**** ******* ******* *****

Las Vegas, NV *****

accg7i@r.postjobfree.com

Home 702-***-****

Cell 702-***-****

Barbara J. Flyr

Skills Summary Senior manager with extensive experience in Home Health,

Hospice, Infusion Care, Skilled/Long Term Care, Education,

Regulatory Compliance, Quality Assurance and Performance

Improvement Activities. Skilled in Care Management,

Management of Staff, all aspects of Patient Care,

Performance Improvement, Case Management, Utilization

Review and Infection Control. Excellent background in

Medical Review, HEDIS data collection, JCAHO and Survey

Preparedness. During my current employment the facility

has received the most improved quality for the division for

2009 and AHCA silver award 2010.

Professional

Experience

01/16/12 to Present

Progressive Hospital, LLC

Las Vegas, NV

Manager - Case Management/Utilization Management

. Peer to Peer Review

. Continued Stay and Admission Review

. Discharge Planning

. Case Management activities

. Interdisciplinary Team

. LTCH QRP completion and submission

. Patient Safety Team Member

. CNO back up

. Review of all potential admissions

. Authorization submission for admissions

. Arrange Transportation and post-care services

01/16/2012 to 05/31/2012

Manager - Quality Improvement

. Survey Preparation

. Policy and Procedure Review

10/2011 to 12/2011

Sentara Health Care - Life Care Division

Virginia Beach, VA

Sentara Nursing Center -- Virginia Beach

MDS Coordinator

< Initiate and Complete the RAI and transmit to CMS

11/2008 to 09/2011

Director of Nursing/CNO

* Supervision of all Nursing Staff

* Management of Clinical Operations for the Facility

* In-service Development, Supervision and Provision of

Educational Program

* Medical Record Review

* Quality Improvement Program

* Regulatory Compliance

* Case Management/Utilization Review

* Infection Control

* Patient Safety and Lead in Safety Stand Downs for the

Facility

* Member of Several Corporate Committee

* OSHA Safety Committee

* Wound Committee

* Staffing Committee

* IT/Electronic Records Committee

* Pharmacy Committee

* DON Committee

12/2006 to 08/2008

Medi Home Health and Medi Home Health and Hospice

Chesapeake, VA 04/2008 to 08/2008 as Administrator

Administrator

Responsible for all the duties as Assistant Administrator,

as well as the additional duties as follows:

