Rachel Kravchenko
Hewlett
Summary
Excellent communication and organizational skills. Proficiency in documentation and clinical assessments. Ability to work in collaboration with team members and enjoying the process of learning. Good understanding of procedures, policies and nursing care. Good listening skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Senior Whole Health MLTC
Remote
10.2022 - Current
- Review and analyze patient medical records, ensuring accuracy, completeness, and compliance with relevant regulations and guidelines
- Assess the quality and appropriateness of medical care provided, identifying areas for improvement and adherence to best practices
- Ensure that proper documentation, including diagnosis, treatment plans, and progress notes, following established protocols
- Stay updated on healthcare regulations, policies, and guidelines, and ensure that healthcare practices align with these requirements
- Collaborate with healthcare professionals, including physicians, nurses, and administrators, to provide feedback and guidance for improving patient care and documentation practices.
AgeWell New York MLTC
New Hyde Park,NY
11.2012 - 09.2022
- SCOPE OF PRACTICE: The RN functions under the supervision and direction of the Assistant Director of nursing designee and participates in the interdisciplinary team process of AgeWell NY’s standard operational procedures
- RN is responsible for providing clinical support, and technical assistance to care managers and other staff
- Operates within the scope of practice requirement by the New York State Department of Education and individual must be able to manage their workload with accuracy
- Position requires excellent customer service skills with members, their caregivers, providers and designated team
- RESPONSIBILITIES: Reviews clinical documentation in Care Compass and the UAS for completeness and relationship to the Person Centered Service Plan
- Responsible for reconciling medications with diagnosis and follow up as needed
- Act as a liaison between the care manager, member and the provider Provides all reviews in compliance with regulatory requirements and clinical criteria guidance
- Serves as a member advocate, seeking and coordinating solutions to members’ health care needs without compromising quality outcomes
- Coordinate with facilities or, acting in conjunction with the clinical team, ensures that transition planning and coordination is carried out so that discharge can occur on a timely basis and the return to home or other placement is seamless
- Functions as a resource to the care teams regarding approved criteria, clinical practice guidelines and alternative treatment options as examples
- Demonstrates an ability to problem solve complex, multifaceted situations Acts to ensure that all Care Management Policies and Procedures are followed
- Participates in Quality Improvement activities, as appropriate
- Reviews the Initial Adverse Determination letters for accuracy utilizing the NYSDOH office of Health Insurance Programs and NY codes, Rules and Regulations-Title: Section 505.14- Personal Care Services
- Reviews Fair Hearing Packets for completeness of documentation Attends onsite Fair Hearings in the community representing Agewell New York
- Participates in weekly Fair Hearing meetings.
Senior Enrollment Registered Nurse
11.2012 - 05.2022
- Conducts enrollment assessments to determine clinical eligibility
- Give essential training to the new nursing staff
- Explains Agewell features and benefits, including explanation of the member’s handbook
- Completes UAS along with all enrollment documentation
- Make an enrollment decision and develop an initial care plan for the prospective member
- Maintains frequent communication with the referral sources to keep Agewell an primary option for care delivery
- Coordinates transition of services from prior care provision to Agewell
- Identifies and eliminates barriers to enrollment
- Participates in the care team in conveying information about the new enrollee to facilitate any concerns, or answer questions
- Obtained and documented all pertinent demographic and insurance information on an intake form
- Documented pharmacy, nursing, and other medical services requested then forwarded on to the appropriate clinician for clinical verification
- Verified insurance, in the absence of the Insurance Verification Specialist
- Documented necessary financial paperwork required for patient signature upon entry to care
- Maintained documents of all pertinent demographic medical service requirements, and insurance information
- Participated in the decision to accept or deny a patient for managed home health care services
- Provided skilled, appropriate, efficacious professional nursing care to patients in their place of residence.
Parker Jewish Homecare
New Hyde Park ,NY
04.2012 - 05.2013
- Responsibilities: Visits patient at home with Human Resources Administration (HRA) staff for assessments and reassessments
- Documents accurately the patient care and services rendered according to Agency protocol
- Keeps informed of any changes within the program that would affect patient care
- Keeps informed of community resources and abreast of changes in Medicaid program and home care legislation
- Perform independent health assessments of individuals and families by evaluating their physical, mental and social and environmental health status; and provide nursing intervention based on assessment of need
- Make skilled nursing observations and assessments of client health care status by monitoring and documenting such things as vital signs, pulse, presence of edema, heart and lung auscultation, blood and urine laboratory values, intake and output, consciousness and orientation levels; by completing a health history and evaluation, and evaluating living arrangements
- Develop and provide health education and consultation services to community members, clients and family members on a one-to-one and group basis through home visits, responding to requests for information by phone or in person.
Hillside Manor Home Care
Jamaica, NY
06.2011 - 04.2012
- Responsibilities: Knowledge of Admission, OASIS and transfer from the hospital
- Coordinated home care agencies with client care Provided good and direct client care as per the rules of state law Documented clients' tolerance, competence and compliance according to the prescribed therapy, progress and interventions Modified, developed and evaluated clients' care plan with the physician, family and client Educated caregivers and client in all the latest equipments and procedures Conducted the early stages of nursing assessments and evaluations for qualifying the clients for appropriate safety at home.
NYU @ Columbus Medical Cancer Center
Rego Park, NY
10.2006 - 11.2011
- Responsibilities: Assisting patients during Nuclear Medicine/Stress Test Procedures
- Working with various venous access devices and inputting intra-venous injections
- Explaining upcoming medical and diagnostic procedures and taking vital signs
- Assisting in physical examination prep and patient care
- Act as a liaison between doctor and patient
- Collaborating with multidisciplinary team to provide high quality patient care
- Scheduling appointments, verifying patient’s eligibility and answering heavy duty phone calls
- Filing, organizing, preparing and scanning medical records into the MedInformatix, Syngo, Invision, E-Pass, and Schedule Maximizer system.
Education
Master of Science in Nursing -
Ternopil State Medical University
06.2023
Bachelor of Science in Nursing-Online -
Ternopil State Medical University
06.2013
Registered Nurse Diploma -
Tashkent Nursing School
01.2001
Skills
- Confidentiality adherence
- Multicultural Competence
- Self-care strategies
- Behavior Modification
Certification
- 03/01/2011, NYS Registered Nursing Licensure, #64116-1
- 06/01/2006, National Certification in Phlebotomy
- 05/11, BLS FROM AMERICAN HEART ASSOCIATION
Accomplishments
: Awarded “Employee of the Year” in both 2007 and 2009-NYU
References Available
True
Personal Information
Title: RN, MSN
Timeline
Senior Whole Health MLTC
Remote
10.2022 - Current
AgeWell New York MLTC
New Hyde Park,NY
11.2012 - 09.2022
Senior Enrollment Registered Nurse
11.2012 - 05.2022
Parker Jewish Homecare
New Hyde Park ,NY
04.2012 - 05.2013
Hillside Manor Home Care
Jamaica, NY
06.2011 - 04.2012
NYU @ Columbus Medical Cancer Center
Rego Park, NY
10.2006 - 11.2011
Master of Science in Nursing -
Ternopil State Medical University
Bachelor of Science in Nursing-Online -
Ternopil State Medical University
Registered Nurse Diploma -
Tashkent Nursing School
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