AndrewTBlack,Jr.,MHA,MSN,CMSRN

**** ********** ***** **********, ** 27407

Tel: 336-***-**** E-mail: aduvcb@r.postjobfree.com

Profile

Self-motivated Registered Nurse leader with excellent interpersonal and organizational abilities, creative and performs effectively in a collaborative atmosphere or independently. Competent in disseminating standards related to policy and procedure adherence. Resourceful in utilizing acquired leadership skills in the role of nurse manager, compliance program specialist, staff development liaison, shared governance representative and MDS assessment coordinator. Communicates in an efficient, positive manner and exemplifies the accountability and responsibilities inherent in professional nursing practice.

Education

Pfeiffer University

Master's of Science Degree in Health Administration 2011

GPA (4.0 Scale): 3.9

Master's Project: Implementation of Epidemiological Services in

Canada's Community Care Access Centre

Completion of greater than 130 practicum hours

Winston Salem State University

Bachelor's of Science Degree in Nursing 2005

Cum Laude

Livingstone College

Bachelor's of Science Degree in Biology 2002

Magna Cum Laude

Work Experience

Novant Health Thomasville Medical Center

Utilization Review Nurse 2012 Oct.

Proactively analyze information submitted by providers to make timely medical necessity review determinations based upon evidence based clinical criteria and standards within governmental and contractual guidelines

Identify and present cases of possible quality of care deviations, questionable admissions and prolonged lengths of stay to the Medical Director for further determination

Collect accurate data for system input by using correct coding of diagnoses and/or procedures

Process authorization requests via phone queue according to internal departmental processes.

Perform selected provider calls to address post-hospital discharge services, redirection to in network providers for appropriate steerage, durable equipment usage and utilization of other medical services and/or procedures and other telephonic follow-up as identified by the UM Nurse, the Medical Management Clinical Supervisor or Medical Management Director. Maintain documentation of all contacts with providers for health management activities to meet all regulatory and contractual requirements

Registered Nurse Assessment Coordinator 2008 Oct.

Facilitate timely and accurate completion of the minimum data set (MDS) and transmit data to the State as defined by Centers for Medicare & Medicaid Services (CMS)

Certify the need for skilled care, considering cost awareness, length of stay and discharge requirements

Serve as a resource for residents, family members, social workers, direct-care staff, business office and records personnel regarding Medicare regulations

Reinforce organizational and departmental procedures compliance and vigorously participate in Data Entry/Analysis and Quality Assurance activities

Wake Forest University Baptist Medical Center -Community Physicians

Clinical Compliance Specialist 2008 June

Develop, maintain and revise policies and procedures related to State and Federal regulations and standards compliance

Maintain patient care protocols and standards, ensuring adherence to State and Federal policies, regulations, and guidelines for operations in physicians' practice; establish and coordinate quality improvement, safety and infection prevention programs

Plan, implement and evaluate clinical activities in the practice setting related to infection prevention, occupational health, safety, laboratory and new employee orientation

Collaborate with the Chief Medical Officer, Physicians, Practice Managers, Clinical staff and others in regards to clinical practice and quality improvement matters, continually measuring progress against objectives

Wake Forest University Baptist Medical Center

Unit Based Educator 2007 June

Model excellence in nursing practice through the utilization of advanced concepts in areas of assessment, diagnosis, planning, implementation and evaluation of problems in a variety of patient populations

Provide clinical education expertise for compliance with professional and regulatory standards and orient novice nurses

Collaborate with Staff Development to identify educational opportunities designed to assist nursing professionals in providing optimal patient care

Staff Nurse II 2005 Jan.

Create a nurturing environment for patients, families by identifying needs and priorities while utilizing the components of the nursing process to meet these needs

Develop and revise individualized plans of care to assure positive outcomes and collaborate with multidisciplinary team members to evaluate care outcomes

Utilize the nursing process to ensure high quality patient care is rendered throughout the episode of care

PERSONAL AND RELEVANT ATTRIBUTES

Proven record of passion and innovation for obtaining positive financial results

Strong record of financial improvement in facility reimbursement

Capable of coordinating interdisciplinary involvement in clinical care amongst multiple disciplines

Extensive experience initiating and managing Medicare and Medicaid billing

Effective enforcer of policy, procedure and regulations in the clinical and long term care settings

Capable of resolving challenging issues resulting in positive facility outcomes

Professional and Personal References Available Upon Request

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