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Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Background

Continue to grow and develop my professional expertise in a challenging managerial position combining financial/operational/clinical/ quality innovations within a progressive home health organization, which is committed to positive patient outcomes, quality performance and financial viability. To allow use of my current knowledge, education, and experience to assist in building a quality health organization with sound business, quality and clinical practices. I have 20+years' experience as a Registered Nurse of which 15 years have been progressive management positions within home health, hospice and skilled care. Numerous years' experience in staff development, training, QA/QI manager, and Clinical Application Manager for implementation of a EMR in 60+ Home Health branches.


EXPERTISE Knowledge of Medicare Appeals and Denials and presenting cases to the Administrative Law Judges at Medicare. Knowledge of creating and revising clinical pathways, assessments and working of the HomeCare HomeBase (HCHB) electronic medical record system. Knowledge of reimbursement and alignment of outcomes with financial goals. Experience establishing quality programs, ongoing monitoring and disease management. Coordinating interdisciplinary team in the assessment, utilization and care planning processes. Financial oversight and AR management experience. Experienced with OASIS assessments. Experienced Clinical Quality specialist managing multiple home health agencies clinically, financially and operationally Directing, educating, developing and supervising staff in home health, hospice and skilled facilities. Directing the day to day running of a home health agency, skilled nursing unit and a hospice team. Developing and implementing policies, procedures, processes and programs. Experience in ICD 9 coding and case mix diagnosis, Title XXII and HIM 11 knowledge, active participant in DHS surveys and writing of Plans of Correction in Home Health agencies Experienced instructor- preparing in-services, PowerPoint presentations and other coursework Implementing and monitoring infection control protocols.

Skill Highlights
  • Strong clinical judgment
  • Computerized charting specialist
  • Problem resolution ability
  • Staff training and development
  • Financial, quality and clinical management
  • Home Health Business management
  • Regulatory compliance
  • Licensed RN in California
  • CPR/BLS certified
Accomplishments

Clinical Services/ Financial:

  • Guided multiple home health locations in financial management to result in region exceeding financial goals.
  • Monitoring and management of OPEX and COS management
  • Development and implementation of clinical programs and quality initiatives across multiple sites
  • Plan of correction development and implementation

