Lavern Washington Humphries

Harker Heights, TX **549

ad07wn@r.postjobfree.com

254-***-****

Results-oriented, highly motivated individual with 30+ years of experience treating critical care patients, leading staff training and counseling patients and families. Seeking a position that enables use of clinical knowledge, exceptional communication skills and team-oriented mindset to elevate patient care and support organization. Utilizing extensive knowledge of clinical protocol, deductive reasoning, oral communication and team coordination to support best practices for patient care. Certification in Quality Assurance and Patient Health Education.

Work Experience

Hospice Case Manager

Compassus Hospice

February 2021 to present

As a Hospice Case Manager my responsibilities are responsible for overseeing the care of patients who are nearing the end of their lives. Case Managers work with a team of medical professionals to ensure the patient receive high-quality palliative care, including physical, emotional, and spiritual support. Hospice case managers also help families navigate this difficult time by providing them with resources and information about local services.

Compassus Hospice Case Managers responsibilities:

Meeting regularly with patients and their families to monitor the patients’ physical, emotional, and spiritual needs

Assessing patients’ social and medical history to develop plans of care that meet their needs

Working with physicians, nurses, and other medical professionals to coordinate care and treatment plans for each patient

Coordinating and arranging for services such as home health aides, nursing care, and hospice care

Maintaining records of patient care plans, physician orders, medication administration, and other information about a patient’s condition

Coordinating care with other medical providers and social services agencies in order to meet patients’ needs

Providing counseling and support to patients and families during difficult times in their lives

Coordinating with insurance companies to ensure that patients receive adequate coverage for their treatment plans

Recommending appropriate treatments and equipment for patients based on their condition and available resources

Hospice case managers communicate with patients, families, medical professionals and other hospice staff members on a daily basis. Effective communication skills can help you convey messages clearly, ask questions, listen to answers and resolve issues. You can also use your communication skills to write letters, emails, reports and other documents.

Understand and share the feelings of others. As a hospice case manager, I work with patients and their families who are facing life-threatening illnesses. Empathy helps me as a nurse connect with the patients, their families and help the nurse understand the needs of the patients and caregivers.

Organizational skills: Hospice case managers often have strong organizational skills, as they often have many tasks to complete each day. This can include managing patient files, tracking patient information, updating patient records and communicating with patients and their families. Having good organizational skills can help a case manager stay on top of their work and complete all their tasks in a timely manner.

Time management skills: As a Hospice Case Manager I have to manage my time effectively to ensure all duties are performed on time. This may include completing paperwork, attending meetings, conducting assessments and completing other tasks. Time management skills help prioritize your tasks and complete them efficiently.

Medical knowledge: Hospice case managers often have a background in health care or nursing. Medical knowledge can help you understand the treatments and procedures patients receive and how they affect the patient’s overall health. Medical knowledge also help nurses understand the patient’s goals and how hospice care can help them achieve those goals.

As a Hospice Case Manager I have to travel to patients’ homes or other care facilities. I am required to work evenings or weekends to meet with patients or their families, on call 24 hours a day (one day out the week) to provide support to patients and their families. The work can be emotionally demanding, as hospice case managers must deal with death on a daily basis. They must also be able to handle the stress of working with patients who are terminally ill and their families, who are often grieving.

Executive Director, Health Care Administrator

Journey of Life Home Health

June 2019 to January 2021

• Supervises the schedules and work requirements for all medical contractor and conduct quality control Inspection on a case by case basis

• Making patient/client and personnel assignments,

• Coordinating patient/client care,

• Coordinating referrals,

• Assuring that patient/client needs are continually assessed,

• Assuring the development, implementation, and updates of the individualized plan of care.

• Being available to Agency personnel at all times in person or by telephone

• Participating in activities relevant to services furnished including the development of qualifications and assignment of Agency personnel,

• Ensuring that a patient’s/client’s Plan of Care or care plan is executed as written,

• Ensuring that an appropriate health care professional performs a reassessment of a patient’s/client's needs:

When there is a significant health status change in the client’s condition;

At the physician’s request; or

After hospital discharge,

• Coordinating and integrating care provided by Agency staff, including contractual providers,

• Collaborating on development and implementation of policies and procedures which guide and support the provision of care,

• Recommending resources needed to provide care,

• Collaborating with Agency leadership and appropriate staff to develop the organizational plan as it pertains to patient/client care,

• Ensuring the care offered by the Agency, including any branches (if applicable), is consistently available to all patients/clients,

• Participating in the development and implementation of the Performance Improvement Plan,

• The Supervising Nurse will identify resources needed to implement his or her responsibilities and will notify the Administrator of these needs.

