Nurse Consultant Managed Care
Resume:
Kimberly Campbell
Regional Nurse Consultant/ MDS Consultant
Contact
Forney, Tx. 75126
*********@*****.***
Education
The Chicago School of Nursing
Richardson, Tx.
ADN 2022
Texarkana College
Texarkana, Tx.
LVN - 2004
Experience
July 2022 – Present
Regional MDS Consultant • Sky Blue HC
CHOW of muti state facilities, oversight/ audit MDS, care plans, training MDS nurses over policies, procedures, state guidelines, documentation, MDS process, case management process, managed care, resident assessments and PCC system and ADL training. In-services over facility reports, quality measures, review referrals, collaborate with IDT to implement plan of care. Setup systems and staff roles in PCC, TMHP, Simple LTC, Facility audits for documentation, follow -up, compliance, rate reviews, PASRR processes and care plan.
July 2020 – January 2022
Regional Nurse Consultant - Gulf Coast LTC.
Oversight and training DON's, ADON's, nurses, and aides on policies and procedures, state guidelines, documentation, and infection control. Staffing, conducted facility reviews of resident assessments and various PCC system, wrote plans of corrections, DPOC’s, root cause analysis, fish bone analysis, hiring, created pre and post-test for DPOC, conducted in-services, and facility audits, staffing, standards of care meetings and reports, review referrals. Was part of CHOW team to train staff on systems, write in orders and templates. Setup systems and staff roles in PCC, TMHP, Simple LTC. Facility audits for documentation, QM, QAPI, compliance audits, rate reviews, facility visits to audit systems, ensure compliance and assist with training as needed, assist with facility surveys, established COVID units.
September 2017 – July 2020
Regional MDS Consultant • Gulf Coast LTC
Oversight and training MDS nurses, charge nurses and CNA'S on policies and procedures, state guidelines, documentation, MDS process, case management process, managed care, resident assessments and PCC system and ADL training. Wrote plans of corrections, conducted in-services, and facility audits, staffing, standards of care meetings and reports, review referrals, collaborate with IDT to implement plan of care, CHOW. Help setup systems and staff roles in PCC, TMHP, Simple LTC, Facility audits for documentation, follow -up, compliance, rate reviews, PASRR processes and care plan. OIG audits, state surveys, writing directed plans of corrections, root cause analysis.
March 2008 – September 2017
MDS Coordinator • Crestview Court
Increased Medicare/ Medicaid Reimbursement rate levels, daily PPS meetings to discuss RUG Levels and change of condition with IDT, weekly Medicare / Managed Care meetings to review caseload and review documentation, in-service and train nursing staff on Medicare/ Managed Care documentation, case management, supervised restorative nursing program, implemented programs to help increase reimbursement rates, collaborated with IDT to develop plan of care, managed care plans for short and long - term residents, assisted with training reimbursement nurses in the company, reviewed charts for skilled stay or medical necessity prior to admission, frequently traveled to sister facilities to assist with Medicare/ OBRA/ Managed Care assessments, chart audits and preparation for OIG review and ADR, manage LTCMI’s, PASRRs, Cert/ Recert and documentation updates for Managed Care/ Insurance, ICD 10 Diagnosis Coding.
Key Skills
MDS certification
ICD 10 Coding Certification
Medicare Bootcamp Training
IV Certification
BCLS Certification
References
Available upon request
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