Christopher Gardner

Twinsburg, OH

acxjk2@r.postjobfree.com - 240-***-****

Authorized to work in the US for any employer

WORK EXPERIENCE

Nursing Supervisor

Brentwood Health Care Center - Sagamore Hills, OH - September 2015 to Present Brentwood HealthCare 9/2015 - Current

Nursing Supervisor and Admission Nurse

Responsibilities include supervision of all nursing staff and responsibility of the facilty on 3-11 shift. Nursing supervision includes hiring and employee reviews along with termination of employment. Maintain contact for all the physicians to review labs, change in conditions and send outs. Point person for nursing staff, families and doctors. Provide education to new nursing staff. Have conducted employee inservices for lab draws, codes and case studies.

Admision nurse responsibilities include reviewing all referrals to the facility, obtaining precertification and assessment of resident upon admission including all assessments and verifying and entering orders. Responsibilities also include continued stay reviews to insurances, communicating discharge planning needs with all departments. Have initiated protocols to prevent sent outs and hospitalizations through route cause anaylsis and staff education.

Intake Nurse

Interim HealthCare - Akron, OH - June 2014 to October 2015 Responsibilities include coordinating all referrals to the agency. Reviewing clinical information to determine appropriateness for home care services, insurance eligibility, following physician, face to face requirements, and obtaining orders from physician via verbal or written order. Responsible for confirming face to face requirements, following the process from sending to physician to ensuring returned and completed per CMS requirements. Therapy coordination responsibilities, orientation, time keeping, reviewing notes on daily/weekly basis to ensure appropriate frequencies are being followed. Case conferencing with all therapists upon requests for extension of services and obtaining orders and authorization for appropriate requests. Resource for all office staff and nursing staff, including providing answers and ordering supplies for clients. Resource for referral sources and clients and families regarding home care services, CMS guidelines. Reviewing all labs and orders faxed to agency, calling physicians if needed regarding critical labs and notifying nursing staff of orders and lab results.

Case Manager

Senior Bridge - Akron, OH - July 2014 to September 2015 Case management to in home memebers for Humana insurance. Wellness checks, navigating resources. Intake Nurse

JFSA - Beachwood, OH - October 2013 to June 2014

Responsibilities

Responsible for all new referrals to the home care agency, insurances include Medicare, Medicaid and private pay.

Check insurance benefits and eligibility, this is done via phone and electronically. Obtain pre-authorization when required per insurance, work will all major insurance companies and third parties.

Follow up on all referrals made to agency via phone and electronic. Responsible for scheduling all nursing and therapy staff, schedule RN’s for opening of cases, RN and LPN’s weekly assignments.

Responsible for concurrent chart review and continuing authorization for services through the authorizing insurance company.

Act as resource to all nursing staff for obtaining MD orders, acting as liaison between multiple providers and ordering/arranging consults to other clinicians and agencies as necessary. Market to hospitals, nursing facilities, and doctor’s offices and arrange for admission process from marketing sites as necessary.

Make nursing visits to clients’ home in event of nursing staff shortage, the visits include following physicians ordered POC, venipunctures, monitoring INR, physical assessments, wound care and medication teaching/ compliance.

Nursing Supervisor

Arbors at Fairlawn - Fairlawn, OH - August 2013 to October 2013 Responsibilities

Night time supervisor including: patient care which can range from 15 to 30 patients at night. Responsible for administering all medications, treatments, wound care, physical head to toe assessments, supervising STNA’s, scheduling and making daily work assignments.