• The Supervising Nurse will notify the Administrator immediately if he or she is unable to fulfill his or her responsibilities.

• The Administrator will designate, in writing, a similarly qualified alternate to serve as the Supervising Nurse in the absence of the Supervising Nurse.

• Ensuring that the Supervising Nurse or Alternate Supervising Nurse is available during all operating hours.

• Ensuring that the Agency employs or contracts with qualified personnel, including assuring the development of personnel qualifications and policies.

• Organizing and directing the Agency’s ongoing functions.

• Ensuring the Agency, including any branches, is in compliance with all applicable federal, state, and local laws and regulatory agencies related to the health and safety of patients/clients.

• Taking action on reports and recommendations of any authorized planning, regulatory or inspection agencies.

• Ensuring staff education, evaluations, and availability of applicable regulations to all Agency staff, including contractual providers.

• Ensuring completion, maintenance and submission of required reports.

• Ensuring adequate staff education and evaluations.

• Ensuring the accuracy of public information materials and activities.

• Implementing an effective budgeting and accounting system that promotes the health and safety of the Agency’s patients/clients.

• Maintaining an ongoing liaison with the Governing Body, staff members and the community.

• Maintaining a current organizational chart to show lines of authority down to the patient/client level.

• Responsibility and authority for the administrative and leadership functions of the Agency.

• Ensuring maintenance of appropriate personnel records, administrative records, and policies and procedures of the Agency.

• Managing the daily operations of the agency.

• Supervising to ensure implementation of agency policy and procedures.

• Ensuring that the documentation of services provided is accurate and timely

• Supervising and evaluating patient/client satisfaction survey reports on all patients/clients served.

• Experience with behavioral health practice guidelines; behavioral health quality assessment, assurance, or improvement, behavioral health research and knowledge of Medicare guidelines.

• Plans, develops, implements, and leads authorization and utilization management analysis and reporting activities for assigned services.

• Accurately interprets complex state and federal laws, regulations, and rules related to the program.

• Develops, reviews, and revises internal utilization review program protocols, policies, and tools/techniques for conducting reviews of Medicare to ensure that the organizations are using authorization and utilization review processes appropriately.

• Experience with Medicare and Texas Medicaid, managed care, clinical role in a behavioral health setting.

• Achieved CHAP certified with minimal deficiencies within 6 months of hire date.

• As the Quality Assurance Manager, I am responsible for the development, implementation, coordination, and management of the Quality Assurance program to ensure compliance with company policies and procedures applicable to company regulations, and delivery of quality care and services at all performance levels from CNA, LVN, Registered nurses, Occupation and Physical Therapists.

• Providing internal quality control training programs for all persons performing services duties upon hire and annually.

• Ensure each staff member meet the minimum proficiency requirements as set forth in the company’s plan of operation.

• Ability to analyze organizational and operational problems and develop timely and economical solutions.

• Maintains quality control files, and document results of all inspections.

Ensure the staff and families are educated on Medicare, Medicaid, VA benefits and TRICARE

Lead House Supervisor

Everest Rehabilitation Hospital

• Maintains the hospital patient care standards by ensuring that hospital policies and procedures are implemented and followed. Ensures changes are communicated to staff in a timely manner.

• Demonstrates effective leadership skills through employee performance evaluations, maintaining professional relationship with the staff and providing them pertinent information.

• Interviews applicants, hires, evaluates, coaches and mentors employees according to established performance standards.

• Ensures communication between leadership in the Nursing Department and Administration. Informs appropriate managers/leaders in a timely manner all appropriate information.

• Promotes efficient inter-departmental and intra-departmental relationships.

• Prepares and ensures employee performance evaluations are completed on time.

• Promotes staff attendance at staff meetings, in-service education and training, employee activities.

• Plans, coordinates and directs the activities of House Supervisors, Staff Nurses and Unit Clerks.

• Ensures adequate orientation of nursing personnel. Monitors their skills and guides and observes staff who may need assistance.

• Demonstrates knowledge of regulations, such as State and CMS, and CIHQ standards.

• Population Served: Evaluates patients from young adult (18 yrs) to geriatric patients, taking into account individual needs such as:

All employees who provide direct patient care take precautions when assisting an elderly person with canes, walkers, and wheelchairs to ensure patient safety.

Provides means of communication, such as telephone.

