Knowledge of age specific needs and disease process.
Knowledge of ICD codes and knowledgeable of insurances.
Work without constant instructions.
Able to critically think and analyze and interpret medical records. Able to organize, prioritize and manage work under stressful work environment.
Collaborate with team to discuss patient needs and prioritize patient care.
Overview
13
13
years of professional experience
1
1
Certification
Work History
RN, BSN Clinical Referral Specialist
Sutter Care at Home
12.2018 - Current
Acts as the in-office clinical liaison that represents the SCAH agency via telephone with referrals for patient care from physicians, hospitals, insurance case managers and other sources in the community.
Provides clinical oversight to the processing of home care referrals in accordance to regulatory and payer requirements.
Ensures appropriate physician orders are obtained and input in the medical record to support identified patient care needs.
Facilitates timely and appropriate start of care visits with schedulers and patients/ families to meet patient acuity and business needs.
Summarizes clinical information from referral documentation material in a concise and thorough referral information note to support the field clinician’s ability to conduct an effective and efficient start of care visit.
Identifies objections, concerns or other barriers to patient access to services and provides information in response to address those issues.
Accurately completes referral documentation, including all appropriate insurance reimbursement needs, as necessary to facilitate the admission process.
Processes and documents referrals that are not accepted for admission, indicating specific reason for non-acceptance, according to department policy and procedure.
Assigns diagnosis codes to admissions and or validates diagnosis codes identified by clerical staff.
Accepts additional clinical support assignments designated by Administrator and/or designee.
Appropriately escalates to Administrator for staffing problems or difficulties accepts clinical assignments as designated by the supervisor.
Communicates and collaborates with Internal and External Customers: responds promptly to phone calls, electronic transmissions (Epic/Allscripts/Curaspan referrals) and faxes regarding potential referrals for SCAH home care services.
Demonstrates a high level of service orientation to all internal and external customers at all times.
Ensures consistent and timely communication regarding new admissions with local teams.
Attends department meetings and serves on committees and project teams as requested.
Quality Management:
Participates in the development of policies and procedures and actively assists in problem solving with and between departments to ensure the intake function is collaborative and effective.
Maintain positive professional relations with support personnel through appropriate and timely responses for information or paperwork necessary for the key clinical and billing functions of the agency.
Meets intake productivity goals and maximizes capacity for patient needs by assessing clinical and operational needs.
RN, BSN Admissions Manager
Meadowood Health and Rehabilitation
01.2018 - 12.2018
Review and respond timely to each admission inquiry.
Assure complete and thorough training to another staff to support and provide coverage for admissions.
Establish and maintain referral relationships with area hospitals, physicians, and community organizations for the purpose of generating consistent admissions.
Ensure a consistent and effective process for coordination of admissions with appropriate departments and staff.
Maintain knowledge of regulations governing Medicare/Medi-Cal/Managed Care reimbursement processes.
Effectively communicate special needs of new admissions to staff to ensure a smooth transition.
Manage inquiry calls from hospitals, families, and provide appointments that include a tour and discussion of services offered/provided.
Manage the Social Services staff to meet SNF needs, compliance, productivity and effectiveness of the Social Services Department.
Provide staff evaluations timely.
Conduct interviews for new staff as needed.
Process performance plans or disciplinary actions as needed with the support of Human Resources.
Provide ongoing training to all LVN and RN staff to include but not limited to in-service, refresher training, training for new equipment or infection illness/injuries or rehab needs.
Maintain detailed training documents including topic, date/time and length of training.
Provide SNF coverage as needed and within scope of job description.
Must maintain the highest level of confidentiality at all times.
The ability to maintain business/professional boundaries with all staff, management and outside vendors.
Maintains compliance with company policy.
LVN Hospice Liaison
Bristol Hospice
07.2016 - 03.2017
A liaison between the hospitals, residential facilities, MD offices, clinics and Bristol Hospice.
Performs pre- admission hospice informational visits to patients/families.
Responsible for being proactive in identifying new referral sources, increasing referrals from existing sources, and providing education programs to facilities.
Evaluate patient for hospice appropriateness according to Medicare guidelines.
Discuss/Explanation of benefits to patient.
Discuss and complete hospice informed consents for services with the patients and families.
Facilitate medical equipment, supplies, medications, physician orders for hospice evaluation and treatment.