Kimberly Smith, MS, BSN, RN, CCM

Home 732-***-**** Mobile 347-***-**** ad1rw5@r.postjobfree.com

Knowledgeable Service-Oriented Registered Nurse

Professional caregiver and patient advocate skilled in critical thinking, customer service, collaboration, communication, and culturally competent evidence-based care. Attentive to detail, able to take initiative, prioritize multiple tasks and manage workload. Exceptional time management, problem solving, and analytical abilities. Self-directed, flexible and adaptable to quickly changing priorities.

SKILL HIGHLIGHTS

Patient Assessment ● Medical Documentation ● Strong Written and Oral Communication ● Prioritization Skills ● Quality and Continuity of Care ● Parent/Patient/Family Education ● Gathering Clinical Data ● Highly Organized ● Self-motivated ● Team Player

EDUCATION/CERTIFICATIONS

Master of Science, Business Management and Leadership 5/2021 CUNY School of Professional Studies, New York, NY G.P.A 3.9/4.0

Bachelor of Science, Nursing 5/2014 New York University, New York, NY G.P.A. 3.2/4.0

Bachelor of Science, Health Care Administration 9/2010 California Coast University, Santa Ana, CA G.P.A. 3.5/4.0

Compact/Multi-State Registered Nurse 2022 – Present New York State Registered Nurse 2015 – Present

Certified Case Manager (CCM) 12/22 - Present

Certified, BLS for Healthcare Provider (CPR & AED) 8/22 – 8/24

PROFESSIONAL AFFILIATIONS

The National Society of Leadership and Success 2021 - Present

The North Carolina Association for Healthcare Quality 2022 – Present

TEACHING EXPERIENCE

Responsible for training all newly hired BSN and MSN level nurses who join the department (In-person and virtually).

Lead team meetings in-person and via Teams/Zoom for Population Health/ACO department.

Provide monthly in-service trainings for physician office managers and clinical staff.

Present quality reports to upper leadership in quarterly ACO General meeting.

Created reference guides/cheat sheets for front desk, clinical staff, provider and manager trainings.

Created an Athena user-friendly manual for each user, which was distributed throughout the Network:

oFront desk

oClinical staff

oProvider and manager

PROFESSIONAL EXPERIENCE

Richmond University Medical Center, Staten Island, NY 12/2022 – Present Population Health Manager, ACO/Population Health Department

Oversee programs that aim to improve clinical health outcomes for all patients.

Monitor the goals and objectives of Population Health initiatives while maintaining alignment with strategic goals and objectives for Richmond Health Network.

Maintain the Population Health roadmap which encompasses the Population Health Care Model, Accountable Care Organization, and RHN plans.

Manage quality programs and initiatives to improve health outcomes related to process improvement measures.

In coordination with the Director of Population Health and Informatics, develops, implements, and maintains a standardized quality management work plan and program description to ensure compliance with internal and external requirements.

Spearhead annual GPRO CMS Data collection in partnership with the Director, providers and appropriate vendors.

Obtain, review and utilize population health data, risk and cost analysis to affect positive change in ACO and contract payer beneficiary outcomes. Communicates gaps in quality metrics to providers and their office staff on a monthly basis.

Develop and implement robust provider engagement strategies to meet the goals of Population Health/ACO, such as Annual Wellness Visits, Quality Management data collection, and other pilot programs.

Devise and implement corrective action plans for non-compliant Population Health practices.

Utilizes population health tools and databases, electronic patient registries, and other reports as available to collaborate with providers and quality facilitators to identify, manage, and address care and utilization opportunities with high-risk patients, ACO and chronic disease registries.

Closely monitor all quality, costs and utilization data from CMS and contract payer programs.

Assist the Director of Population Health in screening and interviewing process of new candidates for the department.

Responsible for HEDIS/QARR annual submission/reporting.

Monitors productivity of reporting staff and establish productivity minimum expectations for each role. Provides regular feedback and support to staff in meeting performance expectations.

Applies clinical knowledge and skills to manage and oversee day-to-day operations of the population health team in support of improving performance metrics of organizational goals.

Richmond University Medical Center, Staten Island, NY 11/2018 – 12/2022 RN ACO Coordinator, ACO Department

Managed patient care in the health care continuum to achieve optimum outcomes in a safe and cost-effective manner.

Promoted patient self-management and empowered patients/families to achieve maximum levels of wellness and independence.

Provided follow-up contact with patients to ensure compliance with recommendations, medications, lab/x-ray, specialist visits, PCP visits, dieticians, etc.

Assessed patients for psychiatric/behavioral health issues.

Managed psychiatric inpatient admissions in collaboration with behavioral health and nursing case management.

Monitored emergency room utilization of behavioral health patients.

Performed both internal and external assessments for Medicare and promoted quality objectives through ongoing audits and GPRO reporting.

Partially managed annual GPRO CMS Data collection in partnership with the Director, providers and appropriate vendors.

Functioned as the liaison to the ACO community including physicians and office staff.

Partnered with other areas of the hospital system & community agencies to provide solutions for specific patient populations.

Functioned as the SNF liaison between the medical center and 5 nursing homes within the community. Meeting on a monthly basis individually to discuss the status, progress and discharge plan of the ACO patients within their facilities.

Interim manager of Population Health Department since September 2019 – Daily operational oversight for 2 full-time RN’s, 2 Per-Diem RN’s, 2 Social Workers, 1 MA, and 1 Clinical Systems Analyst.

