Stacie P. Smith
Brevard,NC
Summary
Motivated professional with a strong work ethic and adaptability. Proven ability to work independently while mastering new skills quickly. Expertise in patient advocacy, crisis intervention, and care coordination, leading to improved health outcomes. Exceptional communication and problem-solving skills enhance patient well-being and healthcare service delivery.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Managed Care Coordinator
Blue Cross Blue Shield of South Carollina
Columbia, SC
06.2017 - Current
- Conducted medical and behavioral review and authorization processes efficiently.
- Utilized allocated resources to support review determinations effectively.
- Educated patients and providers on health care delivery systems, network utilization, and benefit plans.
- Maintained up-to-date knowledge of contracts and service provider network statuses.
- Communicated clearly with health care providers and members about requested services through written and phone correspondence.
Supervisor Medical Review- PCR
Palmetto Palmetto GBA
Columbia, SC
10.2016 - 05.2017
- Supervised nurses during pre-claim review process for Home Health Agencies before Medicare submission.
- Ensured documentation compliance with Medicare's coverage, coding, and payment requirements.
- Scheduled training sessions and resolved issues to enhance team performance.
- Evaluated provisional affirmative decisions indicating claim compliance with Medicare guidelines.
- Facilitated submission of complete documentation for pre-claim review requests.
- Communicated non-affirmed decisions to Home Health Agencies and beneficiaries to clarify coverage denials.
Clinical Director
Compassionate Care Hospice
Columbia, SC
10.2015 - 10.2016
- Developed tools and processes for compliance monitoring and reporting, enhancing operational efficiency.
- Directed clinical services for community hospice serving 115 patients, ensuring high-quality care and compliance.
- Educated and trained clinical staff to improve service delivery and adherence to regulatory standards.
RN Case Manager
Compassionate Care Hospice
Columbia, SC
10.2013 - 10.2015
- Coordinated palliative care for hospice patients, managing an average caseload of 17 patients.
- Conducted chart audits and peer reviews to ensure compliance with care standards.
Clinical Applications Analyst
Lexington Medical Center
West Columbia, SC
01.2011 - 01.2013
- Achieved Epic Certification for OpTime and Anesthesia Modules.
- Analyzed, designed, built, configured, validated, and implemented EPIC electronic medical record system.
- Delivered ongoing education and maintenance for system users.
Perioperative Registered Nurse
Lexington Medical Center
West Columbia, SC
01.2009 - 01.2011
- Executed nursing tasks across pre-operative, intra-operative, and post-operative phases in Endoscopy/Cystoscopy department.
- Applied critical thinking and data gathering to effectively assess patient needs.
- Utilized nursing judgment to develop tailored interventions for optimal patient outcomes.
- Conducted thorough evaluations of patient conditions, ensuring delivery of high-quality care.
Manager of OR and Sterile Supply Chain
Lexington Medical Center
West Columbia, SC
01.2006 - 01.2008
- Formulated quality improvement plans and performance goals to enhance service delivery and patient care.
- Managed 20 FTEs and $1.2 million budget to optimize resource allocation.
- Oversaw staffing, training, and performance management to maintain compliance standards.
- Ensured adherence to regulatory guidelines from AAMI, AORN, Joint Commission, and OSHA.
OR Clinical Coordinator
Lexington Medical Center
West Columbia, SC
01.2000 - 01.2006
- Monitored compliance with regulatory and accreditation standards to ensure quality.
- Directed development and execution of nursing quality improvement initiatives.
- Coordinated nursing surveys by regulatory and accreditation agencies for operational assessment.
- Educated staff on perioperative operations and best practices to enhance performance.
- Assessed design processes, analyzed data, and implemented strategies for performance improvement.
- Managed 120 full-time equivalents to optimize operational efficiency.
Circulating OR Nurse & Vascular Team Coordinator
Lexington Medical Center
West Columbia, SC
01.1999 - 01.2000
- Enhanced communication among OR staff, sales representatives, and vascular surgeons as liaison.
- Trained staff and conducted orientation for vascular service to ensure competency.
- Managed supply orders for vascular procedures, maintaining optimal inventory levels.
Education
Associate of Science - Nursing
University of South Carolina in Aiken
Aiken06-1996
Associate of Science - Radiologic Science
Emory University
Atlanta, GA06-1989
Skills
- Nursing assessment skills
- Patient education
- Provider communication
- Time management
- Organizational skills
- Problem-solving aptitude
- Multitasking abilities
- Adaptability and flexibility
- Process improvement
- Critical thinking
- Data analysis
Affiliations
- Hiking
- Kayaking
- Volunteer at local homeless shelter
Certification
- License # 327219
- Multi-State Compact
- Expires 08/31/2026
References
References available upon request.
Timeline
Managed Care Coordinator
Blue Cross Blue Shield of South Carollina
06.2017 - Current
Supervisor Medical Review- PCR
Palmetto Palmetto GBA
10.2016 - 05.2017
Clinical Director
Compassionate Care Hospice
10.2015 - 10.2016
RN Case Manager
Compassionate Care Hospice
10.2013 - 10.2015
Clinical Applications Analyst
Lexington Medical Center
01.2011 - 01.2013
Perioperative Registered Nurse
Lexington Medical Center
01.2009 - 01.2011
Manager of OR and Sterile Supply Chain
Lexington Medical Center
01.2006 - 01.2008
OR Clinical Coordinator
Lexington Medical Center
01.2000 - 01.2006
Circulating OR Nurse & Vascular Team Coordinator
Lexington Medical Center
01.1999 - 01.2000
Associate of Science - Nursing
University of South Carolina in Aiken
Associate of Science - Radiologic Science
Emory University
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