Able to demonstrate flexibility and sensitivity to the specific needs of the adult and geriatric patient in regards to their own schedules and need for self-control in the hospital.

Recognize and accommodates for the potential for fragile skin in the care of geriatric patients. Specifically as it applies to Skin care, assistance in ambulation and Positioning for comfort treatment and diagnostic procedures.

Recognizes potential differences in medication dosing and lab values that may be specific to geriatric patient.

Demonstrates sensitivity to potential mood and mental-state variances in the geriatric patient.

Relates learning of functional tasks to the adult's interests and values.

• Maintains high standards of patient care and personnel performance through implementation of required staff competencies, quality measurements, and quality improvement activities.

• Participates in required committees such as Quality Council, Infection Control, EOC, Policy and Procedure, etc. Implements recommended changes.

• Ensures proper patient documentation through periodic patient record reviews, education of staff, and as necessary, disciplinary action.

• Monitors patient admission and discharge criteria, reporting any issues to leadership and case management.

Seton Shoal Behavioral Hospital

November 2018 to May 2019

• Ensure the nursing staff members are performing initial and on-going bio-psychosocial assessments according to accepted standards of nursing practice.

• Develops a nursing plan of care consistent with the master treatment plan.

• Participates in treatment team conferences to assist in planning and revising goals, objectives and interventions appropriate to the age-related and problem-specific needs of each patient • Implements nursing plan of care for assigned patients and conducts and/or co-leads group therapy sessions for patients.

• Evaluates patient's response to interventions and revises nursing plan of care as needed.

• Collaborates with the treatment team to revise goals, objectives and interventions appropriate to the changes in patient status.

Georgetown Behavioral Health

October 2018 to Present

Contract through Prestige Staffing

• Provides patient increased care through inpatient services, intensive outpatient programs, and the use of tele-behavioral health services.

• Provides accessible, timely Behavioral Health services to military children and families through consultation and collaboration with PCMs.

• Family Advocacy Program • Patient teaching and Quality Assurance

• Communicates and develops the treatment plan, and serves as a point of contact to ensure services are rendered appropriately

• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; works with members to adjust plan of care, when necessary.

• Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.

• Develops recommendations to resolve substantive issues and problems pertaining to programs and work operations’ effectiveness and efficiency throughout the Health Care System that provides treatment and care for inpatient, outpatient and community-based outpatient facilities.

Health Care Manager

Angels of Care Pediatric Home Health - Sherman, TX

January 2015 to Present

• Ensure the nursing staff members are providing quality care for patients with ADHD, ODD, ASD, anxiety disorder, depression, bipolar, learning and conduct/ behavior disorders.

• Acts as a resource to physicians and ancillary departments as needed.

• Serves as the first line contact for greeting patients and resolving patient concerns.

• Ensure the intake process for Nursing Admission Assessment with patient and family at time of admission.

• Develops, evaluates, and revises the plan of care based on patient assessments and multi- disciplinary input.

• Assesses and implements appropriate nursing care based upon comprehensive nursing assessment.

• Provides effective patient/family education based on individual learning needs an provides discharge teaching.

• Using clinical reasoning - developing, implementing and evaluating the nursing plan of care - managing both emotional and physical patients

• Assessing patient and family level of understanding to provide effective communication and education - working collaboratively with medical staff - providing quality care in a compassionate and professional manner

• Helps member actively and knowledgably participate with their provider in healthcare decision-making.

• Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.

• Utilizes negotiation skills to secure appropriate options and services necessary.

• Need to actively reach out and engage the patients in their care • Provides daily assessments of patients' and maintains/ charts detailed reports of observations.

• Performs evaluation tasks, including vital signs and medication review.

• Administers medication as prescribed by the patients' physician.

• Administers dressings to open wounds and monitors progress of healing continuously.

• Educates patients and their families on proper home health care strategies and procedures to ensure that regulations are being adhered to.

• Coordinates with Occupational Therapists, Speech Therapists, Physical Therapists, Physicians and other healthcare professionals to ensure that the patients care plan is followed according to their prescribed needs.

• Provides palliative care as needed.

• Make recommendations for devices or tools that potentially improves the patient's quality of life.

• Listens to the patient and respond appropriately to concerns or requests

• Knowledgeable on Medicaid, Medicare, Managed Care and TRICARE

• Experience working with the needs of member populations who have disabilities

• Long-term care experience • Electronic Medical Record/Electronic Charting

• Provide detailed explanation of treatments and medication to Aide's working within the home.

