Maria Buena Harkins

• Providing support to the Care Management Team who coordinates care for member/patients throughout the healthcare continuum. Works closely as a healthcare team members perform clerical tasks related to overall team function and activities identified during the initial and ongoing assessment of member / patient.
• Developed and maintained efficient workflow processes to enhance operational efficiency.
• Facilitated communication between departments to streamline patient care initiatives.
• Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
• Trained new staff on administrative procedures and software applications for consistency.
• Scheduled P2P for doctors on inpatient admission denials.
• Submitted SAR referrals and TAR.
• Requested RFA for Worker's Comp cases
• Assisted nurse reviewers by gathering data, insurance information and medical records for accuracy.
• Cross trained, fill gaps during short staff; generates hospital authorization for PMF members through Tapestry.

• Assisted CM nurses for data entry's
• Generates authorization for hospital admission, Home Health, DME and outpatient referrals in IDX.

• Provided compassionate patient care, assisting with daily activities and personal hygiene.
• Monitored vital signs, ensuring accurate documentation and timely reporting to nursing staff.
• Collaborated with healthcare team to develop individualized care plans for diverse patient needs.
• Trained new staff on best practices in patient handling and safety protocols.

• Provided compassionate care to patients, ensuring comfort and well-being during daily activities.
• Assisted nursing staff with patient assessments, contributing to accurate health monitoring and reporting.
• Implemented infection control protocols, enhancing patient safety and promoting a clean environment.
• Trained new nursing assistants on best practices for patient care and safety procedures.

1984

National College Entrance Examination (NCEE)

1989

Second Year of College

Major in Business Management

1995-2006

Certified Nurse Assistant