Patient Care Quality Assurance

Stacy Renee’ Meadows

*** ***** ****** *****, ******** Beach, VA 22443

Phone: 540-***-**** Email: *****.************@*****.***

Professional Summary

Compassionate and results-driven Nurse Care Manager with extensive experience in patient care coordination, interdisciplinary collaboration, and regulatory compliance. Adept at conducting thorough assessments, developing care plans, and managing healthcare services to ensure optimal patient outcomes. Proven track record of leading teams, enhancing quality assurance, and supporting members in navigating complex healthcare systems. Strong expertise in Medicaid/Medicare guidelines, home healthcare services, and care management for high-acuity patients.

Professional Experience

LTSS Care Coordinator / Service Facilitator

Anthem Healthkeepers Plus – Richmond, VA

June 2021 – Present

Comprehensive Member Assessments: Conduct comprehensive assessments for members enrolled in CCC+/EDCD Waiver programs, identifying and addressing their unique health needs to ensure optimal health and well-being throughout their care journey.

Healthcare Services Coordination: Coordinate a variety of healthcare services for members, including arranging transportation, scheduling medical appointments, and facilitating home modifications to enhance their quality of life and access to care.

Medical Equipment & Authorization Assistance: Assist members in obtaining necessary medical equipment and navigating the authorization process for healthcare services, ensuring they receive the resources they need to maintain their health.

Interdisciplinary Collaboration: Collaborate with interdisciplinary teams to provide integrated care for high-acuity patients and frequent emergency department utilizers, ensuring comprehensive support and timely interventions.

Education & Training for Care Coordinators: Provide education and training for new care coordinators, equipping them with the necessary skills and knowledge to effectively support members and uphold organizational standards.

NCQA Participation & Compliance Audits: Actively participate in the NCQA committee, conducting chart audits to ensure compliance with HEDIS measures, promoting best practices, and enhancing the quality of care delivered to members.

Post-Hospitalization Follow-Up: Conduct follow-ups with members after hospitalization to coordinate ongoing care, manage medication reconciliation, and ensure adherence to follow-up appointments, thereby reducing the risk of readmissions.

Liaison Role for Regulatory Compliance: Serve as a liaison between members, healthcare providers, and Medicaid to ensure regulatory compliance and facilitate service authorization, streamlining processes to improve member access to care.

Unit Manager

Bowling Green Health and Rehabilitation – Bowling Green, VA

March 2020 – March 2021

Patient Care Coordination: Managed comprehensive patient care coordination for a long-term care unit, ensuring that all aspects of patient care were effectively organized and delivered in a timely manner to meet the needs of residents.

Chart Reviews & Quality Assurance: Conducted detailed chart reviews to assess patient progress, ensure adherence to established care standards, and identify potential areas for improvement in care delivery and patient outcomes.

Care Plan Development & Review: Developed and regularly reviewed individualized patient care plans in collaboration with healthcare teams, ensuring that care interventions adhered to established safety protocols and best practices for quality patient care.

Interdisciplinary Collaboration: Worked closely with interdisciplinary teams, including nurses, physicians, therapists, and social workers, to facilitate safe patient discharges and transitions of care, promoting continuity of care and minimizing readmission rates.

Employee Management & Conflict Resolution: Conducted employee evaluations and performance management, providing constructive feedback to support professional growth. Effectively resolved conflicts within the team, fostering a positive work environment and enhancing team collaboration.

Regulatory Compliance: Ensured compliance with all federal, state, and local healthcare regulations, conducting regular audits and staff training to maintain high standards of care and adherence to regulatory guidelines.

Director of Nursing

Westmoreland Rehabilitation – Colonial Beach, VA

March 2019 – November 2019

Oversight of Nursing Operations: Led nursing operations to ensure the delivery of high-quality patient care, maintaining compliance with all healthcare regulations and standards. Developed and implemented protocols to enhance patient safety and care effectiveness.

Clinical Rounds & Quality Monitoring: Conducted regular clinical rounds to assess patient outcomes, monitor the effectiveness of care plans, and identify areas for improvement. Addressed quality of care issues promptly to ensure optimal patient experiences and outcomes.

Multidisciplinary Coordination: Collaborated with multidisciplinary teams, including physicians, pharmacists, therapists, and social workers, to deliver comprehensive patient care. Fostered a collaborative environment to ensure seamless communication and coordination of services.

