Susan Renee Hedge
Vincennes,IN
Summary
Quality professional committed to maintaining high standards and achieving results. Expertise in improving clinical/operational processes and ensuring compliance with regulatory requirements. Known for strong team collaboration and adaptability to changing needs. Skilled in quality methodologies and process optimization. 33 Years in health care in multiple roles including clinical field positions, inpatient and outpatient services, management and quality roles.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Quality Coordinator
Common Spirit Health at Home
10.2018 - 10.2024
- Managed workflow using HCHB program. Reviewed and assessed proper OASIS, Plan of Care and ICD-10 coding. Clinician suggestions and education given to ensure correct documentation.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems with OASIS, coding and POC deficiencies.
- Monitored Face to Face documentation to ensure it met Medicare/ insurance standards.
- Education and training performed at Clinical Case Conferences regarding OASIS, POC education and proper primary diagnosis
- Experience with Pre-Claim Review in the Ohio/ Illinois Markets.
- Analyzed data trends to identify opportunities for process improvements, leading to a more efficient workflow and higher quality outcomes
- Trained team members on quality assurance best practices, enhancing their understanding of the importance of maintaining high-quality standards.
- Member of Company Best Practice committee
Manager of Clinical Services
Good Samaritan Home Care
09.2017 - 10.2018
- ICD-10 coding, OASIS review and development of the Plan of Care.
- Trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
- Monitored Clinical Outcomes, Patient satisfaction and Implemented changes as needed for Improvement.
- Clinical chart audits to maintain survey readiness
- Responsible for requesting and maintaining Medicaid authorizations.
- Prepared and ran case conference meetings. Ongoing staff education.
- Communication with physician offices, hospitals, skilled facilities, families, Medicaid insurance and outside DME entities
- Staff evaluations
- Conducted comprehensive audits in patient homes to ensure clinical services adhered to established standards, maintaining a high level of accountability across the organization.
- Promoted to Quality Coordinator/ Corporate office of Common Spirit Health at Home
- Member of Corporate Best Practice Committee; Wound Care Specialist
Regional Director of Clinical Services
Preferred Home Health Care
09.2015 - 10.2017
- Direct Supervisor of Clinical and Office staff for Indianapolis office and Washington office
- ICD-10 coding, OASIS review and development of the plan of care.
- Monitor Clinical Outcomes, Patient satisfaction and Implemented changes as needed for Improvement.
- Clinical chart audits to maintain survey readiness
- Responsible for calling insurance companies and maintaining Medicaid and insurance authorizations.
- Prepare and run case conference meetings and education for offices.
- Communication with physician offices, hospitals, families, SNF's and outside DME entities
- Clinical visits as needed for patient and staff evaluations
- Monitored staff performance by actively engaging in and observing day-to-day activities.
- Assisted in recruiting, hiring and training of team members.
- Complaint/ Concern resolution
- Performed Policy and Procedure updates
Regional Clinical Manager for the Southwest Region
American Nursing Care
02.2010 - 12.2014
- Oversight of Clinical Operations for multiple branches in 3 states
- Involved in staff and management education as needed to ensure compliance with State, Federal, TJC and company Best Practices
- Monitor HHCAPS, Outcomes and Process Measures at both Branch and Regional levels and provide education as needed to ensure company benchmarks are being met
- Improved regional clinical operations by streamlining processes and implementing best practices.
- Assisted in the development and implementation of the training manual for The Director of Clinical Services Position at the Corporate level.
- Assisted with the development and implementation of Performance Improvement Activities with in the branch locations
- Direct supervisor of Clinical Educators and Centralized Coding/ Centralized Insurance Employees.
- Performed coding, OASIS review, clinical record reviews and home care visits as needed at the branch locations
- Regularly evaluated employee performance and provided feedback.
- Acted as the Certified Wound Specialist over 3 branch locations to ensure proper wound care was provided
- Worked with nurse manager to develop nursing staff through education, evaluation, performance management, and competency improvement.
- Assisted the branches in writing plan of corrections for State, Federal and company audits
- Member of the Corporate Best Practice Committee
- Assisted in the development and implementation of the following disease management programs: wounds, cardiac and pulmonary.
Manager of Clinical Services
American Nursing Care/ Good Samaritan Home Care
02.2004 - 02.2010
- Managed Clinical Operations over 2 branch locations
- Prepared monthly validation reports, OASIS corrections as needed, infection control and safety reports
- Monitored HHRG scores, LUPA percentages, Outcomes, Process Measures and patient satisfaction scores
- Prepared educational material and presented at clinical staff Meetings, case conference meetings, and home health aide meetings
- Championed best practice sharing among departments, resulting in more consistent execution of patient care processes and improved outcomes.