Administered Covid vaccines to staff and patients on rotation.

Key Contributions & Achievements

Developed workflows (CHF TCM, Diabetes TCM, and Transitions of Care) to ensure smooth transition of care management to primary care for patients treated in a facility (hospital or SNF).

Created and implemented the “Home Is” Initiative throughout the medical center. This initiative decreased SNF admissions by 32% and 30-day readmissions by 25% and increased the in-house homecare referrals by 37%. The initiative reduced overall ACO costs and positively affected our benchmark.

Contributed to a shared savings of over $6M for reporting years 2019 and 2020 in conjunction with a continuous improved quality score.

Summit Health Management, New Providence, NJ 1/2017 – 10/2018 RN Care Manager, Population Health/ACO (Worked Remotely 2 days/3 days in Office)

Participated in a dynamic interdisciplinary team to provide case management services to identified complex, high-risk patients across the care continuum.

Partnered with patients and families by engaging them in the accountability of care to improve patient experience.

Utilized professional judgment and critical thinking to assist patient and families in overcoming barriers to achieving their health goals.

Provided telephonic patient support and acted as a resource for referrals; a data collector and a nurse educator to patients, caregivers and healthcare professionals.

Maintained all case documents in files via excel, electronic medical records and electronic folders to ensure a comprehensive and detailed source of information for all parties involved in the case.

Participated in case conferences for 30-Day readmissions and provided collaborative assistance.

Participated in panel interviewing for new hiring of Care Managers.

Assisted with special projects in the Population Health department as needed. Performed clinical chart reviews via high-quality clinical screening, data compilation, documentation and entry into the Medicare quality reporting system; the Physician Quality Reporting System (PQRS) database.

Assessed patients for psychiatric/behavioral health issues.

Key Contributions & Achievements

Achieved goals of lowering costs by 16% for the assigned providers and improving clinical outcomes by serving as an integral primary care team member, managing assigned populations of patients, and coordinating care for patients identified with potential avoidable utilization, gaps in care, and/or at-risk status.

JFK Medical Center, Edison, NJ 6/2015 – 11/2016 (F/T)

Registered Nurse, Med-Surg Colorectal/Bariatric Unit 11/2016 – 3/2017 (P/D)

Managed the care of up to nine patients per shift on a 49-bed med-surg unit.

Assessed patients’ clinical needs based on reason for inpatient stay.

Advocated for patients/family members to ensure proper services were being rendered.

Communicated frequently with patients and their families.

Ability to function well in stressful situations and to prioritize and delegate work.

Monitored patients on remote telemetry.

Documented nursing procedures accurately, maintained medical records and patient status.

Interacted and communicated with multidisciplinary teams to develop effective care plans for patients.

Clinical duties included: Maintain IV access, blood transfusions, medication administration, IV therapy and drips, computerized charting, admissions, discharges and patient teaching, maintain feedings via NG and PEG tubes, insertion of NG tubes, care of acute GI bleeds, colostomy care, Foley insertions and post-op care.

Charge nurse rotation 1-2 shifts per week.

Regency Heritage Nurs & Rehab Center, Somerset, NJ 3/2015 – 10/2015 (P/D) Registered Nurse, Long Term & Sub-acute Unit

Educated patients and family members regarding disease processes and encouraged participation in the disease management efforts.

Provided clinical care for 21-36 patients including sub-acute, hospice, and long-term care geriatric patients.

Clinical duties included: Pain management, assessments, medication pass, treatments, admissions, discharges, IV therapy, trach care, colostomy care, TPN; GT/PEG feedings, wound care, wound vacs, dressing changes, oxygen therapy, nebulizers, staple removal and accurate documentation.

NYU Langone Medical Center, New York, NY 4/2002 – 9/2012 Revenue Cycle/Charge Capture Secretary

Professional working knowledge of procedures applicable to hospital and physician settings.

Met fast-paced deadlines to ensure timely processing of third party billing for Revenue Cycle Department.

Provided secondary review of charging and documentation for all operating room procedures (33 O.R.’s with an average of 90 cases per day).

Verified, posted, reviewed and processed all patient billing/operating room charges (including Anesthesia/OR Time).

Key member of Revenue Cycle and Patient Financial Services team tasked with billing review, reconciliation and discrepancy corrections.

Effectively orchestrated a full range of strategic administrative functions.

Key Contributions & Achievements

Member of the interdisciplinary team responsible for the 85% reduction of late and suspended charges coming from the operating room.

Instituted and continuously facilitated a communications protocol with the clinical staff in all areas to ensure the timely correction and submission of records to meet the 24-hour metric required for hospital reimbursement.

Collaborated with staff in a multitude of departments to develop means of enhancing patient care and services.

Coordinated the collection of data for reporting purposes, in collaboration with the Revenue Cycle Regulatory Manager.

COMPUTER PROFICIENCIES

Adobe Acrobat; Athena; Charge Capture; Chart Capture; DocuCare Software; eClinicalWorks; Epic Hyperspace; Fuze; Horizon Clinical; HSM; Internet/All Internet Search Engines; Meditech; MS Office: Word, Excel, PowerPoint, Access, Teams, Orbit Software; Outlook; PeopleSoft; PMM (Purchasing Software); Quanum 360 (Care 360); Skype for Business.

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