Staffing & Resource Management: Managed staffing levels and resource allocation to meet patient care demands efficiently. Oversaw staff scheduling, ensuring adequate coverage while maintaining budgetary constraints and operational efficiency.

Employee Performance Evaluations: Conducted employee performance evaluations, providing constructive feedback and guidance to promote professional development and enhance team performance. Developed individualized improvement plans to support staff growth and competency.

Assistant Director of Nursing

Westmoreland Rehabilitation – Colonial Beach, VA

January 2019 – March 2019

Supervision & Staffing Management: Supervised nursing staff, ensuring adequate staffing levels to meet patient care needs and maintain smooth, efficient operations. Oversaw scheduling and resource allocation to optimize team performance.

Chart Reviews & Outcome Monitoring: Conducted comprehensive chart reviews to evaluate patient outcomes, track clinical progress, and ensure compliance with established care protocols. Identified areas for improvement and implemented corrective actions to optimize patient care.

Patient Care Plan Development: Developed and reviewed individualized care plans in collaboration with healthcare teams, ensuring alignment with clinical best practices and addressing patient-specific needs for comprehensive care delivery.

Conflict Resolution & Family Liaison: Served as the primary point of contact for patient and family concerns, utilizing conflict resolution skills to address issues and provide support, ensuring a positive patient and family experience.

Interdisciplinary Team Coordination: Worked closely with interdisciplinary teams, including physicians, therapists, and social workers, to ensure patient safety, coordinate quality care, and facilitate smooth discharge planning and follow-up.

Regulatory Compliance & Adherence: Ensured strict adherence to federal, state, and local healthcare regulations, performing regular audits, training staff, and implementing procedures to maintain compliance with safety standards.

Nursing Operations & Staff Management: Assisted in managing nursing operations, conducting performance evaluations, overseeing staff training, and fostering ongoing education to promote continuous quality improvement and elevate care standards.

Clinical Rounds & Safety Monitoring: Conducted clinical rounds to monitor patient care delivery, assess compliance with safety protocols, and proactively address issues related to patient outcomes or care quality.

Quality Assurance & Improvement (QAPI) Participation: Actively participated in Quality Assurance and Performance Improvement (QAPI) initiatives aimed at enhancing patient care quality and increasing overall satisfaction with healthcare services.

Assistant Director of Nursing

Woodmont Nursing Center – Fredericksburg, VA

December 2017 – December 2018

Nursing Staff Supervision: Supervised nursing staff, ensuring optimal staffing levels to meet patient care needs, enhance team performance, and maintain a smooth workflow on the unit.

Chart Reviews & Compliance Monitoring: Conducted detailed chart reviews to track patient outcomes and ensure adherence to care protocols, identifying areas for improvement and implementing corrective actions when necessary.

Care Plan Development: Collaborated with interdisciplinary healthcare teams to develop, review, and implement individualized patient care plans, ensuring they align with clinical best practices and patient-specific needs.

Conflict Resolution & Family Support: Acted as a liaison between patients, families, and healthcare providers, addressing concerns with compassion and resolving conflicts to ensure high levels of patient and family satisfaction.

Interdisciplinary Team Coordination: Coordinated closely with various healthcare teams to ensure patient safety, quality care, and effective discharge planning, ensuring a smooth transition of care post-discharge.

Regulatory Compliance: Ensured compliance with federal, state, and local healthcare regulations, conducting regular audits and staff training to meet regulatory standards and maintain accreditation.

Nursing Operations & Staff Management: Assisted in managing nursing operations, including conducting performance evaluations, delivering staff training, and fostering a culture of continuous education and improvement for enhanced care quality.

Clinical Rounds & Care Monitoring: Conducted regular clinical rounds to monitor care delivery, patient progress, and adherence to safety protocols, proactively addressing any issues related to patient outcomes or care quality.

Regulatory Standards & Compliance Training: Provided staff training to ensure compliance with healthcare regulations, emphasizing adherence to quality standards and monitoring for continuous improvement.

Education

Bachelor of Science in Nursing (BSN)

Bluefield College – Bluefield, VA

Graduated: May 2016

Associate Degree in Nursing (ADN)

Germanna Community College – Locust Grove, VA

Graduated: May 2014

Skills & Certifications

Care Coordination & Case Management

Patient Assessments & Care Planning

Quality Assurance & Compliance

Medicaid/Medicare Knowledge

Interdisciplinary Collaboration

Staff Training & Development

Electronic Medical Record (EMR) Systems

IV Therapy, Wound Care, and Central Line Management

References available upon request

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