Complete head to toe assessment and all paperwork on new admissions to facility. Nurse Liaison

Centerre Health Care - Cleveland, OH - February 2013 to August 2013 Responsibilities

Clinical liaison for new rehabilitation hospital opening, to include marketing techniques for obtaining referrals internally and external, JCAHO certification, staffing, plans to ramp up bed status. Internal clinical liaison at University Hospitals, obtaining referrals for acute inpatient rehabilitation, chart review for medical necessity, appropriate diagnosis and medical stability for transfer and three hours of therapy. Complete morning rounding to discuss appropriate discharge planning to next level of care. Discuss with patients and families about rehabilitation, disease management and home going plan of care. Promote education to social workers, case management, physicians and therapy staff regarding appropriate diagnosis for inpatient rehabilitation. Develop strong relationships with physicians and discharge planning staff. Other responsibilities include calling insurance company to verify benefits and obtain authorization. Authorization obtained by either electronic, fax or verbal. Obtain referrals from external hospital systems and complete on site evaluations as necessary. I have also been the preceptor for new clinical liaison staff and assisting with case management for concurrent reviews, also to include teaching pre admission documentation system to staff and physician. Cross trained to cover admissions for the rehabilitation hospital. This is to include answering the phone/fax of potential admissions. Completing registration, insurance verification, having the patient complete/sign papers upon admission to the hospital.

Also while with current rehab filled was acting director of quality improvement. This included assistance with JCAHO certification, chart audits, patient/family customer satisfaction. Accomplishments

Worked as admissions coordinator during employement Worked as QI Nurse while preparing for JCAHO Certification Skills Used

Nursing, Admissions Coordinator, Case Mangement, Insurance pre certification, QI Nurse Coordinator Utilization Review

Cleveland Clinic - Cleveland, OH - September 2012 to December 2012 Responsibilities

Current job description is reviewing all elective admission and surgeries to the hospital. Cases’ reviewed for admission include, open heart surgery, diagnostic imaging, chemotherapy and various other medical admissions and surgeries, authorizations obtained by faxing information and also verbally calling insurance company and giving clinical information along with various insurance companies websites. Also to follow up with insurance companies daily to obtain authorization, work with physicians to make sure that surgeries scheduled need to be in patient. Work with physicians on pre determination letters written to insurance companies for various surgeries and procedures to obtain authorization. Will review cases to verify that meet insurance company’s medical policy. Weekly monitoring of approvals and denials, along with surgical case requests changed to out patient from in patient.

District Case Manager/ Discharge planner

Kindred Hospital - Pittsburgh, PA - September 2010 to September 2012 Current responsibilities include providing case management coverage for five local hospitals to provide Case Management and Discharge planning. Case management role included following patient from time of admission to discharge. Would identify discharge barriers and discharge goal at time of admission. Work with all major insurance companies to obtain authorizations for continued stay in the hospital. Authorizations also obtained at time of discharge for home health, DME, skilled nursing and acute rehab. Experience with clinical applications to verify insurance benefits and obtain authorizations via navinet, CWF and passport. During discharge planning, work closely with physicians to discuss placement options and arranging for safe discharge. Duties also provided are educating patients and family on insurance benefits. Experience with disability claims, social security, SSI and Medicaid. Experience also includes applying for disability and medical assistance.

Duties also include UR for chart review, medical necessity and compliance. Experience with coding along with DRG and reimbursement.

Discharge Planner

Allegheny General Hospital - Pittsburgh, PA

Duties included rounding with physicians in the hospital to discuss plan of care and discharge plans. I would be responsible for arranging home needs prior to discharge, including authorization for medications, home health and DME. I would complete necessary paper work for transfer to nursing facilities and LTAC. Educated all patients, family and care takers at time of discharge, regarding new diagnoses, medications and if necessary how to administer medications

Oncology Case Manager

West Penn Hospital - Pittsburgh, PA

closely with physicians while they are rounding on patients in the hospital and out patient clinic. Answering patient phone calls for triage, medical questions and clinic follow up. Was responsible for obtaining all prior authorizations from insurance companies for treatment, medications and DME. Educated patients on chemo mediations and follow up on side affects and answer questions. Would work with hospitals for charity care and out side agencies that would provide financial support to patients that qualified. Arrange all consult to home health and home infusion companies for discharge from the hospital. Experience with workers compensation and disability claims.

EDUCATION

Health and Social Care

Cardinal Newman College - Preston

LPN

James Rumsey Technical Institute - Martinsburg, WV SKILLS

IV Therapy (9 years)

ADDITIONAL INFORMATION

BCLS and AED certified

Certified in reading and performing EKG's

Cardiac dysrythmia course

IV therapy certified

Contact this candidate