Experience

• 

  Service Beakers Inc

  • Cary, North Carolina, United States

  • Director

    • Oct 2020 - Present
    • Cary, North Carolina, United States

    Director and Chairman of the Board

• 

  NC DHHS

  • Raleigh, North Carolina, United States

  • Nurse Consultant Division of Health Service Regulation

    • Dec 2022 - Oct 2023
    • Raleigh, North Carolina, United States

    Survey/Audit Skilled Nursing Facilities for CMS compliance. Investigate Skilled Nursing Home complaints.

• 

  NC Medicaid, Division of Health Benefits, Department of Health and Human Services

  • Raleigh, North Carolina

  • Nurse Consultant PACE Program

    • Sep 2019 - Dec 2022
    • Raleigh, North Carolina

    CMS and State regulatory oversight and inspections for a dozen North Carolina Day Centers for NC Medicaid's PACE Program (Program of All Inclusive Care for the Elderly). Equity Task Force and Diversity, Equity & Inclusion Council for the Division of Health Benefits.

• 

  Cigna

  • Raleigh-Durham, North Carolina Area

  • HEDIS Nurse

    • Jan 2018 - May 2019
    • Raleigh-Durham, North Carolina Area

    Preventive Medicine Quality Assurance and Compliance Data Extraction (Health Care Plan Effectiveness and Data Information Sets) for Preferred Provider compliance. Medical Records acquisition.

• 

  North Carolina Dpt of Health & Human Services, Medicaid

  • Raleigh, North Carolina

  • Nurse Consultant Durable Med Equipment, Orthotics, Prosthetics & Supplies

    • May 2018 - Nov 2018
    • Raleigh, North Carolina

    Durable Medical Equipment preauthorizations and ICD-10 policy review.

• 

  Capital Area Teen Court

  • Wake County Courthouse: 316 Fayetteville Street, Raleigh, NC

  • Exit Interviewer

    • Sep 2016 - Aug 2017
    • Wake County Courthouse: 316 Fayetteville Street, Raleigh, NC

    Review administration and sentencing guidelines for first time teen offenders by offering a second chance; yet holds them fully accountable for their actions. Non-profit program that successfully interrupts developing patterns of criminal behavior by promoting feelings of self-esteem, motivation for self-improvement and a healthy attitude toward authority.

• 

  Blue Cross and Blue Shield of North Carolina

  • United States
  • Insurance
  • 700 & Above Employee

  • Quality Review Clinical Analyst

    • Dec 2015 - Nov 2016

    Compile, analyze and summarize medical records for Provider Quality of Care issues related to readmission within 30 days, member quality complaints and grievances, out-of-state Host Insurance Plan Quality Review Issues with North Carolina Preferred Providers, and Medicare Member Provider Quality of Care issues. Collaborate with the Medical Director for Standard of Care determination, as well as Credentialing for database, reviews and recommendations.

  • Clinical Appeals Analyst

    • Jun 2015 - Nov 2016

    Analysis, research and completion of complex, non-routine appeals to ensure compliance with medical necessity criteria, Corporate Medical Policy, contract provisions, North Carolina Dept. of Insurance, legislative, federal and North Carolina Quality Assurance requirements.

• 

  Carolina Pulmonary and Sleep Clinic

  • Cary, North Carolina

  • Nurse Coding Intern

    • Feb 2015 - Jun 2015
    • Cary, North Carolina

    -Review, code, and process BlueCross BlueShield, Medicare, TRICARE and other third-party medical claim requirements.-Utilization of expertise in medical terminology, documentation compliance, ICD-9, ICD-10, and CPT coding.-Electronic Medical Record software utilization proficiency.

