Lisa Moss
Silver Springs,Nevada
Summary
Motivated nursing professional with expertise in patient-centered care across acute and transitional settings. Collaborates effectively with multidisciplinary teams to achieve high-quality outcomes and streamline discharge processes, enhancing patient satisfaction and operational efficiency.
Overview
20
20
years of professional experience
1
1
Certification
Work History
RN, Case Manager
VA Sierra Nevada Health Care System
Reno, NV
05.2019 - Current
- Assessment of each veteran on the assignment by using the nursing process of assessing, planning, implementing, documentation and evaluating each veteran daily. Interviewing veterans and their families or support system at bedside to collect pertinent information on their current living situation/conditions, their support system, their functional status, safety at home or in their current situation, transportation, financial and food security, their outpatient services such as things like home health, home assistance/caregiver, service connections, primary care services, advance directives, work daily in collaboration with providers, nursing, therapies, mental health, palliative teams, geriatric teams, leadership, making follow up appointments, placing consults for medical equipment, working with pharmacy to make sure they get their medication and other services as needed, work closely with the veteran and family during discharge planning making sure to educate and follow their preferences in their own care, coordination of services and follow up post discharge to promote safety and a successful discharge
RN, Utilization Manager in Quality Patient Safety
VA Sierra Nevada Health Care System
Reno, NV
03.2020 - 05.2025
- Complete pre-admission and admission reviews to the hospital to determine medical necessity and appropriate level of care on admission. Communicate with the providers daily to discuss the results of the reviews completed using the evidence-based criteria from McKesson's InterQual system. Conduct continued stay reviews for each patient that remains in the hospital daily. Have ongoing conversations with the providers regarding diagnosis, symptom findings, interventions being done for the patient along with documentation that supports this. Work closely with surgery regarding procedures and whether they are on the designated inpatient list or if the documentation supports the medical need to remain in the hospital for 2 days to support the inpatient status or do they need to remain in observation status, worked with Revenue Utilization Review nurses when there is a concern regarding veteran status and what the outside insurance company will authorize to ensure the veteran is at the appropriate level of care and that the VHA is getting the allotted reimbursement. Work closely with administration and quality leaders to continue to improve Utilization management processes. Trained and mentored new staff in utilization reviews process, procedures and best practices
RN, Case Manager
Carson Valley Medical Center
Gardnerville, NV
04.2021 - 11.2023
- Independently manage a caseload of up to 25 patients, duties include assessment of patients current living situation, medical condition, support system, discharge needs for appropriate level of care needed on discharge, while working closely with physicians, therapies, nursing staff, CNA's, patients, and families to obtain discharge goals and needs leading to a successful discharge. Work closely with outside agencies for arrangements and referrals sent to skilled nursing facilities, home health, durable medical equipment, and oxygen prior to discharge.
- Current-part time 16hr/week
RN, CASE MANAGER
KINDRED AT HOME
Carson City, NV
07.2019 - 11.2019
- Provide patient centered care while focusing on patients being able to stay home while they continue to heal and return to their prior level of functioning after an illness or hospitalization. Focus on disease process education and management, home safety, medication management and teaching, providing and assisting with community resources for patient success in the community. Encouraging patient's active participation in their health care with follow up appointments and treatment.
- Full time
Integrated Care Manager-Manager of Department
CARSON TAHOE HEALTH
Carson City, NV
04.2017 - 08.2019
- Provided strategic direction, leadership, daily oversight, ensuring compliance with healthcare regulations, while managing resources efficiently for 25 employee Interdisciplinary Care Management team inclusive of RN Case Managers, Social Workers, Transitional Care Staff, Utilization Nurses, UR Specialists, Long Term Acute Care Interdisciplinary Staff and Ancillary personnel. Fostered patient-centered relationships with skilled nursing facilities and home health administrations to coordinate post-discharge care and to ensure that the individualized care plan was being executed in a prompt and professional manner. Liaised between patients and financial services to resolve denials, coordinate appeals, and ensure timely payment for services provided. Played an instrumental role by serving as an ongoing resource to new and continuing employees facilitating additional support for difficult discharges. Identified and evaluated operational deficiencies and recommend improvement plans to drive elevated performance of the staff and the organization. Motivated employees to increase care contributions to sustain optimal levels of high-quality, cost-effective care for patients and their families. Worked closely with Transitional Care Nurses to monitor hospital readmissions ensuring cost-effective utilization of medical resources.
- Reversed the trends of patient satisfaction scores being in the “red” zone to meeting and/or exceeding the national benchmarked average of 75%.
- Streamlined the discharge process so that patients spent less than one hour between initial discharge processing and departing for their home environment.
- Collaborated with Durable Medical Companies to reduce the wait time from up to 6 hours to within 2 hours for the arrival of requisite medical equipment needed for patient discharge.
