Home Health Management
Resume:
M AYRA V. MCCOY, R.N., BSN, M.S.
***** *.*. **** * OURT #1912
AVENTURA, FL 33180
TELEP HONE: 786-***-****
E-MA I L: M V *******@*****.***
MAOR SKILLS:
N ursing Director Experience; Case Management/Utilization Review Director;
Medicare/Medicaid Experience; Performance Improvement; NCQA Quality Measures
reporting; Education; Training; Instructional Design; HR Performance Consulting; HR
Career Development; Budget Management; Critical Care Nursing; Infection Control
Coordinator; TJC Standards; ACHA, and Public Speaking.
EDUCAT ION/MANAGEMENT/PERFOR MANCE CONSULTANT EXPER IENCE
S UM MARY:
Over the years one has utilized clinical management and education expertise in various
positions in acute care settings and home health to deliver excellent quality of care and
services to our community. Have a t rack record of leadership in management, meeting
Length of Stay goals in utilization management, performance improvement, data
collection/analysis reports, customer service excellence related to patient, physician, and
employee satisfaction, General Orientation program development, and delivery, marketing
of seminars, awarding scholarships to employees and students, and designing and teaching
classes to both employees of the hospital and directors at all levels of the organization.
M anaged over 200 FTEs; have worked as director and case manager in coordinating care
p lans and discharge planning; home health experience working with Medicaid/Medicare
recipients conducting overall care/coordination of services; have conducted lectures in public
settings at various professional organizations such as the Florida Society for Healthcare
E ducation and Training (FSHET) and local Universities such as the Bar ry University,
U niversity of M iami School of Nursing, and M iami-Dade College; have published articles in
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Hospital Newsletter and in FSHET Newsletter as Board Director of South Florida Region.
WORK EXPER IENCE:
• Westside Regional Medical Center -Plantation, FL . Di rector Case
M anagement/Utilization Review- 2013-2015.
o Responsible for all department operations and Ut ilization Reviews for all
I nsurance Plans including Managed Care, Medicare, and Medicaid
accounts.
o Management of Discharge Plans for all In-patients.
o Management of Denials/Appeals Program
o Management of all Insurance Authorization/Certification of hospital days.
o Management of staff to include management of CDIs staff, hi ring,
s taffing, education/training, coaching, performance evaluations, K ronos
t ime cards.
o Management and implementation of Performance Improvement Process
and Plans.
o Collection of data, analysis, reports, and action plans for performance
i mprovement.
o Responsible for Utilization Management Plan and Commit tee
o Member of 14 Hospital Commit tees including Leadership Commit tees.
o Physician education on all metrics of their health care services and
Length of Stay.
o Responsible for RAC reviews and process of appeals with
C MS/ACHA/QIO.
o Responsible for Care Coordination and Patient/Physician family
Conferences.
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• Senior Healthcare Services- Ft. Lauderdale, FL . Di rector of Nursing. 5/1/12-
11/1/12-left to care for critically ill mother at home/hospital until she passed.
o Responsible for overseeing the day-to-day operations of managing clinical
care and services provided by home care agency.
o Performed Ut ilization Reviews on 10% of Medicare Cases on all SOC,
ROC and Discharges. Assured proper utilization of all skilled services.
o Analyzed OBQIM reports on all Quality Measures and developed
educational programs to make Performance Improvements and obtain
positive outcomes in quality home health services.
o Performed quality assurance by auditing/reviewing medical records and
supervising staff during home visits to assure compliance with COPs and
n ursing standards.
o Generated quality improvement reports and shared with leadership team
and staff.
o Managed staff in six Senior Living Residences, which included hi ring,
t raining and development, counseling, performance evaluation, functional
development and disciplinary action-managed over 200 employees.
o Assisted in the development/ implementation of policies, procedures and
competencies.
o Conducted agency-specific orientation program in conjunction with
H uman Resources.
o Assisted with patient assessments and developed Plans of Care for clients
both in the Medicare and Private Duty Programs with private pay and
m anaged care insurance.
o Managed clinical practice to assure compliance with standards
p romulgated by appropriate Federal, State and Local regulations.
o Worked in teams with clinical and non-clinical and medical staff.
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o Member of the Leadership Cabinet Team, and lead Performance
I mprovement.
• Metro Dade Home Health, Inc. – Doral, FL. D i rector of Nursing. 2011-2012-left
d ue to Agency’s financial difficulties.
o Responsible for overseeing the day-to-day operations of managing clinical
care and services provided by home care agency.
o Collaborated with Administrator to meet and exceed home health agency
goals.
o Developed and delivered educational programs monthly for clinical and
office staff.
o Performed medical record audits/reviews on 10% of Medicare Cases
monthly.
o Managed all quality measure reports and conducted education for staff for
Performance Improvement and positive outcomes.
o Case Manager of all Medicare cases-developed Plans of Care and
D ischarge Planning in collaboration with physicians and nurses.
o Reviewed all Plans of Care for agency and assisted in the Coding Process.
o Oversees home care staff, which includes hir ing, t raining and
development, counseling, performance evaluation, functional development
and disciplinary action.
o Conducted Patient Satisfaction surveys.
o Manages clinical practice to assure compliance with standards
p romulgated by appropriate Federal, State and Local regulations.
o Assists in the development and implementation of policies and procedures
for agency.
o Responsible for protecting and advocating for client r ights.