* Liaison to the Governing Body, the Professional Advisory

Group and the Professional and Business Staff for both

agencies

* Provide community and professional education related to

Home and Hospice based services

* Responsible for overall operation of all programs for

both

* Assist with Marketing Services for Home Health and

Hospice in the Greater Hampton Roads area

* Evaluation of all programs for both agencies

* Participation in Local, State and National Committees

and Boards

* Interpretation of Policies and Procedures for the Board

of Directors, including the implications of proposed

policies

* Ensure implementation of all Policies and Procedures

* Receipt, investigation and resolution of any complaints

* Home visits when indicated or necessary

* Plans and develops, with other agencies, methods of

interagency work

* QAPI oversight

* Communicate with Federal, State and Local Regulatory

Agencies as well as all other Third Party Payers

* Monitor the fiscal condition of the Agencies and ensure

adequate resources

12/2006 to 04/2008

Assistant Administrator

* Manager of Home Health and Hospice Agencies

* Regulatory Compliance

* Coordination of resources i.e.: Hiring, Training and

Management of all staff

* Assist with the development of Regional Orientation, as

well as Regional Policy and Procedures

* Negotiation of contracts with Hospitals, Insurers, DME,

Physicians and other Health Care Professionals

* Case Management/Utilization Review Oversight

08/2005 to 02/2007

Jewish Family Services

Virginia Beach, VA

Case Manager

* Orientation of New Field Staff

* Admission assessments utilizing OASIS Assessment Tool

* Case Management

* Provision of Patient Care Including but not limited to

the following

* Pleurix Drain management

* IV Therapy via PICC, Central and Peripheral Lines

* Wound Care including use of Wound Vacs

* Pain Management

08/2004 to 06/2005

Kindred Health Care - Nansemond Pointe

Suffolk, VA

Director of Nursing

* Supervision of all Nursing Staff

* Management of Clinical Operations for the Facility

* In-service Development and Education Oversight

* Medical Record Review

* Quality Improvement Program

* Clinical Outcomes/Clinical Indicator Tracking and

Reporting

* Regulatory Compliance

* Infection Control

* Patient Safety

08/2000 to 08/2004

Independent Consulting

Las Vegas, NV Consulting Services in

Acute Care, Acute Rehabilitation Hospitals, Long Term

Care, Acute Hospitals, Skilled/Long Term Care, Home

Health Care and HMOs nationally

* Acting/Interim DON

* House Supervisor/

* Regulatory Compliance

* Medical Records Oversight

* Case Management

* Utilization Review Activities

* Mock Surveys

* Coordination of Care

* Department of Health Data Collection

* Quality Improvement Initiative

* JCAHO Preparedness

* HEDIS Data Collection

* Physician Office Record Review

* Develop and oversee Performance Improvement programs

* Pre-Survey Audits

While running my own business I also performed Interim DON

and Consulting assignments: 08/2000 to 02/2002

Survey Solutions, Inc.

Columbus, OH

During this time I also performed interim DON and House

Supervisor

assignments:

02/2002 to 2003

LeaderStat

Powell, OH

While working for LeaderStat I also performed Home Health

when in-between assignments.

02/2003 to 10/2003

Gentiva Healthcare Services

Virginia Beach, VA

Case Management

Providing health care to clients in their homes as a Case

Manager and Assessment nurse when not traveling as a

consultant

* Admission Assessments

* Case Management

* Provision of care

The following was performed when home from assignments for

my business or assignments with the above referenced

companies

12/2001 to 12/2002

IPA Management Inc.

Las Vegas, NV

Case Management - Per Diem

* Providing Case management and After Hours Management when

not on assignment.

* Concurrent Review Acute/SNF Patients

* Discharge Planning

* Coordination of all care needs i.e.: Home Health, DME

and Transportation

* After Hours Coordination of all care in all settings

including transfers in and out of non-par facilities.

11/2001 to 03/2002

Spring Mountain Treatment Center

Las, Vegas, NV

Case Management - Per Diem

. Utilization Review

. Case Management

. Concurrent Review

. Preparation of Quarterly Reports

09/1998 to 03/2001

Professional Management Strategies, Inc .

Las Vegas, NV

CEO/Co-owner

Health care consultation specializing in the areas of Acute

PPS Hospitals, Acute PPS Exempt Hospitals (including

CARF's), Skilled Nursing Facilities, Home Health Care,

Hospice, Long Term Care Facilities, Rural Health Clinics,

Physician's Office and Outpatient Facilities, such as

Surgical Centers and Rehab Clinics (CORF's). The following

are examples of some of the services. Review was done

utilizing either InterQual, AEP or SIMS Criteria dependent

on the contract preference.

. Case Management/Utilization Review/Management

. Medicare Certification preparation

. Claims Review

. Survey preparation and response

. NCQA preparation including HEDIS data collection

. JCAHO preparation

. Performance Improvement programs and facilitation

. Continuing Education Seminars

. Statistical Analysis

1995 to 1997

Horizon Health Care Corporation

Albuquerque, NM

Medicare Nurse Specialist

. Education for professional and administrative facility

staff

. Assistance with facility based intensives for those

facilities facing decertification

. Mock Surveys

. Evaluation of Medicare claims against clinical

documentation prior to submission

. Assistance with developing, implementing and monitoring

Quality Improvement Programs

. Audits - Medical and Billing, Medical Claims Review

. Regulatory Compliance Oversight

. Telephone Resource for facilities regarding coverage

issues, reconsiderations and appeals

. Responsible for the CMS Compliance and performance of

Acute and Skilled facilities in 7 states

. Utilization Management

The Medicare Department was instrumental in changes that

resulted in a 400% growth in Medicare revenues over 3 years

and profit increase from 5 figures to 8 figures during that

time period.

1992 to 1995

HealthInsight

Las Vegas, NV

Manager, Health Care Assurance and Beneficiary Outreach

Coordinator/External Relations

Both positions reported to the Nevada PRO (QIO) CEO with

the following responsibilities the first several years of

my employment the focus of my duties was as Beneficiary

Outreach Coordinator/External Relations.

. Direct supervision of Las Vegas reviewers assigned to

QA/UR Review and HMO Medicare Review or Special Projects

. Assist with the development of proposals for Medicare

contract procurement or renewals

. Recommend topics for in-service agenda and training

sessions; act as a training consultant, using results of

audit cases to target educational needs.

