Data Entry Utilization Review
Resume:
Rosanne Masse
Professional Seeking Career Change
Baton Rouge, LA 70816
********@*******.***
Accomplished health care professional with more than 35 years of leadership expertise in diverse settings. Adept at cultivating and directing high performance teams to meet regulatory compliance and ensure delivery of high quality patient care. Detail oriented exhibiting excellent communications, proactive strategist, and comprehensive planning skills. Successful at ensuring compliance with all levels of management and direct care staff in health care organizations. Seeking a career change in a position where I can flourish. Master's degree with a minor in Human Resources.
Willing to relocate to: Alabama
Authorized to work in the US for any employer
Work Experience
Director of Quality Assurance
In Loving Arms HealthCare for Kids - Baton Rouge, LA November 2022 to Present
Quality Measures
Regulatory compliance
Policy and Procedures
Infection Control
Licensure/ Certification
Education
Director of Nursing Services
Apollo Behavioral Health Hospital - Baton Rouge, LA April 2020 to November 2022
24 bed behavioral health hospital for adults with acute psychiatric symptoms who are a danger to self or others
Case Manager
Utilization Review/Social Services - Demopolis, AL August 2018 to April 2020
• Comprehensive utilization review and management with success in preventing denials, appropriate use of resources, promotion in improved quality of care
• Perform three types of assessments; prospective, concurrent, and retrospective.
• Minimize LOS by appropriate needs assessment and care transitioning planning
• Initiated staff education (behavioral health units) to enhance documentation to minimize denials Manager of Inpatient Behavioral Health
Tombigbee Healthcare Authority/BWWMH - Demopolis, AL 2016 to 2018
• 10 bed adult unit, 10 bed geriatric unit, 15 bed medical detox unit
• Oversight and responsibility for managing all aspects of inpatient census volumes - admissions, treatment planning, interdisciplinary communication, physician relationships and discharge planning
• Managed ~ 40 FTE to include licensed and unlicensed nursing staff, MSW's, MSCE, Activities Director
• Coordinated medical and psychiatric service integration
• Collaborated with colleagues in the ER to effectively solve clinical and operational challenges
• Well versed in governing regulations (CMS) and standards for the program; well versed in Baker Act
• Instrumental with operational, clinical and EOC preparation for opening of 10 bed adult unit; CMS survey deficient free at 1 year follow up
• Quality measures improved by 70% in 1 year
Psychiatric RN Case Manager
Amedisys - Demopolis, AL
2015 to 2016
Director of Nursing
Prattville Health & Rehab - Prattville, AL
2014 to 2015
Interim Director of Nursing
Central Desert Behavioral Health - Albuquerque, NM February 2014 to May 2014
Diamond Healthcare
Director of Nursing/QA/Ed
The Orchard - Warsaw, VA
2012 to 2014
145 bed nursing facility, to include assisted living and rehab beds Completed AIT process and was licensed in state of Va Education
Master's in Management/HCA
Troy University - Troy, AL
2008
Bachelors in Nursing
Russell Sage College Troy - Troy, NY
1988
Associate in Nursing
Junior College of Albany - Albany, NY
1986
Certification LPN in Practical Nursing
Albany Occupational School of Nursing - Albany, NY 1981
Nursing Licenses
RN
Skills
• Program management; "big picture" perspective
• Natural leader/Inspirational motivator
• Staff training/development
• Versed in the regulatory/CMS survey process; Core measures; patient safety goals; quality indicators
• Therapeutic expertise
• Proficient at root-cause problem solving and designing enduring systems which: 1) Integrate work/systems to create interdepartmental checks and balances to decrease wasted effort and minimize error, 2) Improve information flow, 3) Improve timeliness of task completion, 4) Maximize reimbursement, 5) Minimize exposure to litigation.
• Nurse Management
• Behavioral Health
• Dementia Care
• Case Management
• Nursing
• Medication Administration
• Hospital Experience
• Leadership Experience
• Home Care
• Conflict Management
• Data Entry
• Utilization Review
• Quality Assurance
• Discharge planning
• Documentation review
• Medical records
• Leadership
• Infection Control Training
Certifications and Licenses
BLS Certification
Assessments
Attention to Detail Skills — Expert
July 2018
Measures a candidate’s ability to use diligence when drafting and editing documents. Full results: Expert
Clinical Judgment — Proficient
September 2020
Assessing a patient's condition and implementing the appropriate medical intervention Full results: Proficient
Supervisory Skills: Motivating & Assessing Employees — Expert July 2020
Motivating others to achieve objectives and identifying improvements or corrective actions. Full results: Expert
Management & Leadership Skills: Planning & Execution — Proficient October 2020
Planning and managing resources to accomplish organizational goals Full results: Proficient
Case Management & Social Work — Highly Proficient
March 2020
Prioritizing case tasks, gathering information, and providing services without judgment. Full results: Highly Proficient
Electronic Health Records: Best Practices — Expert March 2020
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Expert
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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