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o Conducted agency-specific orientation program in conjunction with HR.
o Managed clinical practice to assure compliance with standards
p romulgated by appropriate Federal, State and Local regulations.
o Responsible for establishing Plans of Care for clients and signing POCs.
o Visited clients on a regular basis to supervise staff.
o Continuously monitored and evaluated staffing ratios and patterns and
r ecommended appropriate staffing levels to meet business demands.
o Successfully passed ACHC accreditation.
• Kendall Regional Medical Center – M iami, FL. D i rector of Telemetry; I nfection
Control Coordinator; Severe Sepsis Coordinator; I n terim Di rector of
E ducation. 2010-2011-moved North to Aventura, FL and needed a new job closer to
home.
o Responsible for the daily operations of the Telemetry Services
Department.
o Managed staff: H i r ing, t raining, development, counseling, performance
evaluation, and disciplinary action.
o Assisted in the development, management of and monitoring department
budget.
o Manages clinical practice to assure compliance with standards
p romulgated by appropriate Federal, State and Local regulations.
o Participates in case conferences for multidiscipline healthcare providers
t o discuss patient care and outcomes.
o Performed performance improvement audits and reviewed medical records
for compliance with standards of practice and The Joint Commission
S tandards.
o Achieved 90th Percentile on all National Quality Measures.
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o Achieved 90th Percentile on Patient, Physician, and Employee Satisfaction
scores-my department achieved Second Place in Patient Satisfaction in
t he hospital.
o Directed Infection Control and collected, analyzed and reported infection
control data to Department of Health, NCQA, and hospital commit tees.
o Served as In terim Director of Education and conducted education
p rograms such as General Orientation, Nursing Orientation, and
M andatory Education Classes.
o Team Leader of the Severe Septic Shock Program.
o Served as Administrative Nursing Supervisor when needed.
o Continuously monitored and evaluated staffing ratios and patterns and
r ecommended appropriate staffing levels to meet business demands.
o Directly supervised staff and conducted daily patient rounds.
• Nation’s Best Care Home Health, Corp. – Doral, FL. D i rector of
N ursing/Alternate Administrator, Case Manager . 1/2008-11/1/2009-left due
t o Agency was sold.
o Responsible for the daily operations of the Telemetry Services
Department.
o Managed staff: H i r ing, t raining, development, counseling, performance
evaluation, and disciplinary action.
o Assisted in the development, management of and monitoring department
budget.
o Visited clients on a regular basis to supervise staff.
o Conducts case conferences for multidiscipline healthcare providers to
d iscuss patient care and outcomes.
o Worked as Case Manger- Managed 78 patients receiving Medicare skilled
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services.
o Developed Plans of Care in collaboration of physicians, nurses, and
clients.
o Performed Start of Care, Recertification, and Discharges of patients.
o Successfully passed AHCA Accreditation.
• Coral Gables Hospital – Coral Gables, FL. D i rector of Medical/Surgical
Services. 10/23/06-08/06/07- left due to Strict Operational Changes having one
d irector overseeing multiple departments and eliminated Director of Telemetry
position.
o Responsible for the daily operations of the Medical/Surgical Services.
o Managed staff: H i r ing, staffing, t raining, development, counseling,
performance evaluation, and disciplinary action.
o Assisted in the development, management of and monitoring department
budget.
o Managed clinical practice to assure compliance with standards
p romulgated by appropriate Federal, State and Local regulations.
o Performed performance improvement audits and reviewed medical records
for compliance with standards of practice and The Joint Commission
S tandards.
o Achieved 90th Percentile on all National Quality Measures.
o Achieved 90th Percentile on Patient, Physician, and Employee Satisfaction
scores.
o Member of multiple leadership commit tees.
• Baptist Hospital of Miami, Baptist Health South Florida – M iami, FL. 4/1991-
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9/2006 N urse Manager, I I; HR/Education Performance Consultant; Career
D evelopment Performance Consultant; Educator/Trainer, Critical Care
S taff Nurse, Charge Nurse in ICU, N ICU, SICU, Medical/Surgical and
T elemetry Staff Nurse, R espiratory Therapist. M anaged over 100
employees as Nurse Manager I I. ICU RN and charge nurse. A pril 1990-
October 2006-left to become a nursing director and for career development.
SELECTED ACH IEVE MENTS AND OTHER SKILLS:
• Achieved LOS Goal for Hospital for eight months in 2014.
• Increased patient satisfaction, physician satisfaction, and employee satisfaction to
t he 90th percentile at Kendall Regional Hospital, and Baptist Hospital of Miami.
• Developed and managed the Scholars Program and started Career Development
P rogram: Awarded $2 million in scholarships for nursing and other Allied Health
S tudents.
• AHCA Accreditation in Home Health Agency: Passed with 100% compliance of
S tandards.
• Award: Received C linical Excellence in Adult and Gerontology Care Award
• Other Skills: Exceptionally strong writ ten and verbal communication skills; highly
personable and capable of working with all members of an organization; hands on
leader; Bilingual-f luent in Spanish Language; Proficient in problem-solving and
conflict resolution; works well under deadlines and stress; hands-on leader;
p roficient in computer skills such as Word, PowerPoint, Excel, Access, IGEA and
McKesson Computer Systems, M IDAS, Meditech computer program.
EDUCAT ION:
Master’s Degree in Human Resources Development : Florida International University,
College of Education, M iami, FL.
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B.S.N. Degree in Nursing: F lorida In ternational University, Miami, FL.
A.S. Degree in Respiratory Therapy: M iami Dade College, Miami, FL
Cur rent BLS Healthcare Provider
CCRN from 1998-2001-Critical Care RN Certification
GOAL:
To work long-term for an organization commit ted to delivering high quality services,
continuous performance improvement and excellent customer services.
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