RN Specialist Resume Samples
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RN Specialist Resume Samples
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HM
H Marquardt
Henderson
Marquardt
465 Champlin Flat
Dallas
TX
+1 (555) 421 5162
465 Champlin Flat
Dallas
TX
Phone
p
+1 (555) 421 5162
Experience
Experience
Houston, TX
RN Specialist
Houston, TX
Kessler Group
Houston, TX
RN Specialist
- Instructs and Assists physicians with pacemaker clinic equipment use and interpretation of pacemaker and ICD as ordered
- Manage technical staff performing apheresis procedures in a multiple procedure setting.
- 4) Identifies relevant BCBSMN and community resources and facilitates program and network referrals
- Independently Manages patient testing assignments
- Responsible for pacemaker and ICD testing in the emergency room, operating room, nursing units, ICUs, ancillary departments and arrhythmia device clinic
- 6) Ensures member data is documented according to BCBSMN application protocol and regulatory standards
- Follows and Assists in updating and developing departmental and hospital policies and procedures in accordance with the Heart Rhythm Society and American Heart Association guidelines
New York, NY
RN Admissions Specialist Hospice
New York, NY
Braun-Lockman
New York, NY
RN Admissions Specialist Hospice
- Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards
- Actively participates in creating and implementing improvements
- Receives and processes requests for screening patients regarding Hospice services to facilitate patient admission to the program
- Facilitates meeting with referred patients/families, hospice team members and facility care management staff to review Hospice philosophy, services and reimbursement issues
- Responds to emergency situations in the home identified during screening process
- Review patient medical record and history and consult with Medical Director/Hospice physician to determine hospice eligibility
- Collaborates with Clinical Managers for assignment to complete intake assessments
present
Chicago, IL
Clinical Documentation Specialist RN
Chicago, IL
Witting Inc
present
Chicago, IL
Clinical Documentation Specialist RN
present
- Reflects HCA’s mission and values. Maintains sensitivity and commitment to HCA’s ethics and compliance principles (Code of Conduct) in his/her daily activities/conduct
- Maintains and protects confidentiality
- Reviews medical records and identifies potential gaps in clinical documentation for specified facilities, patient types and payer populations, as directed on admission and throughout the hospitalization
- Assigns working DRG based upon identification and selection of principal diagnosis, complications or co-morbid conditions and/or valid OR procedures, including capture of POA indicators
- Ensures documented conditions, clarifications, and coded diagnoses are clinically supported
- Documents reviews and other pertinent information in designated systems by established deadlines
- Uses clinical judgement to determine when and/or if a query is necessary
Education
Education
Bachelor’s Degree in Nursing Required
Bachelor’s Degree in Nursing Required
Webster University
Bachelor’s Degree in Nursing Required
Skills
Skills
- Independently Manages patient testing assignments
- Performs inpatient and outpatient patient pacemaker and ICD test and reports results to physicians. Notifies physicians of apparent malfunction and “troubleshoots” by reprogramming device per order
- Responsible for pacemaker and ICD testing in the emergency room, operating room, nursing units, ICUs, ancillary departments and arrhythmia device clinic
- Ensures test ordered are appropriate for the patient and communicates when necessary with physicians for orders
- Ensures all patient charts are completed in a timely manner per hospital policy
- Initiates, Maintains and updates all outpatient clinic records. Notifies physician of apparent malfunction; notifies accounting department of expected warranty information
- Instructs and Assists physicians with pacemaker clinic equipment use and interpretation of pacemaker and ICD as ordered
- Manages schedule to minimize scheduling errors, ensure all patients have appropriate orders prior to test, notifies supervisors when testing is delayed
- Provides appropriate teaching and information to patients and families about pacemakers, ICDs, and trans telephonic equipment
- Follows and Assists in updating and developing departmental and hospital policies and procedures in accordance with the Heart Rhythm Society and American Heart Association guidelines
15 RN Specialist resume templates
Read our complete resume writing guides
1
Tricare Senior RN Accreditation Specialist Resume Examples & Samples
- Provide Leadership to NCQA / URAC accreditations programs for the end to end successful survey process for a variety of modules including: Quality Management / Improvement, Network Management, Credentialing Utilization Management Case Management, Disease Management, Beneficiary Rights and Health Information
- Provide Subject Matter Expert (SME) recommendations on a variety of accreditation standards and have the skills to recognize the appropriate information to reflect compliance
- Conduct mock NCQA clinical audits on case files for denials, appeals, case management to make clinical determinations for accreditation compliance
- Develop and conduct gap analysis research specific to each accredited program assigned