- Assisted in the education and training of new clinicians
- Organized, performed, evaluated and implemented a plan of correction for monthly clinical record reviews
- Responsible for the interviewing, hiring, retention and orientation of all clinical staff
- Responsible for the follow through on all client and employee concerns and complaints
- Direct supervision of Clinical Coordinators, Customer Support Coordinators, Clinical Educator and all Clinical Field Staff
- Performance Improvement Manual: Maintained and performed all follow-through on clinical and office operational Performance Improvement Activities
- Assisted with ICD-9 coding and OASIS review on admission, re-certification, resumption of care, transfer and discharge documentation
- American Nursing Care became an LLC with Good Samaritan Care in 2004.
- Promoted to Regional Clinical Manager corporate office/ American Nursing Care
Clinical Coordinator
American Nursing Care
01.2001 - 02.2004
- Direct supervision of field staff
- Responsible for professional staff schedules, episode management and client outcomes
- Responsible for keeping recertification and physician orders current and up to date
- Data entry of admission charts and certifications
- ICD-9 coding, OASIS and plan of care review of all team charts.
- Coordinated multidisciplinary team meetings to streamline patient treatment plans, improving communication and treatment outcomes.
- Promoted to Manager of Clinical Services for American Nursing Care
Admissions Nurse
American Nursing Care
11.2000 - 01.2001
- Educated clients regarding home health care services
- Prepare clients plan of cares based on client needs in coordination with attending physician and client input
- Direct patient care and educational needs
- Organize community resources as needed per client
- Promoted to Clinical Coordinator American Nursing Care
Registered Nurse
Riverfront Home Health Care
02.2000 - 11.2000
- Direct patient care and patient education
- Supervision of home health aides in the home environment
- Ongoing communication with physicians, clients and families to ensure proper plan of care and outcomes for the client
- Riverfront Home Health was bought out by American Nursing Care
Cardiovascular ICU Nurse
Deaconess Hospital
01.1999 - 01.2000
Staff Nurse
Crestview Nursing Home
01.1998 - 01.1999
Physical Therapy Assistant
Indiana Home Health Care
01.1997 - 01.1998
Physical Therapy Assistant
Country Heart Home Health Care
01.1996 - 01.1997
Burn/Trauma/ER Nurse
Wishard Memorial Hospital Burn Center
01.1995 - 01.1996
Education
Associate of Science Degree - Nursing
Vincennes University
Vincennes, IN01.1995
Associate of Science Degree - Physical Therapy
Vincennes University
Vincennes, IN01.1991
Associate of Science - Business Administration
Vincennes University
Vincennes, IN01.1989
Skills
- Quality improvement
- Management/ Clinical leadership
- OASIS certification
- ICD-10 coding experience
- State, Federal and The Joint Commission Survey Experience
- Clinical Training and development
Certification
- Registered Nurse, Indiana 1995-2025
- Registered Nurse, Compact States 2024-2025
- Registered Nurse, Illinois 2021-2026
- Physical Therapy Assistant, Indiana 1991-2022
- OASIS Certification current- 2026
- Wound Care Certified -2018
- ICD-10 Certified 10 years- 2020
Personal Information
Susan Hedge RN, COS-C
Timeline
Quality Coordinator
Common Spirit Health at Home
10.2018 - 10.2024
Manager of Clinical Services
Good Samaritan Home Care
09.2017 - 10.2018
Regional Director of Clinical Services
Preferred Home Health Care
09.2015 - 10.2017
Regional Clinical Manager for the Southwest Region
American Nursing Care
02.2010 - 12.2014
Manager of Clinical Services
American Nursing Care/ Good Samaritan Home Care
02.2004 - 02.2010
Clinical Coordinator
American Nursing Care
01.2001 - 02.2004
Admissions Nurse
American Nursing Care
11.2000 - 01.2001
Registered Nurse
Riverfront Home Health Care
02.2000 - 11.2000
Cardiovascular ICU Nurse
Deaconess Hospital
01.1999 - 01.2000
Staff Nurse
Crestview Nursing Home
01.1998 - 01.1999
Physical Therapy Assistant
Indiana Home Health Care
01.1997 - 01.1998
Physical Therapy Assistant
Country Heart Home Health Care
01.1996 - 01.1997
Burn/Trauma/ER Nurse
Wishard Memorial Hospital Burn Center
01.1995 - 01.1996
Associate of Science Degree - Nursing
Vincennes University
Associate of Science Degree - Physical Therapy
Vincennes University
Associate of Science - Business Administration
Vincennes University
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