Dedicated Healthcare Leader with over 21 years of progressive experience in diverse leadership and clinical roles. Developed innovative solutions and led initiatives that enhanced patient experience, improved operational efficiency, and strengthened interdisciplinary collaboration. Focused on fostering a culture of collaboration, accountability, and continuous improvement to empower teams and optimize processes.
Directed daily operations of the Case Management department by planning, organizing, and managing staffing, assignments, timecards, performance evaluations, and competencies.
Collaborated with interdisciplinary teams to develop and implement individualized patient care strategies.
Reviewed denied claims and processed appeals to the payer to secure payment for medical necessity, authorization, and level of care denials.
Assisted treatment team to look after the needed health care services available for patients, and supported doctors and nurses in evaluating the health care programs necessary to promote healing and guidance to patients and their family members.
Coordinated comprehensive patient care plans to enhance treatment outcomes and resource allocation.
Collaborated with multidisciplinary teams to streamline care transitions and improve patient satisfaction.
Oversaw the operation of the observation unit, assessing shift staffing needs in relation to patient mix, census, and acuity level.
Delivered direct patient care by evaluating and planning tailored interventions to meet individual patient needs.
Triaged patients via telephone, referring to appropriate providers based on complaints and nursing assessment to ensure timely care. Performed nursing assessments in the clinic for patients who could not be scheduled with Providers.
Worked as Urgent Care Clinical nurse when needed.
Provided direct patient care for pre and post-operative adult and geriatric patients by utilizing nursing process standard to deliver the highest standard of care for safe patient outcome.