- Develop and manage program specific project plans to ensure accreditation success is obtained / maintained and ensuring timely submissions
- Participate in oversight of clinical quality studies, baseline data, benchmarks, interventions, monitoring, re-measurement, and reporting to ensure accreditation compliant Quality Improvement Activities
- Independent problem solve skills with the ability prioritize in a fast-paced dynamic environment
- Current unrestricted RN license in the state of residence
- Accreditation survey, end to end experience
- Data analysis experience
- CPHQ experience
- Demonstrated success with health plan or related accreditation survey
2
Clinical Documentation Improvement Specialist RN Resume Examples & Samples
- *This will be an onsite role at the St. Joseph’s Hospital and Medical Center in Phoenix, Arizona
- Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the patient condition and acuity of care provided
- Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
- Performs regular rounding with unit-based physicians
- Provides face-to-face educational opportunities with physicians on a daily basis
- Provides complete follow through on all requests for clarification or recommendations for improvement
- Ensures effective utilization of the Optum360 Enterprise Computer Assisted Coding (CAC) documenting all clarification activity
- Utilizes only the Optum360 approved forms, whether paper or electronic
- Proactively develops a reciprocal relationship with the Health Information Management (HIM) Coding Professionals
- Engages and consults with Physician Advisor when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
- Actively engages with Care Coordination and the Quality Management teams to continually evaluate and spearhead clinical documentation improvement opportunities
- Current Registered Nurse (RN) License
- 3+ years acute care hospital clinical RN experience
- Must be comfortable communicating & working closely with Physicians
- Basic understanding of Microsoft, Word, Excel, PowerPoint and work related software
- Previous experience in case management and / or critical care
- Clinical Documentation Improvement experience
- CCDS, CDIP, CCS certification
3
RN Appeals Specialist Resume Examples & Samples
- May utilize pre-existing criteria and other resources and clinical evidence to develop sound and well-supported appeal arguments, where an appeal is warranted
- Uses client approved clinical articles or if unavailable, may search for supporting clinical evidence to support appeal arguments when existing resources are unavailable
- Receiving, documenting, investigating, and coordinating appeals
- Tracking the status of outstanding appeals and trending appeals successes to help develop internal appeal strategies for specific payers
- Working off of a task list ensuring timelines and customer commitments are met
- May perform tele-health duties as dictated by program needs
- Significant experience in the healthcare field is required including a minimum of five years as a clinical nurse in an acute care setting or medical insurance setting. In addition, having at least two to three years’ experience in case management, discharge planning, and/or utilization review is preferred
- Experience at an insurance company in a clinical review capacity, or medical office experience with clinical review/PA experience, or direct appeals experience is preferred
4
RN Claims Denial Specialist Resume Examples & Samples
- 1 – 3 years of experience as a Care Coordinator in an acute care or insurance setting preferred
- 2The RN will also review and any associated physician office records that may assist with the appeal process and/or regulatory documentation requirements
- 3The RN must be knowledgeable with commercial and government regulations for reimbursement including, but not limited to: i. InterQual
5
Tricare RN Accreditation Specialist Resume Examples & Samples
- Provide Leadership to NCQA accreditations programs for the end to end successful survey process for a variety of modules including: Quality Improvement, Network Management, Credentialing, Utilization Management, Network Management, Member Connections and Beneficiary Rights
- Conduct mock NCQA clinical audits on case files for UM denials, factual denials, appeals and case management to make clinical determinations for accreditation compliance
- Develop and manage program specific project plans to ensure accreditation success is obtained/maintained and ensuring timely submissions
- Create project planning documents, including process flow charts, work plans using various software programs and maintenance of a current accreditation document library
- Offer excellent written, verbal and presentation skills necessary to effectively convey goals and initiatives to represent the accreditation team in a positive and dynamic manner
- NCQA Accreditation survey, end to end experience
6
RN Specialist Resume Examples & Samples
- Independently Manages patient testing assignments
- Performs inpatient and outpatient patient pacemaker and ICD test and reports results to physicians. Notifies physicians of apparent malfunction and “troubleshoots” by reprogramming device per order
- Responsible for pacemaker and ICD testing in the emergency room, operating room, nursing units, ICUs, ancillary departments and arrhythmia device clinic
