Susan Melton

Work History

Capacity Management Care Coordinator

St. Luke’s Hospital

01.2022 - Current

Escalation contact for identified barriers to patient discharge,
Tracked post-acute care facility authorization and appeal turnaround times and outcomes.
Initiated and verified post-acute care authorization requests,
Initiated and verified post-acute care denial appeals.
Maintained access to prior auth portals (Availity, NaviHealth, UHC, etc.)
Participated in Outlier Meetings at all St. Luke's entities.
Participated in Health System performance improvement projects (discharge lounge, post acute levels of care grid for patients and families, Peer to Peer process, in-house mortality, increase patient use of SLHS post acute resources, decrease patient LOS, Medicare Advantage plan complaints to CMS),
Prepared reports for and participate in meeting with payers (UHC, Aetna, BCBS and Humana) to discuss delays in prior-auth turnaround times.
Participated in patient guardianship court hearings,
Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
Used company software and databases to maintain records of services performed and patient conditions.
Facilitated appointments and transportation for patients, streamlining access to essential medical services.
Advocated for patients'' rights within the healthcare system, working diligently to address concerns or barriers to care.
Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
Demonstrated strong organizational and time management skills while managing multiple projects.
Used critical thinking to break down problems, evaluate solutions and make decisions.
Organized and detail-oriented with a strong work ethic.
Worked flexible hours across night, weekend, and holiday shifts.
Passionate about learning and committed to continual improvement.
Assisted with day-to-day operations, working efficiently and productively with all team members.
Skilled at working independently and collaboratively in a team environment.
Self-motivated, with a strong sense of personal responsibility.
Advocated for patients during care team discussions, ensuring their preferences and needs were prioritized.
Ensured compliance with healthcare regulations and standards, maintaining patient safety and confidentiality.
Negotiated with insurance providers to secure coverage for necessary treatments, alleviating financial stress for patients.
Coordinated with external healthcare services to arrange necessary patient treatments, ensuring continuity of care.
Conducted thorough assessments of patient needs to devise personalized care plans, addressing both health and social determinants.
Facilitated patient access to specialized medical services by building network of healthcare provider partnerships.
Enhanced patient care by developing and implementing comprehensive care plans.
Assessed patient needs and connected them with appropriate resources to ensure optimal health outcomes.

Care Coordinator, Supervisor

St. Luke’s Hospital

01.2016 - 01.2022

Coordinated staff schedule and daily assignments.
Streamlined information sharing between healthcare providers by implementing secure electronic communication systems.
Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations..
Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Facilitated multi-disciplinary team meetings to ensure comprehensive care plans, enhancing patient outcomes.
Worked effectively in fast-paced environments.
Proven ability to learn quickly and adapt to new situations.
Demonstrated respect, friendliness and willingness to help wherever needed.
Adaptable and proficient in learning new concepts quickly and efficiently.
Learned and adapted quickly to new technology and software applications.
Developed and maintained courteous and effective working relationships.
Mentored junior staff members in their career development, sharing knowledge from years of experience in the field.
Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
Enhanced communication within the team by holding regular meetings and encouraging open dialogue among all members.
Evaluated staff performance and provided coaching to address inefficiencies.
Resolved conflicts among team members promptly, maintaining a harmonious working environment conducive to productivity.
Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
Demonstrated commitment to the organization''s core values, leading by example and fostering a culture of excellence.

Care Coordinator, Neuro4/Oncology

St. Luke’s Hospital, KCMO

01.2015 - 01.2016

Understanding and navigation of public and private insurance,
Completion of admission and social determination of health assessment tools.
Coordinated discharge planning, ensuring a smooth transition from hospital to home or other facilities.
Determined need for special assessment activities for complex cases, effectively handling care plans.
Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
Educated patients on self-care strategies, promoting independence and empowering them to manage their health conditions.
Provided emotional support for patients and families during difficult times, fostering resilience and coping skills.
Facilitated appointments and transportation for patients, streamlining access to essential medical services.
Discussed medical histories with patients in effort to provide most effective medical advice.
Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
Coordinated with external healthcare services to arrange necessary patient treatments, ensuring continuity of care.
Monitored patient progress through regular check-ins, adjusting care plans to meet evolving needs.
Managed time efficiently in order to complete all tasks within deadlines.
Paid attention to detail while completing assignments.

