Kyla Touchstone RN, BSN

** * *** * **., Lockhart, TX. 78644

ad3r6t@r.postjobfree.com

512-***-****

Experience:

*/**-*******: Cigna Medicare D-SNP

Transition of Care Case Manager Senior Analyst

●Telephonic outreach to all assigned members for transition of care to home

●Review medication list with the member

●Assess if the member needs home health or hospice services and assist to obtain referral if needed

●Provide disease education as needed

●Develop a plan of care with the member and follow up within 90 or 180 days

●Attend team rounds weekly for high utilizers

●Complete annual training as required

●Communicate with the PCP or specialists to assist the member as needed

●Complete the HRA or post discharge assessments as required

9/21-1/22: Grifols Plasma Center

Medical Staff

●Perform all pre-donation assessments

●Monitor the donation floor for reactions and respond accordingly

●Record all donation reactions per policy and notify facility MD

●Review lab results and communicate with the donor any required delays in donation

●Communicate out of range lab results with facility MD

●Assist donor floor staff with all floor management, to include, set ups, cleaning and disconnects

5/21-9/21: Plum Creek Recovery Ranch

Director of Nursing

●Scheduling 24 hour staff

●Provide CPR recertification for all staff

●Medication administration training for recovery report specialists

●Establish infection control P&P

●Perform admission assessments and consult on call providers for orders

●Attend daily rounds team meeting

●Facilitate groups as scheduled

●Administer medications per orders

●Insure the nursing department staff is knowledgeable of safety procedures for emergencies

●Review potential admissions for appropriateness for the facilities treatment capabilities

4/2020-5/2021: AETNA/CVS

Care Manager D-SNP Medicare Plan

●Telephonic outreach for all assigned members.

●Educate members on plan benefits.

●Assist members to navigate the healthcare system as indicated.

●Refer members to social work and or behavioral health as indicated.

●Assign members a risk stratification of high, medium or low based upon assessment with the members.

●Provide medication and disease management education to assist members in meeting their self stated health goals.

●Participate and present members in the interdisciplinary care team twice a month.

●Complete health risk assessments as required.

●Develop individual care plans for members based upon assessments and member goals.

05/2019-12/2019: Ascension Seton Rural Health Clinic

Clinic RN

●Monitor process for POCT

●Assist with family practice, same day and pediatric clinics as needed.

●Communicate with all providers for any concerns or needs.

●Assist with Vaccines for Children program.

●Educational resource for LVN’s and Medical Assistants.

●Consult and coordinate with the clinic manager to ensure all regulatory requirements are met and current.

●Manage the nursing schedule and float nurses, when needed, to areas that are short staffed or in need of additional assistance.

●Order supplies for clinic needs.

●Reconcile medication stock for expiration dates.

●Reconcile clinic supplies for expiration dates.

●Ensure all nurses and medical assistants are properly trained in the procedures they are expected to perform as part of clinic operations.

01/2015-01/2019: UnitedHealth Group

Nursing Facility Service Coordinator: Community and State

Next Site of Care Case Manager: Wellmed

●Next Site of Care Case Manager with Wellmed, complete NSOC and TDA assessments.

●Utilize Milliman guidelines for prior authorizations for skilled nursing stays.

●Monitor length of stays in SNF, and facilitate safe discharge plans.

●Nursing Facility Service Coordinator.

●Primary contact for Medicaid members in assigned nursing facilities

●Monitor current RUG rates every quarter.

●Make referrals to Money Follows the Person for members wishing to return to the community.

●Assist the nursing facility with any Medicaid issues.

●Review medications of assigned members quarterly.

●Develop and review member care plans quarterly and as needed for hospital stays and changes in condition.

●Issue NOMNC forms to members in skilled care as indicated.

●Participate in rounds with Wellmed providers for discharge plans and continuity of care.

●Coordinate with assigned social workers for any DME, home health or hospice needs upon discharge.

04/2014-02/2015: ST. Davids Medical Center

Case Manager

●Discharge planning for neurology and orthopedic patients.

●Make referrals to skilled nursing, long term acute care and in-patient rehabilitation as indicated.

●Issue Notice of Medicare Non Coverage as indicated.

●Monitor level of care i.e. observation, outpatient, inpatient and correct if needed, for proper billing.

●Complete PASRR for skilled nursing admissions.

●Refer to home health or hospice as indicated.

●Utilize InterQual criteria for level of care.

●Communicate with insurance case managers for coordination of care.

●Provide the patient with discharge planning options for a safe discharge.

Education:

Wichita State University

Wichita, Kansas

B.S. Nursing

Graduate 1982

Brooks Air Force Base

San Antonio, TX

School of Aeronautical Medicine, Flight Nurse Training Program

Graduate 1991

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