- Ensures test ordered are appropriate for the patient and communicates when necessary with physicians for orders
- Ensures all patient charts are completed in a timely manner per hospital policy
- Initiates, Maintains and updates all outpatient clinic records. Notifies physician of apparent malfunction; notifies accounting department of expected warranty information
- Instructs and Assists physicians with pacemaker clinic equipment use and interpretation of pacemaker and ICD as ordered
- Oversees trans telephonic testing performed by cardio scan technician. Notifies physician of apparent malfunction. Notifies patient of need to come to the clinic for further testing and reprogramming, or the Emergency Department for treatment
- Manages schedule to minimize scheduling errors, ensure all patients have appropriate orders prior to test, notifies supervisors when testing is delayed
- Provides appropriate teaching and information to patients and families about pacemakers, ICDs, and trans telephonic equipment
- Follows and Assists in updating and developing departmental and hospital policies and procedures in accordance with the Heart Rhythm Society and American Heart Association guidelines
7
Specialist CDI RN Resume Examples & Samples
- Formulate physician queries regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the health record, as necessary
- Professional Development: Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient and outpatient coding. Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls as well as any required CDI education
- Intermediate knowledge of disease pathophysiology and drug utilization
- Critical thinking, problem solving and deductive reasoning skills
- Effective written and verbal communication skills
8
Assessment Specialist PRN RN Resume Examples & Samples
- Collects data from the patient and other appropriate resources in a systematic manner that is accessible, communicable, and recorded in a clear, legible fashion
- Registered Nurse who is designated as Qualified Medical Persons performs patient Medical Screen Examination prior to completion of the initial psychiatric intake assessment
- Participates in providing a therapeutic milieu
- Ensures confidentiality, privacy, and safety for patients
- Demonstrates knowledge of ECO/TDO according to the Virginia State Code
- Follows established procedures performing job functions. Follows appropriate safety guidelines
- Works as a member of a team to problem solve and deliver quality care to patients
- Attends all in-services and education requirements; completes departmental Competency Based Orientation and Competency Based Evaluation requirements
- Registered Nurse License issued by the Department of Health Professions, Commonwealth of Virginia OR
- Authorization to Practice as a Registered Nurse Applicant in Virginia issued by the Virginia Board of Nursing, Commonwealth of Virginia
9
RN Blood Collection Specialist Resume Examples & Samples
- Set up and perform procedures according to protocol: machine set up; proper Quality Control and maintenance of equipment; Health History knowledge; and venipuncture
- Prepare for distribution, any product obtained during pheresis including centrifugation technique, labeling and storage procedures, distribution requirement as to time and condition
- Initiating and maintenance of all donor records accurately including understanding of pertinent laboratory data and statistics, recording of donor data into current donor records, maintenance of QC reports
- Trains pheresis and other blood services personnel
- Acting charge duties when necessary
- Maintains on-going communication and knowledge in dealing with blood bank personnel with ordering of Pheresis products
- Performs other duties as may be assigned, including canteen activities
- Graduate of an accredited School of Nursing and currently licensed as an R.N. by the State of Connecticut
- Minimum of one year of clinical (hospital experience)-recent critical care and venipuncture experience preferred
- Flexible in time and task requirement. Works effectively and consistently while under stress. Maintains effective communication skills. Consistently performs in a competent, courteous and professional manner
10
RN Specialist Resume Examples & Samples
- Assess patient status relative to therapeutic apheresis, prior and during procedures, utilizing nursing process
- Registered Nurse with current state licensure as required
- A minimum of two years experience in medical/surgical or critical care nursing, or related experience, is required
- A current valid driver’s license and good driving record are required
11
Clinical Documentation Specialist Rn Fountain Valley Resume Examples & Samples
- Must possess a current RN license or an RHIA, RHIT, or CCS credential
- Demonstrate knowledge of clinical or inpatient coding experience in an acute care setting required; 5 years experience strongly preferred
- Familiarity with coding concepts and coding software desired
- Knowledge of age-specific needs and the elements of disease processes and related procedures
- Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes
- Assertive personality traits to facilitate ongoing physician communication
12
Medical Information Specialist RN Resume Examples & Samples
- Answers incoming calls in professional manner following client guidelines and Business Rules
- Perform outgoing calls in professional manner following client guidelines and Business Rules