Registered Nurse,4East Surgical/Oncology

Liberty Hospital, Liberty, MO

01.2001 - 01.2014

Biotherapy/Chemotherapy certified. Administration and monitoring of chemotherapy.
Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
Demonstrated expertise in wound management techniques resulting in accelerated healing times for patients with complex wounds or pressure injuries.
Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
Managed patients recovering from medical or surgical procedures.
Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
Promoted a culture of safety within the healthcare facility by participating in quality improvement initiatives, identifying potential hazards, and advocating for best practices in nursing care delivery.
Provided support for patients'' families during difficult medical decisions or end-of-life care, serving as a liaison between the healthcare team and loved ones.
Assisted in the training and mentorship of new nursing staff members, contributing to a positive work environment and high-quality patient care.
Implemented evidence-based fall prevention strategies, resulting in a significant decrease in patient falls within the unit.
Efficient navigation of Allscripts electronic health records

Lead Clinic Nurse

Kaiser Permanente, Gladstone, MO

01.2000 - 01.2001

Managed daily clinic routine.
Coordinated staff and daily assignments.
Completed FMLA paperwork,.
Triaged walk-in patients.
Educated patients, families and caregivers about conditions and treatments.
Maintained detailed documentation of patient records, ensuring compliance with regulatory requirements.
Coordinated referrals to specialists or external healthcare providers when necessary for specialized care.
Administered medications and topic treatments to address patient symptoms.
Contributed to a positive work environment by collaborating effectively with colleagues and supporting team goals.
Partnered with support technicians, nursing staff and social workers to coordinate services.
Assisted physicians during examinations and procedures, providing expert clinical support as needed.
Managed inventory of medical supplies, maintaining adequate stock levels while minimizing waste.
Stayed on to help close the Gladstone location.

Registered Nurse,4East, Cardiac ICU Step-Down

Research Medical Center, Kansas City, MO

01.1998 - 01.2000

Completed basic critical care and dysrhythmia courses
Certified in Advanced Cardiac Life support
Managed vasoactive drugs.
Monitored telemetry for cardiac patients with permanent and temporary pacemakers, post-operative coronary bypass grafting and acute myocardial infarctions.
Managed patients recovering from medical or surgical procedures.
Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
Equipped patients with tools and knowledge needed for speedy and sustained recovery.
Facilitated patient transitions between different levels of care, ensuring continuity of services and minimizing disruptions in treatment plans.
Provided skilled, timely and level-headed emergency response to critically-ill patients.
Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
Worked effectively in fast-paced environments.
Used critical thinking to break down problems, evaluate solutions and make decisions.

Pain Institute Nurse

Research Medical Center

01.1997 - 01.2000

Completed scrub nurse course.
Completed Medtronic course.
Operated C-arm for fluoroscopic procedures.
Educated patients on disease management, self-care techniques, and wellness strategies to improve long-term health outcomes.
Performed routine wound care and dressing changes on schedule.
Created an efficient shift handover process which improved continuity of care between nursing shifts.
Assisted physicians in performing diagnostic tests and procedures to facilitate prompt diagnosis and treatment.
Educated family members and caregivers on patient care instructions.
Implemented care plans for patient treatment after assessing physician medical regimens.
Recorded details regarding therapies to keep patient charts updated.
Evaluated patient histories, complaints, and current symptoms.

Medical/Surgical Floatpool Nurse

Research Medical Center

01.1994 - 01.1998

Completed Obstetric course
Worked on many units including: gynecology, oncology, same day surgery, rehabilitation, skilled nursing, emergency room, pulmonary lab, cardiac, medical, surgical, neurology, orthopedic, and renal.
Collaborated with interdisciplinary teams for optimized patient treatment plans and outcomes.
Administered medications via oral, IV, and intramuscular injections and monitored responses.
Performed routine wound care and dressing changes on schedule.
Created an efficient shift handover process which improved continuity of care between nursing shifts.
Consistently adhered to strict safety guidelines while administering medications or performing invasive procedures.
Assisted physicians in performing diagnostic tests and procedures to facilitate prompt diagnosis and treatment.
Educated patients on disease management, self-care techniques, and wellness strategies to improve long-term health outcomes.
Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
Reduced medication errors through thorough double-checking of prescriptions and dosages.
Evaluated patient histories, complaints, and current symptoms.
Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
Participated in ongoing professional development opportunities to stay current on best practices in nursing care and emerging trends in healthcare delivery.
Experienced as float pool RN at many locations throughout Health Midwest including: Baptist Medical Center, Trinity Lutheran Hospital, Medical Center of Independence, Research Medical Center, Research Belton Hospital, Park Lane Hospital, and Menorah Hospital

Summary

Overview

Work History

Capacity Management Care Coordinator

Care Coordinator, Supervisor

Care Coordinator, Neuro4/Oncology

Registered Nurse,4East Surgical/Oncology

Lead Clinic Nurse

Registered Nurse,4East, Cardiac ICU Step-Down

Pain Institute Nurse

Medical/Surgical Floatpool Nurse

Education

Master of Science in Nursing - Healthcare Administration

Bachelor of Science in Nursing - undefined

Skills

Publications

Community Service

Accomplishments

Certification

Timeline

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