ROXANNE DUNN

Analyze and defends Firm clients in government and commerical payor disputes, combining clinical expertise with writing and presentation skills in support of Firm clients.

• Research Medicare and LCD-level guidelines to strengthen arguments.
• Use clinical background and proved written templates to document opinions regarding medical necessity for the use of Current Procedural Terminology codes.
• Discuss findings with client and Counsel to present a final written and verbal argument. Assist Counsel in arguing the firm's positions to the Administrative Law Judge level.
• Effectively and efficiently communicate necessary components to key team members and clients, including process and deadlines, to all relevant stakeholders.
• Assisted in trial preparation activities, including preparing exhibits that clearly demonstrated key points in the case.

• Completed and submitted audit documentation in a timely fashion and legible manner.
• Maintained current clinical knowledge through reading, attending seminars, clinical practice, and informal sessions with other departments.
• Coordinated hospital services in collaboration with the Administrator-on-Call.
• Responded to emergencies, including Rapid Response Team (RRT) calls and Code Blue situations, assisting as required.
• Evaluated patient care needs in each unit by conducting rounds in the Emergency Department, Obstetrics, Medical-Surgical, Telemetry, Intensive Care, and all other hospital areas as dictated by departmental needs and activity levels.
• Developed staffing plans for each shift based on patient acuity, census, and the availability of personnel.
• Promoted interdisciplinary collaboration by fostering strong relationships with physicians, therapists, and other healthcare professionals.
• Contributed to positive team dynamics as an approachable supervisor who actively listened to concerns from both patients and nurses.

• Contract
• Developed chronology and summaries of medical records and other documents.
• Analyzed and summarized medical records, identified standards of care, and reported any deviations.
• Researched guidelines, standards, and regulations for a case or claim's healthcare facts and issues.
• Provided support during discovery, depositions, trials, and other legal proceedings.
• Validated the accuracy and appropriateness of services given.
• Served as an expert witness during trials, providing clear explanations about nursing standards and patient care practices, leading to better jury comprehension.
• Continually expanded professional network within the healthcare community to stay informed about industry trends and developments impacting legal nurse consulting work.

• Identified trends and areas for improvement in medical record review practices.
• Participated in developing and implementing quality assurance initiatives for medical record review procedures and documentation.
• Conducted medication audits according to the policy and collaborated with the supervising site managers to ensure that necessary corrections were implemented promptly.
• Participated in departmental projects and educational opportunities to enhance the effectiveness of patient care.
• Performed comprehensive assessments of patients' needs and developed individualized care plans.
• Conducted ongoing healthcare needs assessments for individuals supported by Home & Community Connections.
• Certified Medication Administration Program (MAP) Trainer responsible for delivering monthly certification and recertification classes.
• Discussed patient care and treatment with care team members to optimize intervention plans and care delivery.

• Directed the day-to-day operations of two Emergency Departments by overseeing employees, managing diverse functions, and introducing improvements. Designed and enforced new policies and procedures to ensure compliance.
• Analyzed data from medical record reviews to prepare reports for internal and external stakeholders.
• Worked closely with interdisciplinary teams to address documentation-related issues and improve the overall quality of care.
• Introduced a culture of collaboration, harmony, and trust among employees to increase overall productivity.
• Developed and implemented strategies to fulfill the strategic vision of the Emergency Department and MICU.
• Trained, guided, and mentored staff members to ensure the successful execution of assigned tasks.
• Adhered to established policies and procedures of the hospital while managing clinical practice operations.

• Led daily operations of emergency and operating rooms, such as staff recruitment and onboarding, performance evaluation, schedule management, and disciplinary actions. Successfully served in different Joint Commission and participated in CMS surveys. Utilized lean manufacturing principles to lower departmental costs.
• Developed and implemented policies and procedures related to safe patient care.
• Implemented effective policies to lower the length of stay by 23% and introduced new programs and services across the organization to drastically enhance care quality.
• Improved existing knowledge of clinical staff through providing different professional development and educational opportunities, such as TNCC and ENPC.
• Facilitated the implementation of a new electronic medical charting system to enhance accuracy and efficiency.
• Directed all operations related to establishing a new emergency room for effectively catering to patients.
• Enforced RN patient rounding protocols to enhance Press Ganey patient satisfaction scores to the 90th percentile.

• Worked with senior management and cross-functional teams to create and execute different programs and services. Planned and conducted training programs and addressed personnel issues to foster a collaborative work environment.
• Managed nursing staff by assigning tasks and scheduling nursing efforts to provide qualitative and effective patient care across all departments.
• Enhanced patient care by implementing evidence-based clinical practices and protocols.
• Promoted a culture of safety by implementing risk mitigation strategies and addressing potential hazards proactively.