- Focus and provide exemplary customer service
- Demonstrates an awareness and sensitivity towards patient/family rights and confidentiality
- Complies with departmental standards regarding training, professional development, communication, management of workload, and safety/emergency situations
- Understands and utilizes Phone system and records appropriate information in the CRM database in accordance with customer Business Rules and training
- Interact with patients via phone to educate, motivate, and empower them at every step of the initiation process, and transition to adherence support
- Provides initial patient assessments and surveys, coordination of supplies, coordination and documentation of injection training, reporting of adverse events, and clinical review of all information needed to complete the Care Management function
- Ensures patient compliance by reviewing patient profiles, answering patient medical inquiries, contacting appropriate medical professionals, referring patients when needed to the appropriate departments, and discussing discrepancies with appropriate parties to assure adherence to plan of care
- Complete all job functions in a professional and ethical manner
- Infectious disease experience preferred
- Strong Organizational Skills
- Ability to multitask, take direction, and maintain prioritization
- Must be empathetic and compassionate
- Medical call center experience preferred
- Superior organizational skills
- Knowledge of Microsoft Office products software including Outlook, Word, Excel, SharePoint, and PowerPoint software
- Comfortable interacting with other health care professionals within the pharmacy and outside the pharmacy including physicians and busy office staff
- Good math and computational skills
- Professional communication skills
- Bilingual preferred /Spanish speaking
13
RN Configuration Specialist Resume Examples & Samples
- Supports the Care Managers, Clinical Training, Information Technology and HealthCare analytics, translating the clinical processes documented in TruCare
- Assist with configuration requests for review of system requirements, impact to users and offers alternative recommendations were feasible based on application functionality
- Recognizes opportunities to maximize system capabilities to enhance population outcomes, efficiency and clinical documentation supporting program value
- Participates as a key member of the implementation team for the successful implementation of application service packs, hot fixes and upgrades
- Utilizes critical analysis to plan, problem solve, and mitigate risk in the deployment and implementation of application upgrades
- Problem solves application and workflow issues, works with team members for the ongoing evaluation and enhancement process
- Supports unit and validation testing in conjunction with Information System’s Quality Team and its Application Lifecycle Management web based tool
- Supports the prior authorization process by business rule configuration supporting health plan authorization requirements including authorization rule updates as received
- Follows through on vendor requirements for change in the application’s hard coded features with the required documentation including enhancement request templates and business case impact documentation
- Works directly with Information System’s change process requirements and assist in the documentation necessary for application enhancement installs
- Works with Inter departmental leaders for functional requirement documentation and informs leadership of any delays or issues with configuration deployment
- Configuration supports clinical practice guidelines and meets regulatory requirements
- Serves as the subject matter export for customers of TruCare, understanding and interpreting application supportive functionality for departmental requirements
- Assist with the review and resolution of Service Now cases submitted for TruCare and provide supportive documentation directly in the Service Now application
- Participates in vendor conference calls and meetings related to TruCare
- Configuration requests are completed in a timely manner
- In addition to TruCare, configuration requirements may extend to other software applications
- Bachelor’s Degree in Nursing or related field required (Five additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree)
- Five or more years of progressive experience working in a clinical configuration environment
- Three years of managed care and/or case management experience
- Knowledge in the following areas: medical terminology, referral and claims processes, utilization management, health care delivery systems and standards of care
- The ability to communicate well with all levels of Care Management, Information Systems and External Vendors
- The ability to work independently in accomplishing assignments, program goals and objectives
- Advanced skill level with Microsoft Word and Excel
- Bachelors of Science degree in Nursing or related field
- Case Management certification
- Previous experience with clinical applications
- Proficient with Microsoft Visio
- Possess strong analytical and problem solving skills, with change management experience
14
RN Certified Specialist Resume Examples & Samples
- Must have a current, valid AZ RN license, temporary AZ RN license, or compact RN licensure for current state of practice
