Contact Center Clinical
Resume:
Cynthia Russaw-Mitchell
404-***-**** *********@*********.***, *******.******-********@**.*** 4307 Talley Trail, Conyers, GA 30013
SUMMARY
Dedicated Clinical Contact Center Nurse Manager with over 25 years of diverse nursing experience and a proven track record of leadership spanning 14 years. Proficient in overseeing the operational and clinical aspects of healthcare delivery, I have consistently demonstrated a commitment to quality patient care, staff development, and operational excellence. Skilled in fostering collaborative relationships, I excel in leading multidisciplinary teams to achieve organizational goals and optimize patient outcomes. With a strong foundation in evidence-based practice, regulatory compliance, and process improvement, I am poised to contribute effectively to the continued success and growth of healthcare organizations dealing with our Veterans.
SKILLS
Clinical Contact Center Skills
Veteran Focused
Quality Improvement
Case Review
Budget Management
Task Delegation
Hiring and Terminations
Strong Clinical Judgment
Nursing Assignments
Multitasking and Organization
Policy Development
Electronic Charting Skills
Performance Improvement
Work Planning and Prioritization
Utilization Review
Workload Management
Patient Education and Advocacy
Patient Care
Staff Leadership
Clinical Supervision
Compliance Oversight
Department Management
EXPERIENCE
Clinical Contact Center Nurse Manager, Carl Vinson VA Medical Center, August 2022-Current
Dublin, GA VN-0610, N3, Step10, 40 hours per week
Supervisor: Melissa Johnson *******.*******@**.*** 478-***-**** ext. 73031
Provides strategic leadership and supervises 18 Registered Nurses and 15 Pharmacy Techs in the Dublin Clinical Contact Center (CCC).
Before implementing the new Clinical Contact Center Program, conducted a thorough needs assessment to understand the requirements and expectations of the new program. Identified key stakeholders, including staff, management, and end-users, to gather their input and ensure their needs are addressed.
Implemented the Clinical Contact Center when changed from the TAP program.
Developed and implemented nursing policies and procedures.
Develop a detailed plan for the Clinical Contact Center Program, outlining its objectives, scope, and timeline. Defined the roles and responsibilities of staff members involved in the program, including call center agents, supervisors, trainers, and IT support.
Train staff members on the new program, including its processes, procedures, and technologies. Provide comprehensive training sessions and materials to ensure that all staff members understand their roles and responsibilities within the Clinical Contact Center Program.
Developed new functional statements that align with the processes and objectives of the Clinical Contact Center Program. Functional statements clearly define the duties and responsibilities of staff members within the program, including call-handling procedures, escalation protocols, and quality assurance standards.
Developed comprehensive documentation and training materials for the Clinical Contact Center Program, including standard operating procedures (SOPs), training manuals, and job aids. Ensure that all staff members have access to these materials and receive ongoing support and training as needed.
Analyzes Clinical Contact Center program data, quality assurance findings, and operational data to identify trends and implement early interventions; develops follow-up plans in collaboration with stakeholders.
Guide staff on patient care, clinical practice, and professional development.
Advocates for evidence-based practices to enhance patient care and optimize healthcare delivery.
Prioritizes patient-family-centered care principles, placing patient well-being as the foremost priority.
Manages staff recruitment, interviewing, orientation of new Nurses or Pharmacy Tech, scheduling, performance evaluations, and engagement.
Actively participates in interprofessional committees related to Care Coordination.
Collaborates with the healthcare organization to align with veterans' healthcare goals.
Facilitates problem-solving within the assigned team and undertakes additional duties as delegated by the Primary Care Chief Nurse, including acting as the Primary Care Chief Nurse.
Educates internal and external stakeholders about CCC services and care.
Engages in collaborative efforts with colleagues and serves on Medical Center-wide committees; initiates Performance Improvement (PI) projects.
Monitor quality assurance activities for compliance with standards of care.
Collaborating with other departments' leadership to drive process improvement initiatives for the Dublin Clinical Contact Center will be beneficial.
Prepares budgeting process by forecasting staffing needs and supplies.
Coordinate interdisciplinary team meetings to review patient progress and plan care strategies.
Manages nurse triage services for symptom evaluation, disposition of healthcare concerns, virtual clinical visits, pharmacy services, and appointment scheduling for patients across the medical center.
Promotes a positive work environment through effective communication with staff members.
Provides ongoing education opportunities for staff regarding changes in policies and procedures.
