Mary K. Thompson
AssuriCare
Pittsford,NY
1
Certification
39
years of professional experience
Dedicated healthcare professional with extensive experience in clinical assessment and utilization management. Skilled in case documentation and medical coding, demonstrating a commitment to compliance and quality improvement in patient care delivery.
Work History
Nurse Assessor for Long Term Care Policy Holders
4 Years 6 Months- Educate Policyholders on health management, medication adherence, and lifestyle modifications.
- Conduct thorough assessments for various Insurance Companies for benefit determination and appropriateness of ongoing benefit coverage.
- Conduct comprehensive assessments to determine care needs for clients.
- Ensure compliance with industry standards and best practices in assessment processes.
- Conduct field inspections to verify property characteristics for safety ensuring accurate assessments.
- Part-time position/Per Diem
Certified Medical Case Manager
7 Years 6 Months- Coordinated comprehensive care plans for diverse patient populations, ensuring tailored support and resource allocation.
- Collaborated with healthcare providers to assess and monitor patient progress, enhancing treatment outcomes.
- Managed complex case files using electronic health record systems, maintaining accurate documentation and facilitating communication.
- Developed and implemented strategies to optimize care delivery, improving efficiency in case management processes.
Quality Assurance/Utilization Review Manager
8 Years 2 Months- Streamlined utilization review processes to enhance efficiency and reduce turnaround times for Medicare and Medicaid programs.
- Conducted Quality Assurance Reviews and implemented Clinical Documentation Improvement Plans.
- Analyzed data trends to identify areas for improvement in patient care management strategies for reimbursement.
Director of Nursing Administration
4 Years- Implemented quality improvement initiatives to enhance patient care services.
- Developed and managed budgets for nursing operations, ensuring resource allocation efficiency.
- Led recruitment, training, and professional development programs for nursing personnel.
- Directed nursing staff in compliance with regulatory standards and best practices.
Education
MBA - Business
Associate of Science - Nursing/RN
Bachelor of Science - Health Science/Education
- Awarded Eta Sigma Gamma Induction-Health Science Honory Society
Skills
Clinical assessment
Performing assessment
Case documentation
Healthcare operations
Clinical documentation
Utilization management
Care coordination
Healthcare regulations
Compliance management
Reimbursement management
Insurance evaluation
Case review
Certification
- Certified Case Manager/NA
- NYS RN License
- Eta Sigma Gamma/Health Education Honorary Society
Timeline
Nurse Assessor for Long Term Care Policy Holders
AssuriCare
02.2022 - CurrentRead More
Certified Medical Case Manager
Genex
02.2012 - 08.2019Read More
Director of Nursing Administration
Garvey Manor Nursing Home
01.1990 - 01.1994Read More
Quality Assurance/Utilization Review Manager
Professional Medical Review
01.1988 - 03.1996Read More
Nova Southeastern University
MBA from Business
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Monroe Community College
Associate of Science from Nursing/RN
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Russell Sage University
Bachelor of Science from Health Science/Education
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