- Must have specialty certification from a national wound and ostomy certification board, i.e. Wound, Ostomy and Continence Nursing Certification (CWOCN, CWON)
- Must have minimum of two years experience in wound and ostomy specialty position in the acute or clinic setting
- Must have experience in developing a plan of care including setting goals, monitoring and documenting progress
- Must have the ability to implement and evaluate the effectiveness of interventions in the plan of care and to recognize the need to reassess
- Able to identify opportunities for nursing staff development, and provide wound and ostomy education
- Needs to be autonomous and able to prioritize, direct, communicate, teach and coordinate functions with the wound and ostomy team
- Manages and influences the quality of patient outcomes and clinical care through application of specialized knowledge. Collaborates with staff to integrate quality and cost improvements in clinical care
- Provides specialty focused nursing consultation on complex patient cases. Evaluates patient needs and makes recommendations for treatment, implements interventions, and evaluates outcomes
- Serves as a specialized clinical resource to patients, families and staff to advance the quality of care
- Identifies opportunities for staff development and learning through formal and informal training and education, as appropriate
- Stays current on developments within area of specialty and integrates findings into practice, policies, and procedures
15
RN Simulation Specialist Resume Examples & Samples
- Serves as an internal consultant for simulation design. Designs workforce learning and development outcomes which support facility strategies and initiatives. Conducts assessment of current and projected workforce development needs and provides efficient, effective, high quality programs and services in response. Provides guidance on clinical issues for various service line areas. Serves as a resource for policy and procedures, standards of care, and external agency requirements
- Coordinates and assists in all development of scenarios and training in conjunction with faculty and staff to integrate simulation usage into clinical curriculum. Researches, plans, implements and evaluates curriculum content and sequence. Incorporates proficient clinical practice, safety, and patient centered care in all educational scenarios. Programs, tests and runs scenarios with faculty, assuring that faculty and equipment are prepared for teaching scenarios
- Directly responsible for the development and delivery of employee development programs and designated learning programs which attract new recruits, retain current staff and improves quality of care. Ensures timely delivery and integration between plan objectives and design in order to obtain intended program impact and stakeholder/participant satisfaction while managing required resources effectively
- Uses advanced knowledge to execute set-up, programming, maintenance, use, disassembly, and troubleshooting of simulation equipment. Demonstrates and teaches technical and philosophical aspects of operating and programming simulators to staff. Develops a schedule of simulator activities to include periodic review and maintenance of equipment
- Implements, interprets, and evaluates learning goals and objectives. Implements assessment tools to be integrated as competency measures in all aspects of simulation based education. Evaluates learning effectiveness using standardized outcome measurements. Uses performance measures and workforce needs to drive education plans and learning strategies
- Manages and leads program development of new systems, applications, software conversions and upgrades, and media integration maintaining partnerships and troubleshooting. Identifies opportunities for technology improvement and integration into healthcare education
- Conducts regular evaluations and critiques of programs, soliciting recommendations from both internal and external customers
- Provides consultation for research projects; guides and/or directs process. Effectively translates research outcomes into actions, working with others to improve overall quality and cost effectiveness of patient care
16
Clinical Documentation Specialist Rn Lvn Lakewood Regional Resume Examples & Samples
- Famililarity with coding concepts and coding software desired
- Knowledge of care delivery documentation systems and related medical record documents
- Working knowledge of Medicare reimbursement system and coding structures/national coding guidelines
17
Clinical Integration Specialist RN Resume Examples & Samples
- Facilitates appropriate clinical documentation to support diagnosis capture and to ensure the level of service rendered to all patients is recorded
- Identifies and reviews primary and secondary diagnosis and complications to ensure diagnosis documentation and capture through addendums may identify patients who need to be seen. Identify and review for POA (Present on Admission) documentation
- Reviews clinical issues with medical coding staff and with physicians to identify those diagnoses that impact severity of illness indicators for each patient
- Perform CDI reviews - concurrent, pre-bill and retrospective
- Serves as an expert resource in reviewing all medical records in support of consistent documentation for all payer types (i.e. CMS, Medicare-Advantage, etc.) to ensure complete and accurate diagnosis capture and coding
