Case management acute and subacute, MDS, HHC, physician officeRN
Resume:
Jill Simmons
Midway, GA *****
*********@*****.***
** **** ***** *** *********** short stay rehab/ltc facility. History of 2 plus years acute care case management and utilization review; 8 years of home health care; history acute care in cardiac step unit and pre-surgery. Strong coordination and management skills as well as attention to detail. Dedicated and professional work ethic. Personable and able to work easily with others. Assessment of skilled patients to ensure meeting skilled level requirements per CMS regulations. Issued ABN and processed patient appeals. Authorized to work in the US for any employer
Work Experience
Case mix Director/ MDS
Pruitt Health Savannah - Savannah, GA
September 2005 to June 2017
MDS RN for department of 3 nurses. Fast paced subacute rehab and LTC facility. Managed large Medicare and insurance skilled caseload as well as Medicaid LTC patients. Assessments, care plans to meet state and federal requirements and to maximize patient outcomes and facility reimbursement. Managed coordination of multiple department requirements and deadlines and assisted to coordinate patient care with team approach. Many others meetings and duties including staff, patient and family education. Took early retirement. Case Management
Memorial Health University Medical Center - savannag, ga February 2004 to March 2005
Responsibilities
Case management cardiac step unit and cardiac icu's. Utilization management. Accomplishments
Made arrangements for DC planning, med and education for cardiac patients. Community resources, patient education. Utilization management to ensure continued stay for acute patients. Interqual to satisfy need for acute stay.
Skills Used
Patient and family education, knowledge of clinical need and discharge needs and resources. Case Manager
Medical center of Central GA - Macon, GA
April 2003 to March 2004
Case management, utilization review and DRG assignment. Discharge planning and coordination of care of inpatient caseload. Assessment for appropriateness of inpatient stay and notification to physicians for issues. Communicated with MD's regarding appropriate diagnoses for stay. Left position due to relocation to Savannah area. MDS Coordinator/Care Plan Coordinator
Laurel Baye Nursing and Rehab Center - Macon, GA
November 2001 to May 2003
MDS, care plans, manage entry of Medicare part A skilled stay patients and Medicaid appropriateness. Coordination of care. DMA 6 renewals and completion.
Study Coordinator/Infusion and office RN
Arthritis & Diagnostic Treatment Center - Macon, GA March 2001 to March 2002
Administration of Remicaid IV infusions, office nurse duties. Triage, scheduled OP procedures/tests, insurance pre- certification. Managed clinical studies for caseload at two office locations. Resigned due to need of full time hours. Home Health Care Nurse
UHS - Milledgeville, GA
October 1993 to November 2001
Responsibilities
Skilled nursing for HHC patients. Admission OASIS assessments. Working knowledge of Medicare and Medicaid guidelines.
Staff RN
Medical Center of Central Georgia - Macon, GA
June 1990 to October 1993
6/90 to 11/92 staff RN for cardiac step unit. Patient assessment, care administration, IV infusions of Dobutrex, Dopamine, Nitroglycerin, recovery of post heart Cath and angioplasty patients. Monitored telemetry. Was Med-Surg and ACLS certified 11/92 to 10/93 staff nurse for president surgery inpatient and out patient areas. Prepped patients for surgery, chart and patient assessments. Education
BS Nursing in Nursing
Georgia College and State University - Milledgeville, GA May 1988 to June 1990
BS Biology in Biology
Georgia College and State University - Milledgeville, GA September 1976 to June 1981
Skills
Microsoft word, excel, Interqual
Certifications/Licenses
Prior certifications
January 1990 to December 1998
History of Med Surg certification, MDS certification and ACLS. No certifications at this time
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