Linda Barajas

Provided comprehensive care to diverse patient populations. Skilled in diagnosing and treating acute and chronic conditions, performing physical exams, interpreting lab results, and educating patients on health management. Strong communication skills and a collaborative team player committed to enhancing patient outcomes and promoting wellness.

• Responsible for improving the overall quality and completeness of clinical documentation
• Analyzes medical records for DRG's, complications, and comorbidities; identifies trends; and notes observations and recommendations for documentation improvement
• Facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient care givers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients
• Provide clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services
• Additional duties include supporting the accuracy and completeness of the clinical information used for measuring and reporting physician and hospital outcomes and educating all members of the patient care team on an ongoing basis

• Collaborate with project investigators and research sites to ensure targets are met for study start up, site activation, patient recruitment and enrollment
• Develop/contribute to clinical documents including protocol and informed consent forms, study manuals, source documentation templates, recruitment materials and other study tools
• Work closely with Data Management, Systems and Biostatisticians to assist with the design of case report forms, study portals and electronic data capture systems
• Assist in safety management and reporting to FDA, Data and Safety Monitoring Boards, medical monitors, funding agencies and other regulatory bodies
• Lead cross-functional teams in the timely execution of high quality clinical research projects leveraging knowledge, expertise, and risk mitigation while functioning as the principal liaison with key clients, vendors, and internal team members
• Build effective, high performance teams via expert communication, decisiveness, and technical expertise
• Collect, review and approve of all required regulatory documents; and work file to ensure the study Trial Master File (TMF) is up to date and 'audit ready' throughout the course of the study
• Oversee IND/CTA applications and communication with regulatory agencies (FDA, Health Canada, etc.) for studies with investigator held INDs/CTAs
• Assist project sites with IRB submissions, maintenance of regulatory documents and responding to study related questions from sites, vendors and sponsors in a timely fashion
• Schedule and develop agenda for project meetings and conference calls
• Tabulate key metrics for progress reports, help develop presentations for scientific meetings, and assist in preparing publications
• Prepare presentation materials, such as slide decks, that summarize study progress and efficiency metrics
• Plan, manage, execute and participate in all study team meetings both remote and in person
• Work closely with PI/Sponsor assist with management of vendor activities
• Travel to national and international professional meetings as needed

• Provide strategic and operational direction to the Case Management Department
• Develop and implement strategies that support the delivery of high quality and cost effective strategies that support the delivery of high quality and cost effective case management
• Ensure Case Management processes and procedures are adequately represented and integrated into clinical programs, operations and finance to ensure coordination and alignment with broader organizational goals
• Policies and procedures are developed to meet case management and discharge planning goals
• New clinical program design and development initiatives are participated in to meet customer needs
• Case Management enterprise-wide initiatives are led and participated in to meet organization goals
• Department compliance is monitored and maintained to meet licensing and accrediting agency standards
• Educate members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and care management
• Utilization Review Committee co-chair member responsible for driving change, monitor status, and achieve organization goals
• Team members are hired, mentored, and continually developed to achieve stated goals for performance
• Performance evaluations are completed and accurately and timely in accordance with organization standards
• Business plan is aligned with Steward Healthcare strategy and is updated at least annually to drive change to meet market and organizational goals
• Market and organizationally agreed upon outcomes drive work and team efforts
• Steward Healthcare Organization Values of Innovation, Collaboration, Accountability, Respect, and Excellence are upheld

• Facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient
• Exhibit knowledge of clinical documentation requirements, DRG assignment, and clinical conditions or procedures
• Perform utilization review of inpatient admissions, outpatient surgeries, and ancillary services using Inter-Qual criteria
• Educate members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, and care management
• Determine medical necessity and appropriateness of services using clinical review criteria and accurately document all review determinations
• Provide clinical expertise and help to clarify issues with claims, quality management and provider as needed
• Identify cases that do not meet established clinical criteria to the Medical Director

• Support leadership in efforts to meet and sustain regulatory compliance of the department and hospital
• Demonstrate consistent integration of Inter-professional Practice Model
• Conduct comprehensive assessment of patient's/family's health and psychosocial needs
• Working with the patient's/family to establish treatment goals that meet the patient's healthcare and safety needs
• Provide self-management support to high risk/complex patients and families
• Educate patient, family or caregiver and members of the healthcare team about treatment options
• Empowering the patients to problem solve by exploring options of care when available and alternative plans, when necessary, to achieve desired outcomes
• Evaluate the timeliness and availability of treatments and services, and adjust level of service according to changing needs
• Evaluate actual outcomes in relation to expected outcomes
• Identify quality improvement opportunities and consistent issues with smooth care progression and communicate them to the unit's management team, providing supporting data
• Participate in the management of metrics (outcomes, value, and experience) across the continuum of care
• Serve as a resource for other members of the healthcare team
• Conduct psychosocial assessments and provide emotional support to patients on the medical, surgical, and intensive care units in a brief treatment setting
• Work with medical team to plan safe dispositions for patients
• Facilitate discussions regarding options, as they relate to complex situations
• Assist with the transition of care and/or planning
• Coordinate medical educational and community based support services
• Impart supportive counseling and crisis services
• Act as intermediary to community resource programs
• Extend services to patients and family members
• Coordinate as member of interdisciplinary clinical team
• Utilize Milliman and Inter-Qual guidelines to recommend correct level of care for medical and surgical patients admitted through all portals of entry to Maine Medical Center
• Assist physicians and house staff in determining medical necessity for inpatient admissions