- This would include core measures and patient classifications and/or continued stay
- Reviews would include: 1) Identifying evidence of appropriate documentation of medical necessity to support the treatment plan and compliance with regulatory requirements and standards. 2) The documentation reviewed may include, but is not limited to: admission order, H&P, consultation, operative report, discharge summary, progress note, medication orders, and emergency department report. 3) Reviews for completeness, contradictions, omissions, and accuracy of medical, surgical, pathological, pharmaceutical and diagnostic documentation
- Collaborates in the development of programs which provide alignment with education for internal customers to support clinical documentation guidelines
- Communicates information effectively with medical center leaders
- Works with Coding Supervisor to develop, implement and monitor departmental policies and procedures that support organizational goals, business objectives, regulatory needs and requirements
- Conducts data and root cause analysis, provides feedback and shares findings on the analysis to leaders, local regional management and medical team
- Report all issues timely to Director, Health Information Management
- Monitor and track verbal and written queries and produce reports as required
- Minimum three (3) years of clinical experience (i.e. inpatient, clinical documentation, discharge planning or case management)
- Prefer two (2) years of experience as a Clinical Documentation Specialist
- CCDS/CDIP Certification preferred
- Proficient with coding classifications systems such as, but not limited to ICD-9 CM, MS-DRG, HCC
18
Esrd Renal Care RN Specialist Resume Examples & Samples
- Interaction with Various Teams including but not limited to: Function as part of a multidisciplinary team (nephrologist, nephrology department nurse, pharmacist, dietitian, social worker, administrative assistant) to develop, implement, manage, and evaluate the medical treatment plan and facilitate the flow of clinical information among care providers
- Facilitate continuity of care across Plan and non-Plan care settings, including medical centers, dialysis units, surgery centers, and hospitals. Conduct dialysis unit rounds quarterly and other on-site activities as needed and address/resolve any problems in conjunction with other members of the team
- Serve as liaison to contract providers and hemodialysis units and peritoneal dialysis clinics; visit hemodialysis units routinely and as needed to build relationships with staff, review charts and patient plans of care
- Monitor member demographics, utilization of services, quality of care, and clinical outcomes
- Participate in orientation and training of new members of the nephrology team
- Patient Related including but not limited to: Assess and monitor the impact of functional status on overall quality of life and response to treatment. Plan and provide early intervention when these factors impact negatively on successful treatment and patient outcomes
- Facilitate development of individualized member care plans; Collaborate with contract hemodialysis unit regarding abnormal quality improvement indicators; perform monthly lab and report card review
- Maintain regular contact with members during the renal clinics as needed. Provide telephone support to inquiries from patients
- Collaborate with PD multidisciplinary clinics and follow up activities with patients
- Educate patients and their families to ensure understanding of dialysis modality, nutrition, and medications, increase compliance with treatment plans, and maximize self-care abilities. Provide consultative services for Health Care Teams on renal disease management theory and practice
- Coordinate with appropriate Health Plan staff to ensure compliance with benefit plan provisions, Medicare eligibility, and the use of contracted, credentialed providers. Participate in selected referral processes, ensuring eligibility verification and appropriate documentation in all relevant data systems
- Consistently communicate and document all patient care activities in compliance with organization and department guidelines
- Refer members to education services on co-morbid conditions, as appropriate
- Manage clinical parameters including but not limited to: Perform continuous dialysis outcome and vascular access surveillance for assigned panel of patients. Aggressively screen for patients at risk for poor outcomes or imperiled vascular access and facilitate problem solving among multiple providers and systems
- Implement and manage comprehensive assessment tools, processes, clinical pathways, and clinical guidelines to evaluate patient's plan of care, including processes to identify and correct deviations from optimal clinical pathways. Identify, analyze and decrease barriers that may affect patient outcomes
- For patients who demonstrate high-risk for maladaptive utilization patterns, monitor and ensure implementation of complex outpatient treatment plans. Coordinate with ambulatory case management staff on issues not directly related to dialysis/transplant
- Ensure safe transitions across care settings from outpatient dialysis to hospital to SNF back to outpatient
- Identify opportunities for and facilitate implementation of changes in renal care practices that increase efficiency in the delivery of quality care