Utilize computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system i.e., Erlang C Calculator, Knowledge Management, CRM/TRM+ etc.
Trained other nurses on patient care and daily tasks, supporting growth and professional development.
Ensure compliance with regulatory requirements such as HIPAA and OSHA.
Manage the scheduling of personnel assignments based on patient acuity levels.
RN Case Manager, Carl Vinson VA Medical Center, August 2021-August 2022
Dublin, GA VN-0610, N3, Step 8, 40 hours per week
Supervisor: Miszpah Lawhorn *******.*******@**.*** 478-***-**** x73633
Coordinated appropriate levels of care (basic, emergency, in-patient, contract nursing home, dialysis, home oxygen needs, and home health) for veterans in community facilities.
Collaborated with interdisciplinary teams involved in veteran care.
Assessed veterans' eligibility for various VA programs.
Facilitated and supported veterans in transitioning to their next level of care.
Participated in interprofessional committees focused on Care Coordination.
Worked with healthcare organizations to achieve veterans' healthcare objectives.
Provided education to patients, families, and healthcare professionals regarding Care in the Community.
Collaborated with VA and non-VA healthcare organizations to optimize veterans' care.
Analyzed Care in the Community data to identify trends and needs.
Engaged in problem-solving with the assigned team and undertake additional duties as assigned by Care Coordination leadership.
Collaborated with the Transfer Coordinator of VISN 7, managing transfers within and outside of the state.
Reviewed and processed emergency notifications related to veteran care.
Addressed Care Coordination questions via phone triage.
Handled vendor calls on Care Coordination's cell phone.
Served as a liaison between care coordination stakeholders and the National VA Community Care (NVCC).
Coordinated care with veterans' Patient Aligned Care Teams (PACT) for community hospital care requests.
Collaborated and coordinated care for veterans requiring spinal cord injury, palliative, and hospice care.
Participated in bi-weekly nursing home placement case reviews.
Educated internal and external stakeholders about Care in the Community and care coordination.
Troubleshooted Care in the Community issues as they arise.
Attended weekly and monthly internal and external collaboration meetings.
RN, Mammogram Coordinator, Atlanta Healthcare Systems, August 2019-August 2020
Atlanta, GA VN-0610, N3, Step 8, 40 hours per week
Supervisor: Jamya Pittman, *****.*******@**.*** 404-***-****
Reviewed all normal and abnormal mammograms conducted at the Medical Center.
Coordinated scheduling of care until completion, working closely with the Breast Health Nurse Navigator both internally and externally.
Ensured that all care provided adheres to VHA directives.
Educated providers, mid-level providers, and other staff members on VHA guidelines.
Communicated with veterans to provide education regarding Breast Health and promote compliance with breast care recommendations.
Collected data and analyzed trends related to abnormal mammograms, sharing findings with leadership.
Collaborated with Care in the Community, providers, Care Managers, schedulers, and non-VA providers to ensure seamless coordination of care for patients.
Developed and implemented nursing policies and procedures.
RN, Process Improvement Coordinator, Atlanta Healthcare Systems, August 2018-August 2019
Atlanta, GA VN-0610, N3, Step 7, 40 hours per week
Supervisor: Ilene Davis RN, Chief of Mental Health Nursing ***********@***.*** 815-***-****
Lead the Process Improvement (PI) initiatives for the Mental Health Service Line and Patient Care Services at the Atlanta VAMC.
Participated, facilitated, and tracked continuous survey readiness for accrediting bodies such as the Joint Commission, CARF, OIG, and other regulatory agencies.
Developed, reviewed, and updated policies and procedures related to quality improvement and patient care.
Served on various Process Improvement Committees within the Medical Center, providing expertise and guidance on quality improvement initiatives.
Conducted regular data reviews and educated staff about the Strategic Analytics for Improvement and Learning (SAIL) metrics annually and quarterly, ensuring understanding and alignment with organizational goals.
Served as a resource for staff regarding Process Improvement projects, offering guidance, support, and assistance as needed.
Provided education and training to staff on data collection methods and tools to ensure accuracy and consistency in data reporting.
Collaborated with interdisciplinary teams to identify areas for improvement and implement evidence-based practices to enhance patient care and safety.
Lead and coordinate process improvement projects, from inception to completion, ensuring timely execution and achievement of desired outcomes.
Analyze trends and patterns in data to identify opportunities for quality improvement and develop strategies to address areas of concern.
