24 years of health care experience as Case Manager/Discharge Planner in hospital and nursing home settings. Knowledge of community resources and payer sources. Years of experience in working with insurance companies and advocating for patient needs. Extensive knowledge of home health care, hospice, nursing home in addition to hospital discharge planning.
Started Case Management Program Lincoln Surgical Hospital
Met with patients regarding discharge needs post hospitalization
Determined patient status when admitted to hospital
Worked with payer sources to hospital stay covered
Obtained authorization insurance companies for physician ordered services
Worked directly with physicians whose patients were medically complex
Presenter at bi-monthly Joint Education classes for patients.
Provided information from hospital scheduler to facilitate accurate therapy staff to match weekly orthopedic census.
Worked with off site pharmacy to deliver discharge medication to
patients in hospital on day of discharge.
SCIP and IMM abstractions.
95 percent or above yearly discharge planning satisfaction rate for hospital for past 6 years.
Worked as facility liaison for St Elizabeth Regional Medical Center to meet with and explain/set up home health care, hospice, nursing home and private pay services following referral from hospital staff.
Obtained authorization from payer sources for determined services.
Worked with other community resources to facilitate additional services as deemed necessary
Answered office phones and set up services accordingly.
Monthly presentation to LPN classes explaining Tabitha services
On call one week night and one weekend a month to set up services and be available to staff
Managed Activity Aide staff for 2 years
Companies Worked For:
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