- Coordinate and assist with the planning, implementation and evaluation of ongoing educational programs for members and their families
- Assure that medical records are present and complete
- Assure clinical goals are met or that corrective actions are taken; document such goals and actions
- Participate in Quality Indicators/Quality Management Process
- Practice and promote innovative practice within ethical and legal guidelines using established policies and procedures. Maintain confidentiality of patient records, information, and departmental activities involving patient information
- Three (3) years of clinical experience including at least one (1) year of recent nephrology nursing experience required. Additional years of relevant disease, or case management experience may be substituted for nephrology experience
- Two (2) years of recent dialysis nursing preferred
19
Rn-practice Specialist Resume Examples & Samples
- Manages the work of all project participants, including outside consultants and other department staff, when used
- Serves as a content expert for responsible area of expertise
- May provide expert consultation to multiple projects at any given time
- Provides leadership and direction in accordance with the overall strategic direction of the department and organization
- Develops clear project plan that allows teams to achieve desired outcomes
- Oversees work to ensure high quality deliverables and adherence to timeframes and budget (when applicable)
- Identifies areas where specialty expertise may enhance work of department
- Contributes to a team environment that encourages collaboration, supports receiving and providing feedback and encourages participation from all levels of staff
- Adapts management style as appropriate to meet needs of a particular situation or team resulting in optimal performance
- Encourages staff participation in non-project related activities that support culture and values of the department and individual development
- Models behavior that staff wants to emulate
- Ensures that all communications produced under his/her direction are timely and of high quality
- Participates in the development and management of department staff through coaching, providing and encouraging feedback, consistent application of department policies and procedures, conducting project based performance reviews, and other departmental activities
- Participates in development of staff through the sharing of new techniques and problem solving approaches specific to their area of expertise
- Participates in the development and implementation of department-wide activities that support the culture and values of the department
- Registered Nurse licensed in the State of California preferred
- Health Plan Utilization Management experience preferred
20
Ecmo RN Specialist, Ecmo Dept Per Diem / Call Resume Examples & Samples
- Assists as needed in the assembly, priming, initiation, and discontinuation of the ECMO circuit according to policy and procedure
- Maintenance and shift responsibilities as to ECMO Circuit and the ECMO Patient
- Assists in data collection and research activities related to ECMO
- Members of the ECMO Per Diem position will be required to maintain eight hours of ECMO education per month including but not limited to wet drills, priming, and staffing
- Assumes responsibility for staffing his/her scheduled shift coverage if replacement is needed
- Monthly mandatory ECMO Specialist Meeting attendance (75% required)
21
Documentation Specialist RN Resume Examples & Samples
- Louisiana RN license is required
- Experienced in coding and DRG assignment
- Prefer CCDS certification
- Experience in Clinical Documentation Program for at least one year
- Ability to effectively communicate with physicians
- Excellent prioritization and organizational skills
22
Clinical Practice Specialist Rn-multiple Counties Resume Examples & Samples
- Current unrestricted RN licensure in Missouri
- 5+ years clinical experience in any setting
- Must be self - motivated and have ability to work autonomously
23
CDI RN Specialist, Seton Medical Center Resume Examples & Samples
- Intermediate knowledge of MS-DRG classification and reimbursement structures
- Understand and communicate documentation strategies
- Ability to maintain an auditing and monitoring program as a means to measure query process
- Preferred: Acute Care nursing relevant experience
- Zero (0) to two (2) years’ experience
24
Clinical Specialist RN Resume Examples & Samples
- The Clinical Specialist performs telephonic initial assessment and counseling to new patient referrals on their disease process, prescribed drug action, common side effects and treatment parameters
- Provides patient education directly or in response to telephonic inquires to ACS patients
- Patient education will include but will not limited to the following areas: Chronic disease states such as , Oncology, Asthma, Multiple Sclerosis, Cancer, Hepatitis C, Rheumatoid arthritis, Psoriasis,Current treatment modalities, Common side effects and management, Injection or injection device trouble shooting, Adherence monitoring and outbound calls
25
Rn-infection Control Specialist Resume Examples & Samples
- Two years as critical care nurse or other specialized nursing unit
- Two years as medical technologist
- Able to extract information from the hospital computers, and from the specialized software used for Infection Control
