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Environmental Health Medical Director

Location:
New Bedford, MA
Posted:
May 12, 2021

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Resume:

Monica Sylvia Kenney, RN

*** ****** ******

Dartmouth, MA 02748

Phone Number: 508-***-****

Email: Your admckl@r.postjobfree.com

Objective

Seek a position as a Registered Nurse

Experience

o2016-Present Utilization Review Nurse

BMC healthnet Plan

529 Main Street

Suite 500

Charlestown, MA 02129

Phone number: 617-***-****

Determine the medical necessity of the acute inpatient, skilled nursing and acute rehabilitation stay according to the established criteria.

Monitors Patients length of stay and documents pertinent clinical information for cases referred to Care Management or Plan Medical Director withing required timeframe guidelines

Identify and manage members who do not met Hospital Level of Care (HLOC) per policy

Conversion of Hospital Level of Care to Administratively Necessary Days or Observation status

Anticipates Members post discharge needs and is proactive in conduction preadmission reviews for admission to skilled nursing facilities and acute rehabilitation facilities

Assist providers with discharge planning

Provides monitor and guidance to ACC specialist to ensure timely discharge

Participates in clinical rounds for member with barriers to discharge and appropriately sends referral based on members needs.

Experience with FACETS, CCMS, JIVA, InterQual

o2010-2016 Registered Nurse/Case Manager

Southcoast VNA

200 Mill Road

Fairhaven, MA 02719

Phone number: 508-***-****

Perform independent health assessments of individuals and families by evaluating their physical, mental, and social and environmental health status; and provide nursing intervention based on assessment of need.

Make skilled nursing observations and assessments of client health care status by monitoring and documenting such things as vital signs, pulse, presence of edema, heart and lung auscultation, blood and urine laboratory values intake and output, consciousness and orientation levels; by completing a health history and evaluation and evaluating living arrangements.

Provide case management for clients by developing care plans, consulting with other health care providers such as physicians and social workers, referring clients to other Health care resources, participating in team meetings, coordinating health care services provided by ancillary personnel such as home health aides, and instructing clients and families on methods of positive health maintenance; initiate and conduct interdisciplinary conferences.

Develop and provide health education and consultation services to community members, clients and family members on a one-to-one and group basis through home visits, responding to requests for information by phone or in person.

Knowledge in billing procedures required by Medicare and other third party payors.

The ability to work independently and prioritize multiple tasks.

Education

o2008-2010 Bristol Community College

Associates Degree in Nursing

o2019-Present Chamberlain College of Nursing

Bachelor Degree in Nursing

Certifications & Licensures

o2010-Present Registered Nurse Licensure of Mass RN2269834

o2011-Present Registered Nurse Licensure of RI RN50407

o2015-Presnt Sutter Case Management Certification



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