Samantha Weidner, BSN, RN, CCM

Highly skilled and experienced RN leader responsible for providing clinical, operational, administrative, and leadership to the RN team.

• Accountable for onboarding, training, and ongoing performance and productivity management of RN Care Managers.
• Supports individual RNs during 1:1 sessions to provide coaching, assessment of skills/strengths, and helping to drive personal goals in alignment of overall company goals.
• Accountable for driving KPIs for the team, managing/rolling out new initiatives and clinical programs, and serving as SME for Athena EHR.
• Demonstrates detailed and accurate chart review and data synthesis to measure performance against quality measures and initiatives, while driving changes to internal processes/workflows to improve overall outcomes and member care.
• Lead in coordinating LTSS efforts with contracted payor: revamped LTSS policy including new optimized workflows, tracking, and documentation efforts for quality and visibility.
• Manage oversight of partner program pilots (Override Pain Program) to ensure identification of members, review eligibility criteria, and continually collaborate with co-founder and internal medical director to improve program engagement efforts.
• Contribution to project management efforts for rolling out changes to processes, programs, and new clinical/pilot programs.
• Analyze and identify gaps in current processes and workflows while leading and contributing to process improvement initiatives to drive outcomes.

Managed a panel of rising risk, high risk, and medically complex members to support integrated chronic disease and behavioral health care.

• Collaborated with members to provide clinical assessments to create a care plan and oversaw progress to the plan, frequently reassessed needs, coordinated with providers and specialized resources/disciplines, and partnered closely with the Community Health Partner to build trust and demonstrate advocacy.
• Provided clinical assessment and education to members for preventative health and disease process management to reduce overall cost of care and utilization.
• Integral role in the Athena EHR implementation across the market, and across the organization.
• Highly involved in training clinical and non-clinical staff on the usage of the EHR, training sessions, troubleshooting, and continually act as a SME and resource for clinical staff.
• Drove member retention and satisfaction by building rapport
• Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
• Interdisciplinary team meetings for wrap around care.
• Willingness to support other projects within the department.

Remotely conducted comprehensive health assessments that included medical, behavioral, pharmaceutical, and social needs of patients, while contributing to building the foundational RN care management program at a Value Based Care start up company.

• Established care plans with identified patients using a collaborative approach to involve patients in goal setting.
• Collaborated with patients to foster trusting relationships and promote patient engagement and collaboration with the care team.
• Improved processes/workflows utilizing critical thinking and problem-solving skills to identify areas for improvement and solutions to address them.
• Willingness to take on and assist on projects, process improvement, and pilot programs displaying creativity to lead by example.
• Active participation in daily multidisciplinary team meetings utilizing communication skills to identify, and solve problems to improve on processes and patient care/quality.

→ Notable Accomplishments:

• Act as team lead to provide troubleshooting assistance to colleagues.
• Lead onboarding training and mentorship as well as assisted/collaborated with onboarding team for process improvement and mock scenarios.
• Initiated contribution to or identifying areas for process/workflow improvement.
• Cross-functional collaboration to align data reporting tools. Fine-tuning Nurse-Athena processes by collaborating with leadership to improve the functionality of letters and inbox task routing.
• Created and implemented clinical huddle agenda template to be used for clinical huddles that were implemented across the organization. ▪
• Collaborated to develop Athena clinical template macros utilizing current clinical guidelines.

Developed and administered (remotely and in person) an individualized family education program for families with children, ages prenatal to five within McKean county.

• Independently analyzed, created, and implemented assessments geared toward identifying gaps in parent/caregiver knowledge, learning style, and health literacy for enhanced process improvement and evaluation of gaps.
• Worked closely with diverse populations of first-time parents, adults, and children with acute, chronic, and complex medical issues; parents with intellectual disabilities, mental health diagnoses, substance abuse challenges, low socioeconomic status, high risk, and those involved in Children and Youth Services.

→ Notable Accomplishments:

• Engaged small and large groups within the community to promote the program and collaborate with and educate community partners resulting in a significant expansion of the program.
• Provided training and education to internal and contracted external staff for professional development and company needs.
• Analyzed current processes and developed innovative assessment tools to assess for knowledge gaps and areas for improvement to better track and improve outcomes and goals.
• Developed and managed quality improvement projects: Evidenced base curriculum to promote positive program outcomes
• Forged strong community partnerships to provide additional resources for families and children as needed.

Directed patient care in a home setting across the lifespan to improve patient outcomes, decreased re-hospitalization, and increase patient/caregiver knowledge.

• OASIS and HCHB documentation and quality review
• Initiated diagnostic, preventive, and rehabilitative nursing procedures as appropriate to care and safety.

→ Notable Accomplishments: ▪

• Collaborated with physicians and other healthcare providers to manage care across disciplines.
• Promoted positive patient outcomes increasing in home care and safety while decreasing readmission rates.
• Obtain referrals for other services as required.
• Educated patients and caregivers on disease process, home safety, SDOH needs, medication regimen, and preventative health.
• Effectively communicated with individuals from various situations, cultures, ethnicities, and socio-economic backgrounds providing culturally competent care.

Directly supervised multiple levels of staff including RNs, LPNs, and CNAs. Delegated assignments, led hiring/onboarding, and evaluated staff performance. Managed administrative functions including unit staffing, schedule coordination, planning, record keeping, and implementation of short and long-range departmental goals. Delivered education and instruction to individuals, families, and caregivers on health education, disease process, and plan of care. Contributed to state licensing and audits, and MDS data

• Participated in monthly staff meetings to conduct presentations and served as an active member of the Quality Assurance Committee.
• Promoted a culture of teamwork by encouraging open communication among staff members and facilitating collaboration across departments.
• Contributed to the accreditation process by maintaining compliance with state and federal regulations for nursing standards.
• Improved patient care by implementing evidence-based nursing practices and protocols.
• Oversaw and approved recruitment, hiring and orientation of new nursing staff.
• Participated in quality improvement initiatives aimed at enhancing overall service delivery within the facility.
• Evaluated staff performance regularly, providing feedback and guidance for improvement when necessary.

→ Notable Accomplishments:

• Developed a wound care program and policy from the ground up, serving as Head of Restorative Program.
• Enhanced documentation process to implement electronic charting for CNAs to better align internal and state auditing as well as efficiency for staff.
• Implemented staff education program for CNA’s
• Developed and updated policies and procedures, maintaining compliance with guidelines relating to HIPAA, benefits administration and general liability.

• Charge nurse responsibilities for assignment and monitoring of care to colleagues with care of own patient assignment.
• Observed and documented patient factors such as overall health status, diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
• Collaborated with interdisciplinary teams during rounds, providing input and advocating for patient needs.
• Consistently met or exceeded performance metrics through diligent monitoring of patient progress and proactive identification of issues requiring intervention.
• Provided comprehensive assessments of patients' physical, emotional, and social needs, informing personalized care plans.
• Educated family members and caregivers on patient care instructions.
• Improved patient outcomes by consistently providing high-quality care and timely interventions.
• Investigated and resolved issues affecting hospital operations and patient care.
• Equipped patients with tools and knowledge needed for speedy and sustained recovery.
• Utilization of the nursing process to care for patients from admission through discharge.

• Provided care to patients in conjunction with the overseeing clinical team in acute care environments: Med-Surg, ICU, ER, and Inpatient Psychiatric care.