Carl R. Darnall Army Medical Center Behavioral Health

June 2015 to September 2018 Contract

• Provides Soldiers increased care through inpatient services, intensive outpatient programs, and the use of tele-behavioral health services • Provides accessible, timely Behavioral Health services to military children and families through consultation and collaboration with PCMs.

• Family Advocacy Program • Patient teaching

• Communicates and develops the treatment plan, and serves as a point of contact to ensure services are rendered appropriately

• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; works with members to adjust plan of care, when necessary.

• Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.

Licensed Practical Nurse/Registered Nurse (Home Health Pediatric Case Management)

First Choice/Encompass Home Health Agency - Temple, TX October 2007 to November 2014

West 31 Street, Temple, TX 76504

• Provided care for patients with ADHD, ODD, ASD, anxiety disorder, depression, bipolar, learning and conduct/ behavior disorders.

• Provided daily assessments of patients' and maintains/ charts detailed reports of observations.

• Performed evaluation tasks, including vital signs and medication review.

• Administered medication as prescribed by the patients' physician.

• Administered dressings to open wounds and monitors progress of healing continuously.

• Educated patients and their families on proper home health care strategies and procedures to ensure that regulations are being adhered to.

• Coordinated with Occupational Therapists, Speech Therapists, Physical Therapists, Physicians and other healthcare professionals to ensure that the patients care plan is followed according to their prescribed needs.

• Provided palliative care as needed.

• Made recommendations for devices or tools that potentially improves the patient's quality of life.

• Listened to the patient and respond to concerns or requests • Provides effective patient/family education based on individual learning needs and provides discharge teaching • Performed Trach care • Performed GB care and change out GB every six months.

• Provided detailed explanation of treatments and medication to Aide's working within the home.

Veteran Claim Representative

First Choice/Encompass Home Health Agency

April 2009 to July 2009

• Prepared and submitted appeals contesting decisions denying claims or the benefit amount awarded clients.

• Researched and evaluated applicability of regulations and documents supporting claims; may represent clients before appeals board.

• Interviewed veterans and their dependents for information needed to determine eligibility for a variety of benefits and services.

• Discusses sensitive matters (e.g., marital or medical history) with veterans and their dependents.

• Advised and assisted patients in establishing their rights to veteran's benefits such as pensions, education, insurance, hospitalization, home loans, out-patient medical care and burial.

• Processed applications for benefits.

• Answered general inquiries made by phone and in person.

• Provides information regarding claims procedures, and eligibility criteria; deals with clients of various socio-economic levels and temperaments.

• Made referrals to other agencies; conducts routine briefing sessions as needed.

• Communicated with representatives of other agencies to determine status or explain circumstances of claim submitted.

• Clarified regulations, communicated and made client referrals, prepared and maintained records and case files.

• Maintained currency with legislation and regulations.

• Completed claim forms for a variety of benefits and programs.

• Prepared transmittal letters, orders documents (e.g., marriage licenses, medical records, school transcripts) and processed documents needed to support claims.

• Established and followed up on case files that may have been assigned routine administrative duties.

• Inputs, accessed and analyzed data using a computer terminal, including preparing reports for higher authority.

• Acts as Local Area Network (LAN) administrator and primary liaison with other Management Information Services (MIS);

• Researched, interpreted and explained applicable federal and state laws, regulations and documents supporting claims.

• Obtained documentation of discharges, births, marriages, divorce of veterans and dependents, deaths, naturalization, and other types of evidence in support of application or claims.

• Assisted in presenting evidence to prove veteran's disability or preference rating.

• Referred veterans and their dependents to other governmental agencies, veteran's groups and service organizations.

• Corresponded with the Veterans' Administration, local and state governmental agencies and with veterans or their representative in regard to claims or benefits.

• Scheduled medical appointments for evaluation of disabilities, general health care and welfare of veterans and dependents.

• Made field call visits to homes, hospitals and other agencies; may act for the County Veterans Services Officer as assigned.

Patient Advocate/Labor and Delivery/Post-partum

Carl R. Darnall Army Medical Center Behavioral Health - Fort Hood, TX

December 2005 to November 2007

• Properly introduced myself to patients who had been admitted to the hospital and assessed needs.

• Provided patients with information regarding rights, policies/procedures, and whom to contact about advocacy, etc.

• Expedites admissions discharges and transfers to maintain effective patient flow.

• Assists Nursing Director, Nurse Manager or Staffing Office to ensure proper coverage of personnel.

