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Patient Care Operations Management

Location:
Summerville, SC, 29485
Posted:
October 10, 2023

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Resume:

Melissa Barnes

Summerville, SC 843-***-**** ad0ag3@r.postjobfree.com

Hardworking and reliable Licensed Practical Nurse with 15+ years of clinical operations management and patient care expertise. Analytical and detail-oriented with a rich history of providing quality patient care by reviewing vital signs, analyzing EHR data, documenting changes in patient condition to improve patient health and wellness. Committed to producing impactful clinical results by building collaborative partnerships with diverse medical teams in fast-paced environments.

Professional Experience

HealthSnap Miami, FL

Care Navigator - Chronic Care Management August 2020 - Present

●Provide compassionate care by proactively managing a caseload of 227 patients to achieve positive health results

●Conduct monthly virtual consultations and assessments with patients by focusing on patient education

for lifestyle and behavior in relation to medical diagnosis and prevention of chronic disease progression

●Exceed expectations by managing competing priorities to successfully complete 95% of caseload monthly

●Review and respond to remotely transmitted patient data, including blood pressure, blood sugar, weight, and oxygen saturation to document in Epic EMR

●Strengthen operations by communicating with primary care physician regarding critical readings and further orders

●Optimize patient care by assisting patients with medication refills and scheduling appointments

●Enhance communications by utilizing multiple platforms, including Slack, Salesforce, and HS portal

Emblem Hospice Chandler, AZ

Clinical Operations Manager August 2013 - June 2023

●Managed operations by verifying benefits and eligibility, obtaining prior authorizations, following up on pending authorizations and PCP referrals, and reviewing client records for accuracy

●Exercised keen attention to detail by coordinating, scheduling, and tracking monthly F2F visits, re certifications, and admissions

●Ensured accuracy of time-sensitive documentation by meticulously reviewing patient charts to identify errors and maintain Medicare and Medicaid compliance

South Carolina Department of Health & Environmental Control Charleston, SC

COVID Case Investigator January 2020 - March 2022

●Coordinated with a 40 member COVID team to mitigate the spread of COVID through case investigations and contact tracing

●Reduced the spread of disease by collecting information to gain a greater understanding of the virus

●Delivered world-class patient care by managing 40+ phone calls daily to provide guidance and education to patients and facilities

Cigna CJ Harris Tempe, AZ

Urology Nurse September 2012 - May 2013

●Improved patient care by triaging patients, assessing and documenting findings, drawing labs, and testing urine with high levels of accuracy

●Assisted 25+ patients a day by renewing prescriptions, administered Chemo monitoring diagnostic results, and scheduling appointments, consults, and surgeries to provide continuation of care

●Supported urologists by assisting with Cystoscopies, bladder and prostate biopsies, vasectomies, and penile injections

Hospice of the Valley Gilbert, AZ

Inpatient Unit/Field Nurse March 2010 - July 2012

●Provided individualized care by identifying physical, social, and spiritual needs to achieve desired outcomes

●Ensured smooth transitions by admitting clients to hospice services from home, hospital, and skilled nursing facilities in collaboration with discharge planners and case managers

●Embraced challenges by managing symptoms and anticipating patient needs to improve comfort

Laser Spine Institute Scottsdale, AZ

Patient Care Coordinator March 2009 - March 2010

●Coordinated patient care by educating clients on medical conditions, treatments, medications, and procedures

●Communicated across multiple departments to negotiate and expedite scheduling and completion of tests, procedures, and MRI consults

●Evaluated outcomes of care with an interdisciplinary team by measuring intervention effectiveness to identify areas of improvement

Additional Experience

Banner Nurse Travel Division Travel Nurse/Float

Core Competencies

Patient Care, Communication, Problem-Solving, Time Management, Critical Thinking, Decision-Making,

Medical Terminology, Scheduling, Clinical Operations Management, Case Management, Care Coordination Technical Skills

Zoom, Microsoft Office Suite, Excel, Outlook, Google Workspace, Sheets, Slides, Slack, Salesforce, Epic, PointClickCare, HCHB, Cerner etc.

Education & Certifications

Diploma in Licensed Practical Nursing, Horry-Georgetown Technical College

Basic Cardiac Life Support, American Heart Association

Professional Development

Nursing Informatics & the Future of the Healthcare Workforce Aromatherapy in Hospice Palliative Wound Care



Contact this candidate