Renata Smith
Rural Hall,NC
Summary
High-performing Registered Nurse with 22 years of healthcare experience that includes caring for patients and members with a variety of medical problems such as diabetes, arthritis, cancer, kidney disease, cardiac related conditions, infectious disease, neurological problems, as well as other chronic medical conditions in an inpatient hospital, home health, managed care, and LTAC setting. Highly organized with a keen ability to maintain accuracy while handling multiple priorities. Veteran of the US Navy. Having a strong commitment to the care of individuals in a variety of settings demonstrates my ability to be flexible, grasp and apply information quickly, creating the basis for a phenomenal nursing career.
Overview
23
23
years of professional experience
1
1
Certificate
Work History
Care Manager II
AmeriHealth Caritas Family Of Companies
01.2023 - Current
- Educated clients and families on community resources, treatment options and health care services to better manage conditions
- Participated in team meetings and trainings to stay updated on best practices and new developments in care management
- Communicated with healthcare providers to facilitate continuity of care
- Maintained detailed records in compliance with agency standards and regulations
- Developed and implemented individualized care plans and coordinated necessary services to avail quality care for clients
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care
Independent Assessor
Liberty Health Care
01.2018 - 01.2023
- Conduct independent assessments for Personal Care Services in beneficiary's home and adult care home settings for the state of North Carolina.
- Process health data and submit assessments in a timely manner.
- Evaluate beneficiary's home environment for health and safety issues.
- Participate in independent assessment project training.
- Documentation of conditions in QiReport, participate in mediation and appeal hearings as needed.
- Determine medical necessity and appropriateness of services using clinical review criteria.
Resident Care Consultant
Kerner Ridge Assisted Living
08.2017 - 12.2017
- Researched issues and took appropriate action to resolve issues within turnaround time requirements and quality standards
- Prepared documents and reports for clinical reviews and discharge plans
- Documented activities and progress in electronic medical record per defined policy and procedures
- Compiled and maintained patient medical records to keep information complete and up-to-date
- Worked with patients to ascertain issues and make referrals to appropriate specialists
- Recommended service improvements to minimize recurring patient issues and complaints
Assistant Director of Nursing
Salemtowne Retirement Community
05.2015 - 08.2017
- Participated in management team meetings to discuss resident status, census changes, and resident complaints or concerns
- Established and monitored infection control programs to provide safe, sanitary environment to prevent transmission of disease and infection
- Identified department issues to recommend corrective actions
- Monitored and evaluated nursing staff performance, providing feedback and guidance to support standards of care
- Worked closely administration to develop and implement best practices to improve patient outcomes
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction
Case Manager
Northwest Community Care & Wake Forest Care at Home
12.2013 - 05.2015
- Developed and implemented comprehensive case management plans to address client needs and goals
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients
- Monitored clients' progress and tracked client services to provide crisis interventions
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Collaborated with interdisciplinary team to determine timely delivery of services.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
Nursing Supervisor & Unit Manager
Salemtowne Retirement Community & Birmingham Green Nursing Facility
05.2010 - 11.2013
- Provide supervision to staff in LTAC and retirement community setting.
- Onboarded new employees through orientation meetings and training sessions before deployment to different departments.
- Evaluated and monitored care and services throughout shift to improve quality levels.
- Enforced nursing practice standards and recommended unit and institution policies and procedures to boost medical care quality.
- Reviewed staffing patterns, quantities and nursing units' census to meet resident needs and budgetary controls.
- Coordinated nursing activities and staffing with health-related, therapeutic and support services to streamline service delivery
- Inventoried medications, supplies and equipment and distributed stock to patients
- Created, implemented and evaluated programs that promoted staff recruitment, retention and development.
Case Manager/Utilization Review Nurse
Active Health Management
11.2007 - 05.2010
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
- Developed and implemented comprehensive case management plans to address client needs and goals.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations, and procedural costs.
- Collaborated with an interdisciplinary team to determine timely delivery of services.
Staff Nurse
Sentara, Inova, And Reston Health Care Systems
05.2001 - 11.2007
- Assessed physical, psychological, physiologic, and cognitive status of patients on telemetry, IMCU, PCU inpatient units
- IV insertion, indwelling urinary catheter insertion & care, enteral feedings, EKG placement/monitoring
- Administered medications via oral, IV (to include cardiac drip medications, Heparin, Insulin), and intramuscular injections and monitored responses.
- Performed various nursing interventions such as wound care/dressing, vital sign monitoring, and specimen collection.
Education
Bachelor of Science - Nursing
South University
Savannah, GA2011
Associate of Applied Science - Nursing
Tidewater Community College
Portsmouth, VA2001
Skills
- Medicare & Medicaid Regulation
- Diagnostic Software to include Epic, Milliman, JIVA, QiReport
- Case Management and Utilization Review & Chronic Disease Management
- Nursing Consultation & Quality Improvement
- Treatment Plan Modification & Community Program Referrals
- Microsoft Office, Excel, Powerpoint
- Documentation according to nursing process
- Telemetry, IMCU, PCU Inpatient Units
- Strong assessment skills according to the Nursing Process
- Home Health Care, Acute Care, LTAC, Manage Care Setting
- Wound care to include Wound Vac, Medication Administration/Monitoring (IV, oral, IM, sq, enteral), IV insertion, Indwelling Urinary Catheter Insertion/Management, lab collection
Certification
BLS certified; Certificate in Spirituality, Health, and Healing
Certificate in Holistic and Integrative Health
Timeline
Care Manager II
AmeriHealth Caritas Family Of Companies
01.2023 - Current
Independent Assessor
Liberty Health Care
01.2018 - 01.2023
Resident Care Consultant
Kerner Ridge Assisted Living
08.2017 - 12.2017
Assistant Director of Nursing
Salemtowne Retirement Community
05.2015 - 08.2017
Case Manager
Northwest Community Care & Wake Forest Care at Home
12.2013 - 05.2015
Nursing Supervisor & Unit Manager
Salemtowne Retirement Community & Birmingham Green Nursing Facility
05.2010 - 11.2013
Case Manager/Utilization Review Nurse
Active Health Management
11.2007 - 05.2010
Staff Nurse
Sentara, Inova, And Reston Health Care Systems
05.2001 - 11.2007
Bachelor of Science - Nursing
South University
Associate of Applied Science - Nursing
Tidewater Community College
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