• Documented, investigated and took steps to resolve all patient complaints.

• Worked in the behavioral health clinic.

• Followed-up on all complaints.

• Checked with the patients to ensure the problem has been satisfactorily resolved. Included but not limited to making additional calls to patients after discharge to remedy, if any, issues that need to be investigated and resolved.

• Worked various departments and administration to implement changes that needed to be addressed to minimize future similar complaints.

• Provides white-glove level service, removing burdens and providing end-to-end resolution for members. This includes, but is not limited to: Clinical, Financial Decision Support, Behavioral Support, Claims inquiries, and more.

• Provides effective patient/family education based on individual learning needs an provides discharge teaching.

• Supervised twenty five soldiers and twenty three civilians.

• Answer up to 50 to 70 incoming calls per day from members of our health / dental / vision / pharmacy plans.

• Resolves escalated complex and repeat calls from members and works directly with business partners (complex claim reconsiderations, notifications, appeal considerations).

• Monitor and provide proactive support to members with more chronic disease process issues.

• Work with partners including medical, clinical, financial, behavioral and treatment to resolve issues.

• Provide coaching as needed, provide feedback on process improvement, and work with supervisors on enhancing performance.

• Provides direct nursing care for day patients including pre-procedure, intra-procedure and post procedure assessment, monitoring and education.

• Administers Moderate Sedation

• Worked with different units on base as patient liaison/advocate.

• Working knowledge of Family Advocacy Program, safety planning, risk assessments, local community resources, and federal and state laws pertaining to domestic abuse, Family law and the Victim Rights Bill.

• Ability to demonstrate an understanding, sensitivity, and empathy for victims, allow the victim or family members to vent their frustration without interrupting.

• Worked independently while solving multiple issues in a timely manner with the ability to develop a trusting relationship with the soldiers and family members

• Ability to work effectively with individuals and Families from diverse racial, ethnic, and socioeconomic background.

• Work independently to assess and evaluate safety and intervention plans to meet victim needs; and the ability to operate within established guidelines of the FAP.

• Ability to conduct briefings to small and large groups of civilians, soldiers, family members and unit commanders.

• Ability to work cooperatively with military and civilian medical, social service, law enforcement, and legal personnel on behalf of victims.

Community Health Nurse NCOIC/Budget Officer

U.S. Army Tripler Army Medical Center

January 2002 to January 2005

• As a Community health Nurse NCOIC acted as a teacher and counselor primarily, but also played a vital role in preventing widespread illness and disease in the community.

• Assessed the health needs of assigned community.

• Determined the health needs of families and the community at large, as well as any social determinants that impact the health status of that community.

• Assessed health risks, injuries and disabilities.

• Developed a plan to address the health care needs of the community, given the resources that are available.

• In charge of and supervised 20 civilian Registered Nurses and 12 Licensed Vocational Nurses.

• Conducted annual evaluation of all employees.

• Improved the health of families and communities through teaching them about healthy lifestyle choices. Educating the public on eating healthy.

• Effectively delivered care based on evaluations and tailor the care as needed.

• Planned, developed, and issued solicitations for contracting requirements including such services as consolidated contracts, complex, unique, specified program requirements, environmentally sensitive services, those which lack historical precedents and those that require unusual and innovative approaches.

• Recommended the appropriate method of procurement i.e. simplified acquisition procedure and negotiations.

• Utilized electronic systems for contract, contract management, contract reporting, fiscal management, Accounting, and Procurement, in accordance with Agency policies.

• Responsible for implementing accounting systems in a company to ensure the transactions, budgets and overall finances are maintained in a consistent manner. The implementation process includes compiling and analysing the needs of the company through previous accounting data and using the available resources provided by the accounting and financial departments in the company. If the company uses a software program, the budget office modifies the accounting system to suit the company’s need.

• Implemented budgeting and financial record keeping procedures to ensure efficient coordination of various departmental, grant, and designated accounts, while maintaining accurate information regarding the financial status of the cost center and advising the immediate supervisor regarding financial decisions.

• Evaluate budget proposals to determine the optimal allocation of project funds. Responsible for reviewing budget proposals and requests for funding, evaluating spending needs and conducting cost-benefit analyses, among other duties.

Substance Abuse Program Coordinator

Carl R. Darnall Army Medical Center Behavioral Health - Fort Bragg, NC

October 1998 to December 2001

• Educated and trained Soldiers about drugs and alcohol, and the potential impact/consequences of use and/or abuse to the Army and

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