• 

  Passport to Health

  • Greater Raleigh, North Carolina area

  • Flu Vaccine Registered Nurse

    • Aug 2014 - Dec 2014
    • Greater Raleigh, North Carolina area

    -calculate expenses and establish field-based flu vaccine clinics at client workplaces

• 

  Wake Area Health Education Center

  • Wake Med Cary Hospital

  • Medical-Surgical RN/NR (Nurse Refresher) Intern

    • Apr 2014 - Jun 2014
    • Wake Med Cary Hospital

    -Safely and accurately applied critical thinking, best practices and health education skills in a modern medical surgical environment using current clinical and pharmacological knowledge-Provided customer service oriented support and assessment of patient needs, with plans of care that documented planning, positive outcomes, and injury and adverse response prevention to illness and treatments-Participated and communicated effectively within an interdisciplinary team to meet patient needs-Utilized Soarian electronic charting and Pyxis pharmacological computer system access

• 

  St. Michael School

  • Cary, North Carolina

  • Classroom Communication Liason

    • Aug 2013 - Jun 2014
    • Cary, North Carolina

    -Led teacher-parent communication and activity coordination for a classroom of 29 students-Managed project timelines using Excel, SignUp Genius, and email communications

• 

  Household6

  • Scholarship Recipient and Advisor

    • Jun 2012 - Jun 2013

    -Earned $1,320 professional continuing education scholarship through the National Military Family Association-Successfully completed with grade of "A" the Medical Surgical Nursing Refresher Course through the University of North Carolina at Chapel Hill Friday Center for Continuing Education-Successfully mentored client to earn two scholarships: 1) Four year $400,000 scholarship to the United States Military Academy at West Point, NY, and 2) $1,500 college scholarship funded by Proctor and Gamble

  • Nutritional Advisor for Optimal Health and Athletic Performance

    • Jun 2011 - Jun 2013

    -Oversaw nutrition planning. Led athletes to achieve ideal performance by planning and discussing nutrition goals, weekly menus, and the preparation of whole foods.

• 

  US Army

  • Relocation Specialist, Information Specialist

    • Dec 1991 - Jun 2011

    -Employed high levels of multicultural, and resiliency skills in 11 professional relocations in three continents, including Germany, South Korea and all regions of the US-Developed keen assimilation and analysis skills through extensive internet, reference book and map research-Managed $1.2 million real estate purchases and sales in a down market

  • Officer and Registered Nurse

    • Nov 1988 - Dec 1991

    -Charge Nurse for 12 patients on a step-down cardiac telemetry unit at a large Army Medical Center-Managed and oversaw up to three LPN's and Nurse Assistants per shift-Quality Assurance program manager for 24-patient cardiac telemetry floor-Demonstrated flexibility in nursing skills and people management while Medical Surgical float nursing-Conducted research study at Presidio Army Medical Center: "Op-site versus Gauze for IV Dressings" for implementation of hospital policy change

• 

  Fort McPherson and St. John the Evangelist School

  • Atlanta, Georgia

  • Hospitality Program Planner, Health Policy Presenter, Hospice Coordinator

    • Jun 2009 - May 2011
    • Atlanta, Georgia

    -Promoted professional and community outreach programs by planning professional, community and multicultural events at Army and school programs-Presented for Army Family Action Program: "Workplace Breast Feeding Accommodation: An Examination of Six Months versus One Year Deployment Leave in All the Services"-Ensured optimal plan of care outcomes and Medicare and private insurance utilization for complete hospice care for a private patient.

• 

  United Information Systems

  • Frederick, Maryland

  • Special Projects Federal Grants Management

    • Nov 1996 - Aug 1997
    • Frederick, Maryland

    -Federal Cancer Grants Program Management for federal contractor. Responsible for hiring and training cancer survivor advocates to sit with scientists on cancer grant evaluation panels for funding

• 

  University of Oklahoma

  • University of Oklahoma and Frederick, Maryland

  • University of Oklahoma graduate student

    • Jan 1993 - Aug 1996
    • University of Oklahoma and Frederick, Maryland

    -Master of Education with an emphasis in Adult & Higher Education, and a Master of Human Relations-Internship at the Army's Cancer Grant Advocacy Program at Fort Detrick, Frederick, Maryland

• 

  Frankfurt Military Community

  • Frankfurt, Germany

  • Educator and Sales Clerk

    • Jan 1992 - Dec 1992
    • Frankfurt, Germany

    -Planned and taught religious education classes and community outreach projects for 4th, 5th and 8th grades-Provided customer service and inventory management as a sales clerk at a military family Consignment Shop

• 

  Sunrise Nursing Registry

  • San Francisco Bay Area

  • RN Float Nurse

    • 1989 - 1990
    • San Francisco Bay Area

    Medical Surgical Float Pool RN for HIV and AIDS patients at specialty care facility