Tracy Spigelmyer

• Nanny/babysitting in home care for infant starting at 3 months of age through current age of 18 months
• Provided a safe, nurturing and stimulating environment for a child to learn and grow.
• Supported a child's emotional and social development, encouraging understanding of others and positive self-concepts.
• Communicated with child's parents or guardians about daily activities, behaviors and related issues.
• Provided transportation to and from several library programs and organized play for child.

Worked in a telephonic capacity, educating members on self-management of chronic health conditions and informed them of strategies to reduce unnecessary burden on hospital resources. I completed the CM enrollment process, created care plans with specific goals/interventions, managed a large caseload of members and completed discharge follow up calls to decrease risk of re-admission.

Managed processes pertaining to denials as outlined by the insurance carrier. I functioned in a dual role. In addition to managing prior authorization denials, I applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.

Worked in a telephonic capacity in a call center environment. Managed multiple cases for Medicare beneficiaries, who were enrolled in Accountable Care Organizations in Virginia, Maryland and North Carolina. Provided disease management expertise by performing disease assessments. Created plans of care with specific goals and interventions. Educated patients with chronic health conditions to promote health and wellness, resulting in decreased number of Emergency Room visits and Hospital admissions.

Worked predominantly in the Pre-Admission testing department, interviewing patients prior to surgery. Responsibilities included, drawing lab work, performing EKGs, evaluating airways and reviewing pre-operational instructions. Performed pre-operational procedures, such as obtaining surgical consents, starting IV and administrating pre-operative medications/treatments. I conducted detailed patient chart reviews to screen/identify high risk patients and potential surgical concerns. Identified and recommended procedural changes necessary to comply with the Pennsylvania Department of Health regulations, resulting in improved patient care and surgical outcomes.

Responsible for multiple functions and worked in various settings, including Pediatrics, Family Practice and rotating Relief Pool nurse. Provided care for a broad range of clients, from prenatal and delivery, infants and pediatrics, through geriatrics in a multi-service medical setting. Oversaw Obstetrical care, worked with special needs children, assisted with minor surgeries/laceration repairs and supervised daily office operations for assigned physician to ensure efficient patient flow.

Supported family physicians by performing multiple functions in a family practice setting. Coordinated Healthy Beginnings program and conducted patient assessments by educating mothers, facilitating quality pre-natal care. Coordinated Medifast weight loss program.

Functioned as a floor nurse in a rotating medical/surgical department, working 11 pm to 7 am shift. Specialized in Obstetrical Nursing for most of employment period. Handled multiple emergency situations independently, until physician arrived.