Collaborate with leadership and stakeholders to develop and implement action plans to address identified gaps and enhance organizational performance.
Monitored and evaluated the effectiveness of implemented interventions and initiatives, making adjustments as necessary to optimize outcomes.
Maintained documentation and records related to process improvement activities, ensuring compliance with regulatory requirements and standards.
Participated in ongoing professional development activities to stay abreast of best practices and emerging trends in process improvement and quality management.
Perioperative Nurse Manager, Carl Vinson VAMC, August 2017-August 2019
Dublin, GA VN-0610, N3, Step 6, 40 hours per week
Supervisor: Debra Mann *****.****@**.***
Coordinated the care of perioperative veterans, ensuring efficient and effective delivery of surgical services.
Supervised Registered Nurses, Surgical Techs, and Clerical staff, providing guidance, support, and direction to ensure high-quality patient care.
Developed and implemented education programs to enhance staff competencies and promote professional development within the perioperative department.
Facilitated unit-based Strategic Analytics for Improvement and Learning (SAIL) data presentations to the VISN 7 Office, highlighting performance metrics and outcomes.
Implemented and adhered to Joint Commission Standards and led Process Improvement (PI) projects to enhance perioperative care delivery and patient safety.
Assisted with various VA-wide projects and reviews, collaborating with interdisciplinary teams and stakeholders to achieve organizational goals and objectives.
Conducted annual staff reviews, providing constructive feedback, recognition, and performance evaluations to promote accountability and professional growth.
Identified opportunities for staff growth and development, facilitating training programs and mentorship opportunities within the perioperative department and throughout the Medical Center.
Served as a mentor to various staff members, offering guidance, support, and expertise to foster professional growth and career advancement.
Managed the hiring process for perioperative staff, including recruitment, selection, and orientation of new team members.
Provided coverage and support to other Patient Care Units when fellow Nurse Managers were out of the office, ensuring continuity of care and operational efficiency.
Nurse Manager Acute Care Medical Surgical Nursing
Coordinated the care of Medical-Surgical veterans, ensuring comprehensive and efficient delivery of acute care services.
Evaluated the learning needs of staff at various levels and facilitated educational initiatives to promote professional growth and development.
Conducted performance appraisals of all staff members, providing constructive feedback and recognition of achievements.
Provided supplemental coverage as the nursing supervisor during off-tours to ensure continuous and effective nursing leadership.
Served on various hospital committees to contribute to organizational initiatives and decision-making processes.
Ensured that all veterans receive interdisciplinary consultations to expedite discharge planning and optimize patient outcomes.
Provided cross-coverage for other areas such as Urgent Care and assumed the role of the Associate Chief Nurse of Acute Care units in her absence, ensuring continuity of care and operational efficiency.
Lead fact-finding efforts for the Medical Center and facilitate the organization and opening of the Infusion Center.
Collaborated with other VA facilities in VISN 7 to gather information and SAIL data to support the development of infusion encounters and nursing templates.
Lead workgroups to address Joint Commission standards and various survey responses, ensuring compliance and adherence to regulatory requirements.
Taught, mentored, led, and engaged staff at the unit level regarding their impact on SAIL data and organizational goals.
Assumed additional responsibilities and duties as assigned, demonstrating flexibility and adaptability in meeting the needs of the department and organization.
MACPAC-Utilization Nurse Reviewer, Inpatient Third Party Insurance, Atlanta Healthcare Systems, August 2005-August 2014, Atlanta, GA, VN-0610, N3, Step 4, 40 hours per week
Supervisor: Michelle Thomas, Retired 803-***-****
Applied concepts from VA, JCAHO, HICFA, and other regulatory bodies to medical records and utilization review activities, actively educating individuals and groups to enhance utilization outcomes.
Utilized various medical criteria routinely to determine the appropriate level of care for continued stay hospitalization, ensuring optimal patient outcomes and resource utilization.
Exercised sound clinical judgment to conduct third-party insurance reviews (both inpatient and outpatient), maximizing payer reimbursement and minimizing denials.
Proactively prevented third-party payor denials by performing physician peer-to-peer reviews as necessary, fostering effective communication and collaboration among healthcare stakeholders.
Collaborated closely with the Discharge Planner at the Medical Center, analyzing, interpreting, and trending utilization findings to recommend corrective actions and policy changes.
Served on various Local and National Committees, contributing expertise and insights to enhance utilization review processes and outcomes.
