MELANIE HOLMES
Rifle,CO
Summary
Nursing leader with extensive experience in clinical case management and discharge planning at Glenwood Springs Healthcare. Successfully reduced readmission rates through effective transitional care strategies. Committed to mentoring staff and ensuring adherence to Medicare and Medicaid regulations while promoting patient-centered care. Proven ability to maintain high standards in nursing practices and policies, demonstrating strong leadership and regulatory compliance knowledge.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Director of Nursing | Case Management Functions
Glenwood Springs Healthcare
Glenwood Springs, CO
03.2019 - 10.2025
- Spearhead care coordination for post-acute patients, ensuring safe, effective discharges and reduced readmission risk.
- Perform detailed chart reviews to evaluate medical necessity and facilitate authorizations per payer requirements.
- Collaborate with physicians, case managers, and therapists to develop individualized care plans aligning with patient goals and insurance guidelines.
- Streamlined transitional care processes, decreasing hospital readmissions by enhancing team communication and proactive planning.
- Monitor documentation quality to maintain compliance with CMS and state regulations.
Director of Nursing
Palisade Living Center
Palisade, CO
11.2015 - 01.2018
- Oversaw patient care coordination, ensuring seamless transitions between hospital case managers and payers.
- Evaluated patient care outcomes to enhance service delivery methods.
- Developed and implemented nursing policies for regulatory compliance.
- Managed budgets and resources to optimize nursing operations.
- Coordinated training programs for nursing staff to advance clinical skills.
- Assessed competency of clinical staff, promoting quality and safety in care delivery.
- Collaborated with utilization review professionals to validate skilled level of care and improve reimbursement.
- Directed staff training initiatives on accuracy in clinical documentation and compliance.
Director of Nursing
Heritage Park Care Center
Carbondale, CO
05.2013 - 10.2015
- Directed interdisciplinary care coordination for SNF patients among nursing, therapy, and ancillary services.
- Advocated for patient needs while ensuring cost-effective care aligned with reimbursement criteria.
- Oversaw nursing staff to uphold high-quality patient care standards.
- Mentored nursing staff to enhance professional development and teamwork.
- Facilitated effective communication between families and healthcare providers.
- Assessed clinical staff competency to promote quality, continuity, and safety of care.
- Conducted performance evaluations for nursing staff and recommended improvements when necessary.
- Developed and implemented nursing policies and protocols to ensure patient safety.
Education
Associate Degree - Nursing
Colorado Mountain College
Glenwood Springs, CO05.1999
Skills
- Clinical Case Management
- Discharge Planning
- Utilization Review
- Level of Care Determination
- Medical Necessity Documentation
- Medicare Compliance
- Medicaid compliance
- Commercial Payer Compliance
- Skilled Nursing
- Post-Acute Care Coordination
- Payer Communication
- Prior Authorizations
- Regulatory Compliance
- Transitional Care
- Readmission Reduction Strategies
- EMR Systems
- PointClickCare
- MatrixCare
- Clinical care oversight
- Recruiting and hiring
- Nursing staff supervision
- Hospital admissions
- Staff evaluation
- Nurse education and training
- Standards of practice
- HIPAA regulations
- Strong work ethic
- Quality improvement
- Patient education
- Risk management
- Supply monitoring
- Business operation management
- Programs development
- Root Cause Analysis
- Quality Assurance
- Patient Education
- Family Education
- Advocacy
- Family support
- Shift scheduling
- Direct patient care
- Clinical resources management
- Critical thinking
- Long-term care
- Documentation and reporting
- Clinical leadership
Affiliations
• National Association of Directors of Nursing Administration (NADONA)
• Colorado Nurses Association
• Colorado Nurses Association
Certification
- Certified Director of Nursing Administration (CDONA), NADONA
- Infection Preventionist Certification, CO-Train
- Licensed Nursing Home Administrator (NHA), Colorado
- Basic Life Support (BLS), American Heart Association
- Registered Nurse (RN), Colorado, RN/122936, Active
References
Available upon request.
Education And Licensure
Associate Degree in Nursing (ADN), Colorado Mountain College, Glenwood Springs, CO, 05/01/99
Timeline
Director of Nursing | Case Management Functions
Glenwood Springs Healthcare
03.2019 - 10.2025
Director of Nursing
Palisade Living Center
11.2015 - 01.2018
Director of Nursing
Heritage Park Care Center
05.2013 - 10.2015
Associate Degree - Nursing
Colorado Mountain College