Implementation

  • Electronic Medical record system across 60+ locations for home health

Training

  • Executive Directors, clinical managers and friled staff in Home health and hospice best practices, policies and procedures and quality initiativesImplementation
Professional Experience
11/2013 to 07/2015
Regional Director of Operations- Southern California Carpenter Health Network Thibodaux, LA,
  • Direct, develop, train, and communicate with staff personnel.
  • Discuss progress, provide general direction, and work with staff on actual situations, providing insight into the handling of problems.
  • Oversee the work of Executive Directors and Regional Staff.
  • Provides leadership and support to locations within my assigned area of responsibility.
  • Assists with the on-boarding of agency managers.
  • Provides direction and guidance in the oversight, implementation, and adherence to internal policies and procedures.
  • Provides assistance in the review and analysis of financial, clinical, and operational performance indicators and provides feedback to the RVP and local management team.
  • Maintains current knowledge of program policy, service and license compliance requirements for agency program.
  • Responsible for filling in as an onsite manager at an agency in the event the position is vacant.
  • Participates in the evaluation of agency performance through the annual evaluation process, quality assurance and performance program and periodic review of operations.
  • Partners with the local leaders to assist in the hiring of a competent workforce, as needed.
  • Supports and communicates the organization’s goals, priorities, and professional standards.
  • Utilizes the company’s software platform other technology tools to review and trend location results.
  • Works with local leaders to ensure they understand the meaning of the data elements and how they have an impact on results.
  • Develops and implements effective clinical and business management systems, oversees the audits of client charts, client satisfaction surveys and all service delivery within the region by conducting routine program audits, as assigned.
  • Maintains effective and cooperative working relationships with community, health resources and agencies, as directed.
  • Works in collaboration with the VP of Operation and sales team to identify and pursue opportunities for new markets and initiatives.
  • Provides sales related support to location sales and operations teams.
  • Guides Agency Managers in all operational areas including process and personnel management.
  • Makes site visits to locations and provides professional development and training to achieve optimum staff performance.
  • Establishes and maintains working relationships with key line, contracts, marketing, and clinical staff to ensure thorough understanding of company products/services.
  • Ensures location leaders are kept abreast of assigned product lines, programs and services. Participates in the education of these to frontline caregivers, as directed.
2011 to 11/2013
Clinical Application Manager Dallam-Hartley Counties Hospital District Dalhart, TX,
  • Customized Homecare Homebase (HCHB) assessments to company documentation standards
  • Assisted IT staff in customization of clinical aspects of HCHB
  • Assisted in training of multiple Home health locations to HCHB platform
03/2011 to 10/2011
Clinical Supervisor The Shyft Group, Inc. Waterville, ME,
  • Supervised clinical staff
  • Performed nursing procedures and assessments
2005 to 2011
Clinical Manager, QI Director, Director of Patient Care, and Regional Clinical Quality Specialist Dallam-Hartley Counties Hospital District Dalhart, TX,
  • Directed clinical staff
  • Monitored quality outcomes and initiatives
  • Ensured OASIS accuracy
  • Performed ICD 9 coding
  • Trained clinical staff
  • Monitored billing completion and other financial stauses
2003 to 2004
Sub-acute Case Manager Avamere Lebanon, OR,
  • Assessed vent and trach patients for appropriateness to be admitted to sub-acute unit
  • Coordinated admission to sub-acute unit
  • Traveled to hospitals all over San Diego County to perform assessments
2003 to 07/2003
Director of Nursing Archcare Tarrytown, NY,
  • Directed and oversaw all clinical matters for 49 bed skilled nursing facility
2002 to 07/2002
Quality Auditor Interim HealthCare City, STATE,
  • Performed QA audits of OASIS and patient charts
03/2001 to 07/2001
Director of Nursing Las Villas De Carlsbad City, STATE,
  • Directed and oversaw all clinical matters for 49 bed skilled nursing facility
2000 to 2001
CNA Instructor Adult Education (ROP), Escondido School District City, STATE,
  • Educated ROP students to be able to take their CNA/ CHHA certification exam
  • Clinical preceptor on the floor at a skilled facility
1997 to 2001
Supervisor, Assistant Director, Director of Staff Development, Director of Nursing Las Villas Del Norte City, STATE,
  • Assisted in directing and overseeing all clinical matters for 49 bed skilled nursing facility
  • On-boarding and in-servicing of staff
1XXX to 1997
Supervisor, MDS Coordinator, Assistant Director Manor Care Health Services, Rancho Bernardo Skilled Nursing City, STATE,
  • Supervised clinical staff
  • Performed nursing procedures and assessments
  • Completed MDS assessments and care plans
1989 to 1XXX
Nursing Supervisor Barnesville Health Care Center City, STATE,
  • Supervised clinical staff
  • Performed nursing procedures and assessments.
Education and Training
Expected in 2008
Master's of Health Administration: Health Administration
University of Phoenix - San Diego, CA
GPA:
    Expected in 2006
    Bachelor's Degree: Health Care Administration
    University of Phoenix - San Diego, CA
    GPA:
    Expected in 1993
    Associate: Applied Science Nursing
    Belmont Technical College - St. Clairsville, OH
    GPA:
    • Registered Nurse
    Expected in
    : General coursework
    Ohio University Eastern - St. Clairsville, OH
    GPA:
    Certifications
    • Active RN License CA
    • Inactive RN License OH
    • Inactive RN License WV
    • Applying for RN license in TN
    Affiliations
    • CAHSAH
    Skills
    • See professional experience

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    Resume Overview

    School Attended

    • University of Phoenix
    • University of Phoenix
    • Belmont Technical College
    • Ohio University Eastern

    Job Titles Held:

    • Regional Director of Operations- Southern California
    • Clinical Application Manager
    • Clinical Supervisor
    • Clinical Manager, QI Director, Director of Patient Care, and Regional Clinical Quality Specialist
    • Sub-acute Case Manager
    • Director of Nursing
    • Quality Auditor
    • Director of Nursing
    • CNA Instructor
    • Supervisor, Assistant Director, Director of Staff Development, Director of Nursing
    • Supervisor, MDS Coordinator, Assistant Director
    • Nursing Supervisor

    Degrees

    • Master's of Health Administration
    • Bachelor's Degree
    • Associate

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