- Organized a readmission workgroup with outside skilled nursing facilities to decrease the readmission rates from the facilities to the emergency room within the 30 days post discharge
- Full time
Case Management – Registered Nurse
01.2011 - 01.2017
- Independently managed a caseload of 25 to 50 patients transitioning between the hospital and their residence or other outside care facilities. Consulted and conferred with physicians at the time of admission to plan for appropriate care throughout the duration of hospitalization. Collaborated with multidisciplinary healthcare providers and community resource partners to develop and carry out the patient's plan of care with an emphasis on therapeutic and restorative care to empower individuals to achieve established care goals and objectives. Ensured the provision of appropriate and requisite levels of care. after discharge to further optimize patient outcomes. Analyzed resource utilization to promote effective use of medical services and to minimize the risk of unnecessary service use or rehospitalization.
- Full time
Nurse Manager – SNF/Long Term Care
SOUTH LYON MEDICAL CENTER
Yerington, NV
01.2014 - 01.2015
- Managed a multidisciplinary team of 70 total employees in a 48-bed Skilled Nursing and Long-Term Care facility ensuring the delivery of high quality, patient-centered care while adhering to strictly established budgetary and staffing parameters. Facilitated human resources processes including recruitment, hiring, and training of highly talented healthcare providers to ensure adequate staffing within organizationally established protocols and federally regulated healthcare guidelines. Conducted routine staff performance evaluations to identify areas in need of improvement; offered education and resources to assist individuals in enhancing their skills and implemented corrective action plans, if needed. Collaborated with physical and occupational therapists to evaluate individual patient's rehabilitative progress and to assess the need for continued services, worked closely with outside hospitals on reviewing referrals for continued skilled nursing and therapy needs to qualify for Skilled nursing stay at the facility; advocated for all identified care needs to optimize patient recovery outcomes.
- Championed influential leadership over committees including: Infection Control, Quality, Behaviors, Fall, and Psychotropic Medication Review; assessed current practices and recommended actionable changes to improve the quality of care and outcomes for each patient.
- Full time
Registered Nurse: Emergency Room
SOUTH LYON MEDICAL CENTER
Yerington, NV
01.2007 - 01.2015
- Utilized the nursing process to deliver comprehensive, integrated care in collaboration with multidisciplinary healthcare professionals for individuals across the lifespan with a broad range of acute and critical injuries and illnesses in a 16-bed Emergency Department. Triaged all incoming patients and prioritized care based on acuity, stability, and available resources. Coordinated and facilitated transfers to large hospitals and medical centers for higher acuity conditions. Produced timely, complete, and accurate documentation to the patient's medical record to ensure exceptional continuity of care.
- Full time, per diem
Registered Nurse: Medical Oncology Unit
01.2009 - 01.2011
- Assessed, planned, delivered, and evaluated individualized, compassionate care for up to 7 patients per shift on a 48-bed Medical/Oncology unit. Coalesced a multidisciplinary team around the provision of holistic care to assist patients in maintaining comfort and achieving established care goals objectives. Administered physician prescribed treatments including pharmacologic and non-pharmacologic interventions; monitored patient's responses to care to maintain the highest level of patient safety. Educated patients and their family members on diagnosed conditions and requisite treatments to assist patients in achieving optimal outcomes. Ensured timely documentation to the patient's electronic medical record to effectively manage continuity of care.
- Full time
Education
Bachelor of Science - Nursing
Nevada State College
Henderson, NV01-2015
Associate of Applied Science - Nursing
Western Nevada College
Carson City, NV01-2008
Skills
- Patient assessment
- Care coordination
- Utilization review
- Discharge planning
- Evidence-based nursing
- Healthcare compliance
Certification
- Nevada State board of Nursing, Registered Nurse License, (Active)
- American Case Management Association Certification
- BLS Certification, (Active)
Areas of Training and Expertise Include:
- Department Management & Servant Leadership for Utilization Review and Case Management
- Skilled Nursing Facility Leadership
- Utilization Management
- Medical necessity and documentation
- InterQual and MCG criteria expertise
- VHA Utilization Management
- Community Utilization Review Revenue focus working with insurance companies
- Case Management
- Interdisciplinary Communication
- Admission/ Discharge Planning
- Collaboration with providers
- Hospital Readmission focus
- Chronic Care Management
- Transitional Care
- Home Health Care
- Evidence Based Practice
- CMS regulations
Timeline
RN, Case Manager
Carson Valley Medical Center
04.2021 - 11.2023
RN, Utilization Manager in Quality Patient Safety
VA Sierra Nevada Health Care System
03.2020 - 05.2025
RN, CASE MANAGER
KINDRED AT HOME
07.2019 - 11.2019
RN, Case Manager
VA Sierra Nevada Health Care System
05.2019 - Current
Integrated Care Manager-Manager of Department
CARSON TAHOE HEALTH
04.2017 - 08.2019
Nurse Manager – SNF/Long Term Care
SOUTH LYON MEDICAL CENTER
01.2014 - 01.2015
Case Management – Registered Nurse
01.2011 - 01.2017
Registered Nurse: Medical Oncology Unit
01.2009 - 01.2011
Registered Nurse: Emergency Room
SOUTH LYON MEDICAL CENTER
01.2007 - 01.2015
Bachelor of Science - Nursing
Nevada State College
Associate of Applied Science - Nursing
Western Nevada College