Provided comprehensive training to a detailed nurse assigned to MACPAC, ensuring proficiency in utilization review practices and standards.
Collaborated with Regional Counsel on complex cases, resulting in significant revenue generation of $100,000.00 for the Medical Center.
Provided coverage for outpatient utilization review, conducting Fee Reviews, Service Connection (SC) Reviews, and utilizing Quadra Med software to streamline processes and enhance efficiency.
Implemented established methods to identify potential healthcare organization risks and take measures to mitigate risks in Utilization Management, such as ensuring safe patient discharge and appropriate admission levels of care.
Utilization Nurse Reviewer, Inpatient Third-Party Insurance
Supervisor: Rhonda Wise, Chief of Privacy ******.****@**.*** 404-***-****
Applied concepts from VA, JCAHO, HICFA, and other regulatory bodies to Medical Records and other utilization review activities and actively educated individuals and groups to improve utilization outcomes.
Forwarded any actual or potential Quality Management concerns to the QM department for further review.
Routinely utilized InterQual criteria to appropriately determine the level of care for continued stay hospitalization.
Responsible for utilizing sound clinical judgment to conduct third-party insurance reviews thus maximizing payer reimbursement.
Involved in the prevention of third-party payor denials by being proactive and performing physician peer-to-peer reviews as needed.
Collaborated with the Discharge Planner- Analyzes, interprets, and trends utilization findings and recommends corrective actions and changes in Medical Center policy, procedure, and/or program.
Provided coverage for Pre-admission screening, Fee-based services, and outpatient utilization. Dailey updates the Chief of Utilization Management of any utilization concerns related to third-party reimbursement.
Worked with the Fee Department to appropriately recoup third-party -reimbursement based on the Fee guidelines. Established a real-time process with notification of Fee cases for review.
Ongoing assessment of areas of risk during chart reviews
Day Nurse Administrator, Inpatient Psychiatric Fac, Georgia Regional State Psychiatric Hospital, February 2006-February 2014, VN-0610, N3, Step 3, 40 hours per week
Decatur, GA
Provide clinical oversight and leadership during day shifts in the inpatient psychiatric facility, ensuring the delivery of high-quality patient care in accordance with established standards and protocols.
Infection Control Nurse, Piedmont Hospital Atlanta, February 2002-February 2003
Atlanta, GA
Reviewed and updated infection control policies and procedures to ensure compliance with current standards.
Quality Manager/Risk Management RN, Jackson Hospital and Clinic, February 1995-February 2002
Montgomery, AL
Develop, implement, and oversee quality improvement programs and initiatives to enhance patient safety, optimize clinical outcomes, and promote regulatory compliance within the healthcare organization.
Quality Coordinator/ Utilization Coordinator 1999 - 2000
Develop, implement, and monitor quality improvement initiatives and programs to enhance patient care outcomes, optimize resource utilization, and ensure compliance with regulatory standards and best practices.
Adjunct Clinical Instructor, Auburn University At Montgomery, January 1995-January 2002
Montgomery, AL
Associate Professor of Nursing, Tuskegee University r, January 1996-July 1999
Tuskegee, AL
EDUCATION AND TRAINING
Ph.D.
Nursing Leadership, Chamberlain University, Downers Grove IL 2022
Master of Science
Adult Health Nursing And Education, Troy State University, Montgomery, AL 1996
Bachelor of Science
Nursing, Troy State University, Montgomery, AL 1993
Associate of Science
Nursing, Southern Union State Community College, Wadley AL 1987
Diploma
Licensed Practical Nursing, Southern Union State Community College, Wadley AL 1984
CERTIFICATIONS AND LICENSE
GEORGIA RN158317 Multistate expires 01/31/2025
ACCOMPLISHMENTS
Honor Student in the MSN Program and DNP Distinction
Member of Sigma Theta Tau Honor Society
Member of AAACN - American Academy of Ambulatory Care Nursing
American Nurses Association
REFERENCES
Leslie Wiggins, retired Medical Center Director, ********@*****.***
Miszpah Lawhorn *******.*******@**.*** 478-***-**** x73633
Shekema Bivings, NP, *******.*******@**.*** 478-***-****
Melissa Johnson, Chief Nurse Manager, PC, *******.*******@**.*** 478-***-**** ext. 73031
Rhonda Wise, Privacy Government Information Specialist, ******.****@**.*** 678-***-****
Frank Jordan, Public Relations, *****.******@**.*** 478-***-****
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