Hard-working, ambitious Registered Nurse with nearly two decades experience in healthcare. Roles include, but not limited to, supervision of long term care unit, short term rehab unit, supervision of a 260 bed skilled nursing facility, wound care in a busy hospital setting, direct care as a treatment and charge nurse and over 10 years experience in case management/MDS 3.0 with coordination/experience in both medicare and managed care payer sources. Most recent experiences in a lead MDS roll with responsibilities in completion of all PDPM skilled admissions, revenue and case management for Medicare, commercial, hospice, managed medicaid and medicare advantage plans. ICD-10 coding of all residents admitted. Contributions to quality assurance, policy writing as well as involvement in quality and performance improvement. RAC-CT certification through the accredited AANAC organization.
Lead MDS/PPS coordinator in a 120 bed skilled nursing and rehab facility. Responsibilities including case management, assessment, scheduling, coordination and completion of all OMRA/OBRA assessments and care plan development. Guidance provided to facility with regard to financial implications related to all Medicare, managed care, managed Medicaid and commercial insurance products for maximum reimbursement based on ongoing clinical evaluations and selection of ARD. Strong working knowledge of PDPM payment models and nuances as it relates to Medicare and managed care insurance products. Tracking of Medicare waivers, daily rates, utilized days in collaboration with the interdisciplinary team for appropriate rehab stay and smooth transition to the community. Completion of and participation of triple check billing processes. Assignment of ICD-10 codes to all admitting residents. Guidance provided regarding quality measures as reported to the public.
Wound care in hospital setting for simple and complex wounds of all varieties and etiologies. Assisted physicians with graft placement utilizing sterile technique, debridement of wounds, wound vac application as well as generalized wound care with use of various products and vendors.
4.0 GPA in nursing program
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