SUSAN HARRIS
Milwaukee
Summary
Dedicated and experienced Registered Nurse with 23 years of diverse experience. Eager to secure a part-time entry-level position within your esteemed company. Possessing strong problem-solving abilities, a willingness to learn, and excellent communication skills. Prepared to enhance team success and drive positive outcomes. Excited to take on new challenges and further organizational goals with unwavering dedication and enthusiasm.
Overview
17
17
years of professional experience
Work History
Nurse Manager
Mc Kinley Place
05.2017 - 06.2018
- Supervised nursing staff, ensuring compliance with healthcare regulations and best practices.
- Implemented quality improvement initiatives, enhancing patient care standards and operational efficiency.
- Coordinated interdisciplinary team meetings to streamline communication and optimize patient outcomes.
- Developed and maintained staff schedules, balancing workloads to meet patient care demands effectively.
Medical review Nurse
National Government Services
08.2014 - 05.2017
- Evaluated medical claims for compliance with federal regulations and policies.
- Collaborated with healthcare providers to clarify documentation requirements and improve accuracy.
- Performs analysis on clinical documentation for Medicare Home Health Claims for necessity and reasonableness using the Medicare Guidelines for Home Health.
- Documents medical record review findings in MARR’s and FISS systems.
- Prepares medical records to be sent to the Qualified Independent Contractor (QIC)
Third Party Liability Appeals Nurse - Third Party Appeals
National Government Services (contracted through Smart IT)
12.2013 - 08.2014
- Performs analysis on clinical documentation for Medicare Home Health Claims for necessity and reasonableness using the Medicare Guidelines for Home Health.
- Communicates in writing the findings from the appeal process to the beneficiary and provider.
- Assures appropriate action is taken within appeal time frames to address clinical denial
- Conducted thorough reviews of clinical data to identify discrepancies and recommend corrective actions.
- Reduced turnaround time for claim processing by utilizing advanced software tools to streamline workflows effectively.
Registered Nurse Care Manager
Community Care
09.2010 - 04.2012
- Liaised between patients and physicians to ensure patient comprehension of treatment plans.
- Closely monitored acute conditions.
- Developed and implemented nursing care plans.
Long Term Care Registered Nurse
Anew Care Management Unit
10.2007 - 08.2010
- Experience with various medical conditions including Parkinson's, Dementia, Diabetes, Cancer, Alzheimer's and Paget's disease.
- Ensured efficacy of treatments through monitoring of treatment regimens. Developed patient care plans, including assessments, evaluations and nursing diagnoses.
- Developed and implemented nursing care plans.
- Liaised between patients and physicians to ensure patient comprehension of treatment plans.
- Effective counseling in health maintenance and disease management.
Director of Nursing
Elizabeth Residence CBRF
07.2006 - 09.2007
- Established staff schedules and assignments based on facility needs.
- Monitored Infection Control and Critical Incidents, Risk Management and Quality Improvement plans.
- Led clinical team in delivering care services that promoted optimal resident health. Confirmed accurate completion of forms/reports for the admission, transfer and/or discharge of each resident.
- Continually improved knowledge, skills and performance based on feedback and self-identified professional developmental needs.
- Facilitated an on-going assessment of patient/family needs and implementation of interdisciplinary team care plan.
- Organized the department in accordance with administrative guidelines in order to provide specified nursing services to meet the legal, organizational and medical staff guidelines.
Patient Care Coordinator
Heartland Home Health Care
03.2005 - 07.2006
- Confirmed accurate completion of forms/reports for the admission, transfer and/or discharge of each resident.
- Conducted monthly patient case conferences, in-services and staff meetings to educate staff and facilitate good communication.
Triage Nurse
Glendale Clinic
03.2003 - 04.2005
- Assessed need for, ordered, obtained and interpreted appropriate lab tests.
- Effective counseling in health maintenance and disease management.
- Liaised between patients and physicians to ensure patient comprehension of treatment plans.
- Ensured HIPAA compliance.
- Participated in unit-based Quality Assurance Program.
- Experience with various medical conditions including Parkinson's, Dementia, Diabetes, and Alzheimer's.
- Assisted doctors with surgeries and non-invasive procedures.
- Authorized drug refills and provided detailed prescription information to pharmacies. Scheduled patient admissions and discharges.
Operating Room Nurse
Saint Michaels Hospital
04.2001 - 03.2003
- Completed head to toe physical patient assessment and laboratory assessments pre-operatively.
- Circulated all surgical procedures with the exception of heart procedures.
- Completed the set up and take down of the surgical equipment and instrumentation for surgeries.
- Participated in unit-based Quality Assurance Program as Vice President of Quality Assurance.
- Participated in the JHACO preparedness committee
- Coordinated Quality Improvement Activities (QIA's) to identify performance areas for improvement.
- Provided on call circulating nurse services at all times of day and night.
- Followed infection control procedures.
- Assisted doctors with surgeries and non-invasive procedures. Assigned as charge nurse of holding room one day per week.
Education
Bachelor of Science - Nursing
Concordia University Wisconsin
Mequon, Wi01.2013
Associate of Applied Science - Nursing
Milwaukee Area Technical College
Milwaukee, Wi01.2002
CHUC - Health Unit Coordinator
Milwaukee Area Technical College
Milwaukee, Wi01.1997
Skills
- Staff supervision
- Quality improvement
- Critical thinking
- Department management
Timeline
Nurse Manager
Mc Kinley Place
05.2017 - 06.2018
Medical review Nurse
National Government Services
08.2014 - 05.2017
Third Party Liability Appeals Nurse - Third Party Appeals
National Government Services (contracted through Smart IT)
12.2013 - 08.2014
Registered Nurse Care Manager
Community Care
09.2010 - 04.2012
Long Term Care Registered Nurse
Anew Care Management Unit
10.2007 - 08.2010
Director of Nursing
Elizabeth Residence CBRF
07.2006 - 09.2007
Patient Care Coordinator
Heartland Home Health Care
03.2005 - 07.2006
Triage Nurse
Glendale Clinic
03.2003 - 04.2005
Operating Room Nurse
Saint Michaels Hospital
04.2001 - 03.2003
Associate of Applied Science - Nursing
Milwaukee Area Technical College
Bachelor of Science - Nursing
Concordia University Wisconsin
CHUC - Health Unit Coordinator
Milwaukee Area Technical College
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