Cheryl K. Kinney, RN

Clearwater Beach, FL *****

727-***-****

advfxx@r.postjobfree.com www.linkedin.com/in/cheryl-kinney Patient Oriented Nurse (RN) Case Manager & Utilization Achieve Highest Level Quality Outcomes with Patient Centric Approach Professional liaison for management staff, administration, physicians, managed care companies, community organizations, and other customers. Experienced in managing available resources to promote quality cost effective outcomes, tracking, and making recommendations for process improvement. An integral member of the care team, coordinates discharge plannings efforts through assessment, referral and interdisciplinary planning. Hardworking, energetic and adaptable to a variety of working environments.

Excels at treating patients of all ages and backgrounds based on ability to empathetically listen, ask the right questions, and put the patient at ease. Committed to doing the right thing for both the patient and the organization, with a strong focus on utmost patient care, safety, cost effectiveness, utilization measures and process.

Direct experience in:

Performance Improvement Compliance and Regulatory Analytics Quality Improvement Resource Planning and Utilization Education Professional Development \ Case Review and Management Documentation Utilization Management Reporting Team Communication Discharge Planning Professional Experience

AMN Healthcare, Tampa, FL 813-***-****

Contract Postitions

Sentara Healthcare Remote position 2022 – 2022

Lake Granbury Medical Center, Granbury Texas 2019 - 2019 Case manager ensuring proper utilization of services and resources and assessing patient home needs for discharge.

• Arranging services to discharge home safely with DME, Home Health, or transfer to an Acute hospital or offsite services. LTACH transfers, Skilled Nursing Facility transfer, Long Term Care transfer or Assisted Living transfer.

• Communicates with physician, pharmacy, dietary, PT/OT/RT for discharge needs using Cerner, Interqual and Epic. Manage documentation and paper faxing clinicals needed for discharge needs.

• Follow up with DME, HHC, NS Facilities to make sure services have been obtained. Healthcare Support, Maitland, FL 407-478-033

Contract Position

Sunshine Health 2018 - 2018

Review medical records electronically to use for Interqual review. Ensure patient meets for Inpatient or Observation admission for all recipients.

• Communicate with MD when not meeting and send for secondary review.

• Communicate with Hospital if more clinical needed. Inform hospital if stay has been denied. Refer to other resource techs for SNF, LTC, DME and Hone Health.

• Participate in weekly rounds for patient stays over 5 days.

• Meet with discharge staff for difficult discharges for those who were discharge issues.

• Submit for review to MD if Single Case Agreement needed for discharge.

• Provide technical assistance to direct care staff to improve the efficiency and effectiveness of clinical services and documentation.

Harmony Healthcare, Tampa, FL 813-***-****

Contract Position

Venice Regional Hospital, Venice, FL 2017 - 2018

Planned patient care and helped patients communicate with their doctors and insurers. Acted as a liaison between patients and their healthcare provider.

• Coordinated DME, HHC, LTC, SNF, ARF, LTACH and hospital to hospital transfers.

• Coordinated care with all ancillary groups for home therapies.

• Attended rounds daily for those with over 5 days stays. AMN Healthcare, Tampa, FL 813-***-****

Contract Position

Northside Hospital, St Petersburg FL 2016 – 2017

Identified patients who need Case Management services, Assessing patient needs for discharge, Evaluating the discharge plan, and following up on the outcomes to ensure patient needs are met for discharge to home, SNF, LTC, HHC, DME and home services.. Florida Hospital North Pinellas, Tarpon Springs, FL 727-***-**** Case Management Nurse/Utilization Nurse 2015 – 2016 Managed and provided Utilization review and discharge planning for all patients.

• Reviewed charts for Inpatient or Observation stays for approval.

• Communicated with MD for discharge planning and disposition.

• Arranged DME and transfers to facilities outside of hospital. Largo Medical Center, Largo FL 727-***-****

Case Management/Utilization Review Nurse/CDI 2010 – 2014 Managed and provided concurrent review and retro review or commercial and Medicare insurance for initial review and continued stay review. Retro review for those missed on Holidays an Weekends.

• Submitted clinicals through Midas to the insurance company for review and approval or appeal.

• Discharge planning with the Dr’s for SNF, ALF, HHC and Home with DME or hospital to hospital discharge, with participating providers be it commercial or Medicare.

• Reviewed medical record for complete and accurate diagnosis by submitting to the physician for completion or to r/o a condition.

• Assisted the Coder in the final coding and billing process of the patient stay.

• Educating the physician on the purpose of the Query and the reason for assisting them with complete and accurate charting.

• Participated in monthly meetings with CFO to review the progress of the CDI personnel and the progress of the physician education. Assisting in planning educational opportunities. For the physician.

Additional Relevant Experience

-Wellpoint Anthem, Quality Evaluator/Complex Care Manager

-Healthways, Nurse Clinical Diseased Manager

-Interlock Pharmacy, IV Nurse Consultant

-SIHCA (IPA), Care Coordination Nurse

-Coventry Healthcare, Preauthorization nurse, Concurrent Review Nurse Education

Southwestern Illinois College

Associates in Science (ASN) Nursing

Associates in Science (AS) Health Information Technology License

Florida Compact License – Active

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