Sherree Vivian LeRoy
Rio Rancho,NM
Summary
Licensed Practical Nurse with experience in home health, rehabilitation, and case management. Skilled in reviewing clinical documentation, evaluating medical necessity, and coordinating care in alignment with payer guidelines. Self-directed and highly organized with the ability to work independently in remote settings. Seeking to transition into a utilization review role.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Home Health Licensed Practical Nurse
Luna Vista Home Health and Hospice
Albuquerque, NM
09.2024 - Current
- Manage a caseload of patients in a home health setting, ensuring appropriate level of care and timely interventions
- Perform comprehensive assessments and coordinate care to prevent hospital admissions
- Review patient eligibility for services and ensure compliance with payer requirements
- Document accurately to support medical necessity and reimbursement
- Educate patients and families on disease management to improve outcomes and reduce utilization of acute services
- Collaborate with physicians and interdisciplinary team to adjust plans of care based on patient needs and insurance guidelines
- Conduct chart audits to ensure accuracy, completeness, and compliance with regulatory and payer standards
- Review clinical documentation to support medical necessity and appropriate billing
- Assist in maintaining compliance with agency policies and healthcare regulations
LPN Case Manager - Rehabilitation
Clearsky Rehabilitation Hospital
Rio Rancho, NM
09.2022 - 09.2024
- Coordinate transitions of care from acute hospitalization to SNF, LTAC, and home health, ensuring appropriate level of care
- Evaluate patient status and collaborate with interdisciplinary team to support medically appropriate and cost-effective care planning
- Participate in utilization review processes, assessing continued stay criteria and discharge readiness
- Assist with insurance authorizations and verify payer sources to support ongoing services
- Review clinical documentation to ensure accuracy, completeness, and alignment with medical necessity
- Identify barriers to discharge and coordinate resources to reduce length of stay and prevent readmissions
- Communicate clinical updates with providers, patients, and families to facilitate timely and appropriate care transitions
- Collaborate with case management and therapy teams to align care plans with payer guidelines and coverage criteria
Licensed Practical Nurse- Rehabilitation
Clearsky Rehabilitation Hospital
Rio Rancho, NM
06.2021 - 09.2022
- Provided direct patient care including assessments, medication administration, wound care, and monitoring of clinical status
- Documented patient progress and responses to treatment to support continuity of care and clinical decision-making
- Collaborated with interdisciplinary team to communicate changes in condition and support appropriate care planning
- Monitored patients for changes in condition and reported findings to providers to facilitate timely interventions
- Assisted with discharge planning by reinforcing education and identifying patient needs for continued care
- Maintained accurate and thorough documentation in EMR (Cerner) to reflect care provided and patient status
Education
Pima Medical Institute
03.2021
Skills
Utilization review support
Medical necessity review
Chart auditing/QA
Care coordination
Independent work & time management
Discharge planning
Certification
- License Practical Nurse LN #63828 Expires 08/2024
- BLS Expires 04/2024
Timeline
Home Health Licensed Practical Nurse
Luna Vista Home Health and Hospice
09.2024 - Current
LPN Case Manager - Rehabilitation
Clearsky Rehabilitation Hospital
09.2022 - 09.2024
Licensed Practical Nurse- Rehabilitation
Clearsky Rehabilitation Hospital
06.2021 - 09.2022
Pima Medical Institute