloading delivery trucks and answering phones and assisting in the pharmacy when needed.