Experience

Anthem

• RN Case Manager

  • Sep 2014 - Present



HCA

• RN Case Manager/Utilization Review

  • Jun 2013 - Jun 2014

  Utilization review activities.



Health Management Associates, Inc.

• Nurse Auditor

  • Dec 2008 - Jun 2013

   August 2008 – present Bayfront Medical Center Transferred to Case Management Department as Nurse Case Manager. Initial primary assignment was to the PCU telemetry unit. Responsibilites included admission and CSR utilizing Interqual criteria, interaction with MDs/ARNPs to assure proper status assigned to patient and to promote the progression of plan of care. Assigned role of educator in the NCM group – responsible for orientation and training of new NCMs. Transferred to role of…  August 2008 – present Bayfront Medical Center Transferred to Case Management Department as Nurse Case Manager. Initial primary assignment was to the PCU telemetry unit. Responsibilites included admission and CSR utilizing Interqual criteria, interaction with MDs/ARNPs to assure proper status assigned to patient and to promote the progression of plan of care. Assigned role of educator in the NCM group – responsible for orientation and training of new NCMs. Transferred to role of Admission Case Manager with responsibilities to include admission assessments on all patients being admitted via the ED, admission assessment and clearance of patients being directly admitted to the hospital and assessment and clearance of patients for whom other facilities requested transfer to our hospital. Most recently I have been working in the Case Management Department as an RN denials specialistnurse auditor with responsibility to submit clinical information to the eQHealth system for Medicaid payment, keep track of patients who will be eligible for BBA days, and prepare appeals for RAC denials. Additionally, this position requires that I float to all hospital departments to cover for PTO/sick days for other NCM giving me experience with all areas of adult hospitalizations and the Interqual criteria for these varied patients. Show more Show less



Bayfront Medical Center

• RN Supervisor Endoscopy

  • Dec 2007 - Aug 2008

  Staff RN supervisor GI/Pulmonology endoscopy lab. Responsible for circulating in procedures, staff education, supervision of cleaning procedures, supervision of GI techs in performance of assist duties, scheduling of procedures. Had on call responsibility for after hours.



Northside Hospital

• staff RN - endoscopy/day surgery

  • Apr 2007 - Dec 2007

  RN Gastroenterology/Day Surgery. Responsiblities included admission/recovery/discharge adult patients for GI procedures and for varied day surgery procedures. Assisted and circulated in GI procedures including upper and lower GI endoscopy, bronchoscopy, ERCP. Worked as staff RN in DaySurgery admit/recovery unit as assigned.



All Children's Hospital

• Assistant Director Special Procedure Unit

  • 1993 - 200714 years

  Hired in May 1993 to set up, train staff for and run Special Procedures Unit. This includes GI endoscopy, Bronchoscopy, Manometry studies, pH and Bravo studies and other procedures requiring conscious sedation. My title was Assistant Director.Experienced in assisting and circulating for both diagnostic and therapeutic GI endsocopic procedures, bronchoscopies, manometry, pH and Bravo studies, caring for endoscopic equipment and implementing plans for other special procedures. Excellent… Hired in May 1993 to set up, train staff for and run Special Procedures Unit. This includes GI endoscopy, Bronchoscopy, Manometry studies, pH and Bravo studies and other procedures requiring conscious sedation. My title was Assistant Director.Experienced in assisting and circulating for both diagnostic and therapeutic GI endsocopic procedures, bronchoscopies, manometry, pH and Bravo studies, caring for endoscopic equipment and implementing plans for other special procedures. Excellent assessment and IV skills. Responsible for planning and implementing education plan for all staff. Responsible for QA/QI activities. Excellent rapport with all physicians utilizing unit. Patient mix included neonate to age 45. Show more Show less



Bayfront Medical Center

• staff RN/manager Endoscopy Unit/charge RN/admissions coordinator

  • 1983 - 199310 years

  Units worked in include Post Anesthesia Care, Day Surgery, Admissions, Endoscopy (combined adult/pediatric). Positions include Staff RN, Charge RN, Admissions coordinator for Day Surgery, Endoscopy Coordinator.



Louisville General Hopsital

• staff RN

  • May 1976 - Apr 1983



St. Joseph's Infirmary

• staff RN

  • May 1975 - May 1976