Tracy TUMMINELLO
St. Louis,MO
Overview
1
1
Certification
24
24
years of professional experience
Work History
Patient Care Manager
Gentiva Hospice
St Louis, Missouri
03.2026 - Current
- Facilitated interdisciplinary team meetings to evaluate ongoing medical necessity of hospice care, ensuring alignment with patient needs and regulatory requirements.
- Applied evidence-based practices to support safe, effective, efficient, equitable, and patient-centered care.
- Reviewed documentation to ensure adherence to hospice policies and care standards, enhancing quality of patient care.
- Supported process improvements for patient flow and staffing models, contributing to more effective resource allocation.
Hospice Clinical Liaison, Senior
Gentiva Hospice
St Louis, Missouri
08.2024 - Current
- Evaluate hospice medical necessity for all referrals through patient and family assessments, and medical record review.
- Coordinate transitions in care with multidisciplinary departments and facilities.
- Provide education to hospitals, skilled and long-term facilities, clinics, cancer centers, and physician offices on hospice indicators.
- Conducted informational meetings with patients and families to discuss hospice services.
Clinical Nurse Specialist
SSM SLUCARE
St Louis, Missouri
03.2024 - 08.2024
- Conducted thorough assessments to identify and address patient needs and concerns.
- Evaluated patient care needs, prioritized treatment, and streamlined patient flow to enhance care delivery.
- Conducted assessments before and after surgeries to ensure patient safety and care quality.
Clinical Nurse Supervisor
SSM St. Louis University Hospital
St Louis, MO
10.2022 - 03.2024
- Supervised hiring, training, and development of nursing staff, ensuring high-quality care standards.
- Facilitated interdisciplinary team meetings with physicians and health care professionals to create comprehensive treatment plans for patients.
- Led team in delivering care services, enhancing patient satisfaction outcomes.
ACUTE REGISTERED NURSE II
DaVita
St. Louis, MO
11.2021 - 10.2022
- Deliver hemodialysis to critically ill patients, utilizing strict safety measures.
- Conducted health assessments to evaluate patient needs and conditions.
- Cultivated strong partnerships with medical staff and departments to ensure effective collaboration. with medical staff and ancillary departments.
CLINICAL COORDINATOR
Shriners Hospitals for Children
St. Louis, MO
07.2020 - 11.2021
- Coordinated with nurse manager to develop nurse education programs, enhancing departmental competencies and addressing patient safety.
- Delegated assignments and supervised staff to maintain high standards of patient care.
- Conducted daily audits of documentation to ensure accuracy in billing and compliance with regulatory standards.
CDI/UM SPECIALIST
Shriners Hospitals for Children
St. Louis, MO
07.2014 - 07.2020
- Completed prospective, concurrent, and retrospective medical record reviews, establishing appropriate LOC.
- Determined medical appropriateness of inpatient and outpatient services in compliance with InterQual level of care criteria, and CMS guidelines.
- Reviewed patient records for accuracy and completeness, ensuring compliance with regulations.
- Generated queries to providers to accurately capture the patient's condition, impacting reimbursement and quality metrics.
- Managed denial cases through peer-to-peer discussions and drafted letters of medical necessity, facilitating timely resolution.
- Reviewed extended-stay admissions for alternative care options, reducing unnecessary hospital days.
- Spearheaded education on ICD-9 to ICD-10 transition for local physicians and staff, enhancing understanding and compliance.
- Conducted orientation sessions for medical staff, focusing on utilization management and documentation improvement.
CLINICAL SUPPORT NURSE
SSM-St. Clare Hospital
St. Louis, MO
08.2009 - 07.2014
- Directed daily flow and staffing needs for a busy 24-bed inpatient unit, caring for orthopedic/general surgery, pediatric surgery, and overflow complex medical patients.
- Cultivated strong professional relationships with provider team, enhancing provider satisfaction and engagement.
- Partnered with administrative team to enhance patient care processes and support division objectives.
REGISTERED NURSE
Shriners Hospitals for Children
St. Louis, MO
08.2002 - 01.2009
- Monitored patient responses and assessed intervention effectiveness through ongoing evaluation.
- Supported patient care within nursing scope, with focus on patient and family teaching during care transitions.
- Assisted with house supervision duties, coordinated staff assignments, and addressed patient needs promptly.
Education
Bachelor of Science - Nursing
Grand Canyon University
Phoenix, AZ01-2019
Skills
- Medical necessity assessment
- Regulatory compliance
- Communication effectiveness
- Documentation integrity
- Chart review
- Utilization oversight
- Quality control
- Document management
- Analytical thinking
- Detail-oriented approach
- Communication effectiveness
- Clinical justification
- Documentation integrity
Certification
- Registered Nurse- Missouri/ National Compact License
- AHA BLS
Accomplishments
- SIGMA THETA TAU INTERNATIONAL NURSING HONORS SOCIETY
- ALPHA CHI NATIONAL HONORS SOCIETY, Grand Canyon University
- DAISY AWARD NOMINEE, 2018 and 2021
Timeline
Patient Care Manager
Gentiva Hospice
03.2026 - Current
Hospice Clinical Liaison, Senior
Gentiva Hospice
08.2024 - Current
Clinical Nurse Specialist
SSM SLUCARE
03.2024 - 08.2024
Clinical Nurse Supervisor
SSM St. Louis University Hospital
10.2022 - 03.2024
ACUTE REGISTERED NURSE II
DaVita
11.2021 - 10.2022
CLINICAL COORDINATOR
Shriners Hospitals for Children
07.2020 - 11.2021
CDI/UM SPECIALIST
Shriners Hospitals for Children
07.2014 - 07.2020
CLINICAL SUPPORT NURSE
SSM-St. Clare Hospital
08.2009 - 07.2014
REGISTERED NURSE
Shriners Hospitals for Children
08.2002 - 01.2009
Bachelor of Science - Nursing
Grand Canyon University