QUALIFICATIONS

-Honest, ethical, seasoned RN of *6 years -Naturally inquisitive thinker and problem solver

-Expert in CMS regulatory requirements -VBC, Medical Homes, CPCI, MyCare Ohio+more

-Documentation & communication specialist -Skilled Home Health & Hospice expertise

-Driven to research and analyze data to achieve quality products and services

-Expert navigating insurance and contractor cost-sharing including, quality outcomes & SDoH

EMPLOYMENT

Aug 2021 – June 2023 Somatus - Care Manager

Collaborated with patients, care team, and practitioners to deter Social Determinants of Health

Performed claims reviews and medical record audits for HEDIS quality measures

Educated, advocated, and supported patients with CKD or ESKD and other complex diseases

Performed patient assessments identified and facilitated healthcare needs in the community

Mar 2021 – June 2021 Kettering Health, Hospital RN Medical-Surgical Unit

Responsible for all care of patients during 12-hour shifts, performed assessments, administered medications, provided treatments

Educated patients throughout their hospitalization, performed care coordination at discharge

Jan 2021 – June 2021 Lancesoft/CVS Pharmacy - Contracted - COVID Vaccinator

Performed vaccination duties for those 18yr and older across multiple counties throughout Ohio during COVID pandemic

Educated, people and monitored for symptoms of anaphylaxis, collaborated with pharmacist & EMT’s

June 2020 – Dec 2020 Crossroads Hospice & Palliative Care - RN Team Lead

Supervised team of RN’s, LPN’s, and aides.

Led weekly Interdisciplinary Team meetings with med director and daily huddle meetings

Scheduled 24/7 death care assignments, assisted with intermittent visits, on-call, supplies

Mentored & educated teams on best care practices, effective communication, and customer satisfaction

Active with onboarding process, reviews, performance improvement plans and terminations

Mar 2020 – May 2020 Addison Home Health Services - Director of Operations/DON

Multiple position responsibilities performed including streamlined operations, fiscal viability focusing on insurance, authorization, billing, and revenue cycle

Active with all home health agency processes

Team educator, applied CMS, state and local regulations

Responsible for quality tracking, process improvement, & increasing revenue

Hired, trained, and completed on-boarding process for both non-medical and skilled home care employees

Created and implemented disaster P&P & SOP during initial outbreak of COVID pandemic

Mar 2018 – Feb 2020 Centene - Case Manager II

Coordinated and facilitated all aspects of the community care needs of MyCare Ohio dual eligible Medicare/Waiver recipients over age 65 in Dayton, OH

Provided support for members and collaborated with multi-disciplinary teams

Patient advocate for elders and their caregivers educating on all available resources

Collaborated with physicians on identified patient needs to close healthcare gaps

Worked with HCBS such as AAA, MOW, PERS, DME and other providers

Jan 2017 – Jan 2020 Cheering for Charity Foundation - Clinical Director

Board member from 2015, networked/marketed throughout tri-state as Liaison

Clinical resource for foundation with sponsors and local senior communities

Presented to the Ohio State Representatives Alzheimer’s Disease and Dementia Task Force

Collaborated with medical director on creation of ODA Nursing Home PI program

Educated the community, clinicians and caregivers, independent providers, physicians and community partners on foundation services and Alzheimer’s Disease and dementia

Mar 2015 – Oct 2016 Otterbein Home Health Care - Director of Operations/DON

Responsible for day-to-day operations, fiscal viability, employee performance, highly immersed in business networking & marketing

Clinically skilled provided education on IV’s, wound care/wound vacs, performed OASIS audits.

Expert analyzed revenue cycle provided streamlined process to achieve and exceed goals

Proficient with payer contract re-negotiations, team development, education of staff,

Change management implementation including compensation changes in productivity expectations resulted with increased revenue

Extensive understanding of CMS Medicare/Medicaid regulations, and HMO guidelines

Educated and directed team through deemed survey, obtained Home Healthcare Elite status and received ACHC accreditation

Sep 2012 – Mar 2015 Otterbein Home Health Care & Hospice Marketing Manager & Liaison

Established trustworthy relationships with physicians and discharge planners

Designed and implemented innovative, navigational program for patients and families

Coordinated care for patients at discharge from all levels of care

Facilitated and fostered partnerships between five different entities and physician’s office that serviced over 8,000 patients under CMS CPCI pilot program

Aug 2011 – June 2012 Oncology Hematology Care (OHC) - Clinical Research Nurse

Researched patient charts seeking eligibility criteria for clinical trials

Assessed and educated patients on trial qualifications and consent signing

Gathered specimens, reviewed medications, symptoms, side effects and answered questions

Performed patient advocacy and notified physician of findings

Adhered to strict documentation requirements, medication stocking, counting, ordering, storage procedures, while following Good Clinical Practices

Oct 2009 – Aug 2011 Interim HealthCare of Dayton & Springfield - Administrator

Responsible for all aspects of business operations, budgeting, fiscal viability, and success

Managed and performed sales functions including community outreach such as Kettering Health Women’s Walk and the Arthritis Jingle Bell Run

Created cohesive team during management change with inclusive culture creation

Implemented and educated staff on process improvement and quality measures for excellent star ratings for patient care

Aug 2003 - Sept 2009 Choice Health Care - Director of Nursing

Completed all hiring, onboarding, educating, counseling, and terminating of nursing staff

Obtained referrals including insurance verification, authorizations, and billing

Created an orientation program and performed all-staff education

Implemented quality processes, educated staff on new policies and standard operating procedures. Completed chart audits, and 100% daily OASIS audits

Performed patient care visits, resource as Director on-call, patient triage, & assignments

Educated all employees for surveys, & successfully became JCAHO accredited

Expert with CMS, Medicare, Waiver, Medicaid, Passport, Comcare along with other home and community-based services

EDUCATION

12/2024-Expected Graduation, Western Governor’s University, Salt Lake City, UT

Master of Science - Informatics

6/2022 Western Governor’s University, Salt Lake City, UT

Bachelor of Science in Nursing

7/1997 Kettering College of Medical Arts, Kettering, OH

Associate Degree in Nursing

AFFILIATIONS

5/2022 - IAW, International Association of Women

3/2017 - NCCDP, National Council of Certified Dementia Practitioners

Contact this candidate