Sue Gresham, RN, BSN

***** *********** **.

Newburgh, IN 47630

E: adoslg@r.postjobfree.com

P: 812-***-****

I am an RN with my bachelor's degree from Indiana University and am interested in a career with your organization. I have worked as a registered nurse since 2005 and possess a strong background in geriatrics, home health, and case management. I have been in my current position working in a skilled nursing facility as an RAC-CT certified MDS Coordinator since 2017.

My current position as an MDS coordinator consists of multiple duties such as collecting and inputing data for medicare, managed care and medicaid reimbursement, tracking managed care updates and skilled stay approvals, promoting positive rehab to home outcomes, recognizing barriers to discharge, processing insurance denials and assisting with the appeals process. I am also responsible for the development of each person’s individualized plan of care in accordance with state and federal guidelines.

Some of my desirable qualities/skills consist of effective time management, ability to be adaptive to change, quick comprehension and implementation of new work related processes, proficient communication skills, attention to fine detail, ability to follow facility policies/procedures, state and federal regulatory requirements, problem solving using critical thinking skills, ability to work with other team members to accomplish a task/goal. I take pride in being able to prioritize my time and work efficiently as well as maintaining a compassionate attitude towards the customer to provide the extra support they need to meet their personal healthcare goals.

I believe my experiences and track record make me an excellent fit for this opportunity. I have enclosed my resume for your consideration. Please feel free to contact me via phone or email at a time of your convenience to discuss my background as well as the requirements for this position. I look forward to speaking with you.

Work Experience

Golden Living Centers Woodlands (Brickyard)

4088 Frame Rd.

Newburgh, IN 47630

10/2017 - Present

Hours per week: 40+

MDS Coordinator (RNAC)

Duties, Accomplishments and Related Skills:

•Perform RAI assessments in the SNF for MCR/MCD, managed care reimbursement and care planning purposes.

•Review patient’s care record, input ICD-10 codes for PDPM requirements and develop base-line/comprehensive plan of care

•Manage skilled care certifications

•Meet and collaborate with PCP, rehab, nursing department, patient and or family and SSD to discuss rehab progress, health care needs, discharge goals/barriers.

•Review insurance updates, managed care approvals, issue skilled care denials, assist with patient appeals.

•Manage post rehab restorative program for ADL decline prevention/maintain existing level of function to promote independence and quality of life.

•5 Star, quality measure monitoring, tracking, improvement plans

•98% State Audit Accuracy

•Exceeded budget requirements

Need-A-Nurse Home Health Agency

2318 W Franklin St.

Evansville, IN 47712

2014 - 2017

RN supervisor/case manager

Duties, Accomplishments and Related Skills:

•Staff supervision in the home to ensure quality of care, adherence to policies and procedures with emphasis on infection control, safety measures, medication and disease management.

•Assess patient satisfaction, assist with care coordination to promote positive health outcomes.

•Provided nursing services to adults and children in the home.

•Perform assessments related to (re)certification for continuance of MCD waiver services.

Trusted Nurse Staffing

500 Seneca St. Suite 501

Buffalo, NY 2015-2016

Case Manager for Medicare Replacement Plan

Duties, Accomplishments and Related Skills

•Home assessments

•Chronic disease management for re-hospitalization prevention

•patient advocate

•Recommend, connect to community and insurance related resources

•Multidisciplinary collaboration

•Patient education

•Medication management and reconciling

•Assist with medicaid applications and SSI benefits

•Assist with prior authorizations and medical billing issues

•Discover home barriers to preventative care

United Home Healthcare

7212 Shadeland Ave #100

Castleton, IN 46250

2011 - 2014

Home Health Nurse

Duties, Accomplishments and Related Skills:

•Provided skilled home health care nursing services

Cypress Grove Rehabilitation (Extendicare)

4255 Medwell Dr.

Newburgh, IN 47630 United States2006 - 2011

RN/ADON

Duties, Accomplishments and Related Skills:

• • Skilled rehab and dementia care units

•Passed state survey with no deficiencies.

•Prevention of negative outcomes and unnecessary hospitalizations by recognizing acute health care needs and providing quick and appropriate interventions that were specific to the patient centered plan of care.

Education

Indiana University Southeast New Albany, IN

Bachelor's degree 5 /2017

University of Southern Indiana Evansville, IN

Associate's degree 5 /2005

Job Related Training:

2019 RAC-CT certification, numerous training sessions related to quality care measures and reimbursement processes related to MCR/MCD.

Numerous employment required trainings over the years related to policies/procedures, infection control and disease management, abuse (recognition of, types and reporting requirements), compliance, privacy of health records and data.

Additional skills and interests:

Enjoy performing analysis and research of data and nursing processes, diseases, evidence based medicine.

Word process (data input) efficiently, timely

Proficient with computer programming, installation, modification and usage of new and existing programs.

References: Available upon request

Contact this candidate