Home Health Registered Nurse
Resume:
Emily Branham
Registered Nurse
Clinchco, VA **226
**********@*****.***
Dependable RN for 20 years working in Case Management, Home Health, Recertification/Audit Nurse, and hospice. I have not only worked in the home health and hospice. I have also been a Director of Operations and Clinical Manager/Branch Manager with included PI and many Audits. Team Player, caring, honest, and trustworthy and always will learn new things. Strong Knowledge of community based care and methods of delivery. Knowledge of CMS guidelines with Medicare and Medicaid regarding various aspects of care. Excellent understanding of Case Management of treating the patient as a whole, ensuring the member is utilizing resources available, and doing in the most cost effective way possible. 2 years working as LTSS Service Coordinator under the EDCD waiver Proficiency in using computers and computer software. Microsoft Word, Excel Spreadsheets, Outlook and various nursing computer programs
Work Experience
Patient Care Manager
LHC Group - Richlands, VA
August 2018 to Present
Performed assessments, Admission, Recertification and Post Hospitalizations. Wound care, administer IV medications, called MD when issues or concerns arise with patients. Provided nursing care to patients in their homes. On Call evenings and weekends- every other week.
SNP RN Case Manager HUMANA at Home
Total Med Staffing contract - Remote
July 2019 to Present
Case manager for Special Need Program. Remediation Team and Contingent Team. Call members- UHRA, update Medication profiles, vaccinations and allergies records. Review HEDIS Information during the assessment. Formulate care plans based on member’s needs. Correlate with interdisciplinary care team regarding anything members may need such as: behavioral health, pharmacy, clinical health educator, medical director ETC. Review members benefits and send any resource information or added benefits to members home. Teach on disease process, signs and symptoms to monitor for, safety, to contact for the member in order to be help the member overall health. Overall goal is for member to have better quality of life and better outcomes of care. Provide excellent care in the most cost effective manner
LTSS Coordinator
Anthem - Richmond, VA
August 2017 to March 2019
Case managed individuals with chronic illnesses, co-morbidities, Case Management all aspects of care under Medicaid guidelines, performed HRA in the homes and in the Nursing homes. Medication lists and reconciliation with each visit, Vaccines, and Allergies, Pharmacy and PCP. Ensured members were receiving proper care in Skilled Nursing Facilities- reviewed medical records in nursing facilities. I also oversaw members who were under the EDCD waiver and ensured they were receiving proper care. Under EDCD waiver as a LTSS Coordinator I ensured that the Personal Care agencies requested hours were not excessive and reported the agency if they were. Monitored for any signs of fraud and reported concerns to supervisors/fraud and abuse team for investigation. Found resources for members who were in need. Presented members cases to medical directors in rounds when needed to be an advocate for my members. Ensured Pre-authorizations were in place for meds, DME, procedures, MD appointments, ETC, Reviewed all hospitalizations and ER medical records with each visit that was made in hopes to of finding alternative ways to prevent re-hospitalizations or avoidable ER visits. Made follow- up calls and follow- up visits after a member had been hospitalized. My assessments also helped to coordinate and manage member care with our ICT regarding any of the members needs
RN Case Manager
Amedysis Home Health Kingsport TN - Kingsport, TN
June 2016 to July 2017
Performed assessments, Admission, Recertification and Post Hospitalizations.
Wound care, called MD when issues or concerns arise with members. Provided nursing care to patients in their homes.
Admissions Nurse
Suncrest Home Health Kingsport TN - Kingsport, TN
May 2015 to June 2016
Performed all admissions and any care needed during admission.
Called high risk members twice a week in efforts to prevent re-hospitalizations
Oversaw all aspects of the patients care to help ensure patient received the best care and was done in the most cost effective way
RN Field Nurse
Dickenson County Home Health - Clintwood, VA
June 2014 to April 2015
Performed assessments, Admission, Recertification, and Post Hospitalizations. Wound care, called MD when issues or concerns arise with members. Provided nursing care to patients in their homes. Until they were going out of business
Clinical Supervisor of home health and hospice
Total Home Care and Hospice Clintwood VA - Clintwood, VA
June 2009 to March 2014
I supervised all nurses and HHA who were caring for home health and hospice patients. Performed all PI, InterQual, audits, and infection control data. Reviewed all charts for accuracy. Assessed patients when needed and ensured proper care was being provided to patients. Audited charts for billing. Called MD and patients when needed. Reviewed all oasis, Coded DX for oasis, reviewed all nursing notes and orders to ensure accuracy. Oversaw the care of all the patients at this location. The hardest thing I have done in my career was report one of the best nurses I have ever worked with in my nursing career to the state board of nursing due a narcotic issue in a patient’s home. It still bothers me to this day. Not that I turned her in, but that an excellent nurse was lost and a hospice patient suffered. Had I not went to do visits that day, counted the narcotics and caught what was happening. That poor man would have died in unimaginable pain. I also provided care for home health and hospice patients in their home.
RN Supervisor/Case Manager
Heritage Hall - Clintwood, VA
April 2007 to October 2009
RN Supervisor for the entire skilled nursing facility. I gave medications in the am assessed any residents that were ill or having issues. I obtained labs that the night staff were unable to obtain. Reviewed all labs and orders. Performed admissions. Sent residents to the ER if needed. Called MD with any concerns. Wrote all orders. Managed all of the residents care and supervised all staff in the building. Charted on all the skilled residents after performing assessments. Ensured all meds were given, wound care, ADL and IALD care was given to each resident in a safe and caring manner. (Please see below- a lot of what I did in this position was the same as below)
Director of Patient Services
IN HOME CARE, INC - Wise, VA
January 2002 to April 2007
Started out as Field Nurse, then promoted to Recertification/Audit nurse. I audited all charts, Oasis, Orders etc. for billing and PI. Maintained infection control logs and areas of concerns that needed to be addressed. Called MD with any concerns. I was Promoted a second time to Director of the Home Health. I oversaw all aspects of patient care. Made all schedules. Audited charts and Oasis as I had done being Audit nurse. Any issues I had to find solution and then give in-services to staff to ensure we were meeting the requirements for accreditation. I made sure patients received the absolute best care available and in the most cost effective way. Ensured the agency and staff was following all CMS and accreditation guidelines. Established mechanisms to measure quality care and performance. Interviewed, hired and in serviced all staff as need to ensure growth and maintain excellent performance. Reviewed all referrals to ensure the agency could accommodate the care. I would go do visits or even go with a nurse to help if they nurse did not understand a procedure of we were short staff. We worked together to make sure all the patients were cared for, whether that meant you were a RN or CNA. If a snow storm has hit and you are there to do wound care, you can help the patient to sponge off. Ensured all case conference meetings took place with all disciplines so that we had a continuity of care to give our patients the best of care.
Education
Bachelor's in Nursing RN to MSN
Grand Canyon University - Arizona State University, AZ
Present
Associate in Nursing
Southwest Virginia Community College - Richlands, VA
August 1997 to May 1999
Skills
RN, Case Management, Home Health, Utilization Review, Care Management
Certifications and Licenses
Registered Nurse (RN)
February 2019 to February 2021
CPR
October 2018 to December 2020
• Strong problem and issue resolution experience
• Strong collaboration and consulting skills
• Broad knowledge of multiple and integrated systems
• Strong analytical and critical thinking skill
Awards & Acknowledgements
2011 won 2nd place in the Best of the Best Nurse in Dickenson County
2012 won 1st place in the best of best nurse of Dickenson County
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