Michelle Smith

• Team Lead: staff resource person, preceptor for new Nurse Case Managers, maintained administrative logs and daily assignments.
• Provided comprehensive daily clinical reviews to insurance companies in timely manner utilizing Interqual and MCG Criteria.
• Proficient in Public Aide reviews utilizing eQhealth/Accentra software.
• Denial Management: Provided reconsideration documentation, arranged Peer to Peers, provided inpatient care timelines to physicians to assist with Peer to Peers and denials.
• Facilitated interdisciplinary rounds to develop the plan of care, discuss barriers to discharge and discharge needs.
• Collaborated with physicians and other healthcare providers to ensure appropriate utilization of resources.
• Completed TPAs, IMM and MOON
• Collaborated with Social Services in arranging transitions to next level of care, Home Health Services, Durable Medical Equipment and Transportation.
• Arranged transfer to Higher level of care.
• Proficient in the following systems/programs: Cerner, Paragon, Availity, Care Port, Word and Excel.

Staff nurse on Surgical and Med/Surg Units. Also worked in Pre-admission testing, Same Day Surgery, IV therapy Team, In-house float pool for the Ambulatory Care Clinics: Internal Medicine, Plastics, GI lab and Occupational Health.