MICHELE A. PEYERK DNP, RN

ad10rl@r.postjobfree.com 586-***-**** Surprise Arizona

www.linkedin.com/in/michelepeyerk

PROFESSIONAL SUMMARY

Transformational nurse leader promoting highly functional multi-disciplinary partnerships and clinical practice collaboration utilizing a unique blend of academic achievement with strong knowledge and clinical experiences. More than three decades of professional nursing practice within a dynamic and fluctuating healthcare environment demonstrates exemplary adaptive abilities. Working as a nurse and patient advocate in the acute health care industry, I strive to ensure the patient receives the highest level of safe, quality, cost-effective care and that the patient and family care experience exceeds expectations.

. EDUCATION

Doctor of Nursing Practice---University of Detroit Mercy

Master of Science in Nursing --- University of Phoenix

Bachelor of Science in Nursing --- Wayne State University

Associate Degree in Nursing --- St. Clair Community College

LICENSE/CERTIFICATIONS

Registered Nurse Michigan-470-***-****

Registered Nurse Arizona-290571

Case Manager Certification (CCM) # M-21743

Legal Nurse Consultant Certification (LNCC) #M-9793

CAREER SUMMARY

October 2014-November 2023 McLaren Health Care Macomb campus

Prospective Payment Coordinator (March 2021-Present)

Create/implement new workflow processes to support continuous improvement.

Assist with new program development, collaborating across disciplines and campuses.

Performs chart review to ensure compliance with regulatory and professional standards.

Collaborate proactively with medical directors to gather pertinent clinical data, resolve audit-related issues, and offer recommendations for business and process improvement activities.

Utilization Review & Case Management (April 2017-March 2021)

Utilized critical thinking to determine alternative courses of care.

Applied Inter-qual criteria to obtain authorization for care and maximize reimbursement.

Facilitated patient care and expedited plans for safe and effective discharge.

Quality Improvement Specialist: HMS VTE Project/PICC October 2014-April 2017)

Identified VTE safety concerns, trends & quality care, and maintained database integrity.

Assessed PICC data utilized; developed PICC program for the campus.

Functioned in a consultative capacity to physician/nurse manager leadership.

Created process initiatives to optimize patient safety/care-related activities.

2008-2017 Beaumont Health System-Corporate

Nurse Clinician-External Quality Measures: (May 2012-Oct 2014); cont. 10/2014–12/2017)

Identified safety concerns, trends & quality of care.

Functioned in a consultative capacity to physician/nurse manager leadership.

Created process initiatives to optimize patient safety/care-related activities.

RN Care Manager-Supervisor: (Jan 09-Sept 2009)

Supportive role for clinical resource management and discharge facilitation.

Collaborated daily with nurse managers and nursing staff.

Managed assignments for fifteen RN care managers and social workers

RN Care Manager-Orthopedics/Progressive Care/Pediatrics: (2008/Sept 2009-May/2012)

Utilized critical thinking to determine alternative courses of care.

Facilitated patient care and expedited plans for safe and effective discharge.

2006-2008 Sedgwick Claims Management Services

Clinical Supervisor-Chrysler LLC: (2006-2008)

Mentored nursing teams assigned throughout the country for catastrophic injuries.

Managed Worker’s Compensation and Medical Disability Substantiation units.

Implemented corporate-based process improvement activities to enhance performance.

Target Telephonic Case Manager: (Feb-April)

Utilized clinical expertise to facilitate inter-disciplinary team communication within seven states’ worker’s compensation/medical management programs.

2005–2006 Coordinated Care Solutions

Clinical Team Leader:

Identified clinical cases meeting catastrophic criteria for 52 Michigan hospitals.

Collaborated with performance leaders to identify and develop corporate processes to ensure quality and patient safety utilizing performance analytics.

Accountable for leading projects impacting Blue Cross Blue Shield of Michigan for contract authorizations.

2005-2006 Baker College

Adjunct faculty:

Facilitated Nursing, legal, and health sciences courses.

2004-2005 Plunkett & Cooney

Legal Nurse Consultant:

Analyzed and interpreted medical issues in legal cases.

Researched complex medical conditions and standards of care.

Summarized Medical Malpractice, Worker’s Compensation, and Product Liability cases.

2001-2004 Mount Clemens General Hospital

Case Manager:

Utilized critical thinking to determine alternative courses of care.

Facilitated care and expedited plans for safe and effective discharge.

2000-2001 SCCI Long Term Acute Care Hospital (LTACH) Hospital Detroit MI

Interim Director of Patient Care Services/Assistant Administrator:

Accountable for daily operations and overall hospital implementation of patient care policies and procedures. Maintained reporting relationships with all department managers.

Case Manager:

Facilitated team collaboration on setting the estimated length of stay based on clinical criteria and insurance authorization timeframes.

1994-1999 CRA/Concentra Managed Care, Bingham Farms, MI

Certified Senior Field Case Manager

Participated in care experiences for Worker’s Compensation and No-Fault Auto cases. Effectively performed comprehensive file reviews to provide case direction to customers.

1989-1994 St. Joseph Mercy Hospital, Mount Clemens, MI

Registered Nurse:

Provided bedside care to hospitalized patients in multiple specialty units including Telemetry, Step-down Unit, Intensive and Coronary Care Units, Neurology, and the Women’s Surgical Unit, and worked independently within a team environment within the Community Education Center.

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PUBLICATIONS

The Journal of Legal Nurse Consulting “Informed Consent”. Vol. 12, # 4, October 2001.

Additional Professional Education & Training

IHI Basic Certification in Quality and Safety February 2019

AQ ICD 10 CM Coding for PPS Coordinators September 2023

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