. Oversee daily work management and nurse reviewer

workload to assure maximum efficiency, timely completion

and reporting requirements

. Participate in CMS surveys, prepare reports and

responses, analyze feedback and institute necessary

changes to correct deficiencies

. Provide support to physician review training panels,

criteria development committees and assist the Medical

Director with physician audit profiling

. Budgetary preparations for Scope of Work Contract

Negotiations with the Federal Department of Health and

Human Services, CMS

. Project leader and TQM/CQI Facilitator for internal and

external (Provider) CQI projects and project selection

. Primary liaison between QIO and CMS, Fiscal

Intermediaries, Carriers, Medicare Beneficiaries, All

types of Providers, Physicians, State Agencies and Aging

Services Organization

. Preparation and submission of beneficiary records for

ALJ Hearings when requested to do so by Beneficiaries

(pts.) and/or Providers

. Telephone resource for Public and Provider questions

. Management of the "Beneficiary complaint" system

. Assist with analysis of relevant hospital trends and

medical review/case management

1989 to 1992

Charleston Home Health

Las Vegas, NV

Case Manager/UR Review Nurse/486 Specialist

. Patient Care Coordination

. Medical Record Review for Quality and Utilization

. Initiation and Completion of 485 and 486 forms

. Case Management of all care provided to home care

patients by all disciplines

1989 to 1991

NMC Infusion Care

Las Vegas, NV

Reviewer/Statistical Analyst/Infusion Specialist

. On-site review/audit of the company's submitted

Medicare/Private Insurance data

. Infusion Specialist providing highly technical nursing

care to home infusion patients

1990

Medical Management Services

Las Vegas, NV

Case Management/Utilization Review/Prior Authorization

Specialist for Boyd Self Insured Plan

. Concurrent Review Utilizing InterQual and AEP criteria

. Case Management/Discharge Planning

. On-site Utilization Review

. Pre-certification for specified procedures

1986 to 1988 and 1981 to 1983

Desert Springs Hospital

Las Vegas, NV

Quality Assurance/Charge Nurse/Staff Nurse

. Review of records for compliance with hospital

standards, JCAHO, State and Federal regulations

. Patient care in the ICU, IMCU, Emergency, Surgical and

Medical Units

. Discharge planning and patient care coordination as

Charge Nurse

1986

AHM Home Care

Las Vegas, NV

Case Manager

. Management of all care provide to home care patients by

all disciplines

1984 to 1986

Upjohn Health Care Services

Ft. Worth, TX

Administrator/DON

. Preparation and administration of a 6 figure budget

. Analysis of statistical reports

. Supervision and management of 50 to 100 employees in 3

cities, including Dallas and Ft. Worth

. Physician and Provider education

. Reduction to and maintaining a zero denial rate for all

3 offices

. Designed and implemented a supply inventory system that

resulted in significant decreases in equipment and

medical supply loss

. Implementation of corporate policies and procedures as

well as assist with development of Regional policies

. Designed and implemented an orientation program for new

administrators at the request of the Regional Medicare

Manager the orientation was also provided by me

1978 to 1981

State of Wyoming

Greybull, WY

Public Health Nurse/Floor nurse at State owned SNF

1976 to 1978

Worked as an RN Staff Nurse for St. Joseph's Hospital and

for the VNA Denver, Co

Education 1973 to 1976 University of Wyoming

Laramie, WY

BSN/Nursing

1972 to 1973 Northwest Community College

Powell, WY

AD/Liberal Arts

Professional Sigma Theta Tau

Memberships

References Available Upon Request

Accreditations Certified Professional Utilization Review (CPUR)

11/1995

Training MDS 3.0 by CMS in Las Vegas 2010

Certified TQM/CQI Facilitator InterMountain Health Care 4/1994

to 11/1994

Salt Lake City, UT

CPUR Course 11/1995

Awards and Recognition

Qualified for inclusion in Who's Who for Professionals and

Executives 2005 to 2006

2006 to 2007

Selected as a Media Expert in the area of Health Care 1999

Regulation by Sigma Theta Tau International for inclusion

In their data base

Nominated for March of Dimes Nurse of the Year 1999

Featured Speaking Engagements

Medicare Basics Training from 6/1998 to 8/1998 Casper,

WY

Reno, NV

Las Vegas, NV

Nevada Health Care Association Mid-Year Meeting 7/1997 Tahoe, NV

Idaho Health Care Association Annual Meeting 7/1996 Boise,

ID

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