- Able to enter data into the specialized software used for Infection Control
26
Clinical Documentation Specialist RN Resume Examples & Samples
- Current RN License or CDIP/CCDS, CCS/RHIT/RHIA eligible
- Minimum of 5 years experience in an acute care setting as Registered Nurse or inpatient coder
- Experience in Critical Care, Medical/Surgical or Emergency department nursing preferred
27
Clinical Documentation Specialist, Rn-him Resume Examples & Samples
- BSN, RN, or comparable clinical degree. English is required for both verbal and written communication
- Must possess at least five years of acute hospital nursing experience (e.g. medical/surgical unit, intensive care). Experience in Utilization Management/Case Management, Critical Care, patient outcomes/quality management and/or inpatient coding considered a plus
- ICU/Critical Care experience strongly desired
- Prior experience educating physicians/providers preferred
- Previous experience working in a clinical documentation improvement department or as a consultant strongly encouraged
- Minimum of one-year auditing experience strongly encouraged
- This individual must possess a comprehensive knowledge of medical terminology, disease processes and clinical competency
- Candidate must possess excellent communication (verbal and written), interpersonal, collaboration and relationship-building skills
- Strong critical thinking skills and ability to integrate knowledge is necessary
- Prioritization and organizational skills required
- Must exhibit the ability to educate members of the healthcare team about clinical documentation
- Individual must demonstrate data quality and integrity skills
- At least one of the following is required: BSN, RN, or comparable clinical degree
- In addition, the following are highly desired: RHIT, RHIA, CDIP, CCDS, CCS and ICD-10 certification or designation
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LTC Field Clinical Assessment Specialist, RN Resume Examples & Samples
- Conducts home/facility visit(s) for comprehensive health re-assessments regarding clinical, behavioral and home safety requirements on existing members
- Identifies applicant's health needs and completes medical assessment of applicant
- Tracks assessment schedule and updates assessments in a timely manner
- Initiates direct communication with health care providers involved in care of the applicant to obtain complete and accurate information as needed
- Collects information concerning ongoing eligibility
- Coordinates with Care Management team and provides updates regarding member health status
- Inputs visit and assessment data into systems
- Adheres to all HIPPA standards and confidentiality requirements
- Valid Drivers license may be required
- Required An Associate's Degree in Nursing or related field
- Required 2+ years of experience in a clinical acute care setting, preferably in home health and/or geriatrics
- Required Other Current case management experience
- Intermediate Ability to work independently
- Intermediate Ability to multi-task Ability to work independently, handle multiple assignments and prioritize workload
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Clinical Documentation Specialist RN Resume Examples & Samples
- Reflects HCA’s mission and values. Maintains sensitivity and commitment to HCA’s ethics and compliance principles (Code of Conduct) in his/her daily activities/conduct
- Maintains and protects confidentiality
- Reviews medical records and identifies potential gaps in clinical documentation for specified facilities, patient types and payer populations, as directed on admission and throughout the hospitalization
- Performs initial concurrent review of assigned population consistent with Facility, Division, or Corporate program volume and frequency requirements
- Performs follow-up reviews consistent with Facility, Division or Corporate program volume frequency requirements
- Assigns working DRG based upon identification and selection of principal diagnosis, complications or co-morbid conditions and/or valid OR procedures, including capture of POA indicators
- Ensures documented conditions, clarifications, and coded diagnoses are clinically supported
- Documents reviews and other pertinent information in designated systems by established deadlines
- Uses clinical judgement to determine when and/or if a query is necessary
- Queries physicians within established timelines via approved query forms for conflicting, imprecise, incomplete, illegible, or inconsistent documentation by requesting and obtaining additional documentation within the health record when appropriate
- Uses clinical judgement to determine appropriate and relevant clinical indicators and to discern appropriate reasonable diagnostic options when formulating non-standard queries
- Interacts with Physicians to complete/resolve queries prior to patient discharge
- Collaborates with the Parallon HSC to assure accurate DRG assignment and billing
- Performs reconciliation of CDI-assigned DRG against final coded DRG
- Escalates DRG mismatches as appropriate per established protocols
- Develops collaborative relationships to facilitate accomplishment of work goals
- Possesses excellent interpersonal skills in building, negotiating, and maintaining crucial relationships
- Demonstrates a willingness and ability to assist others
- Uses critical thinking skills and independent discretion to analyze and interpret query trends/responses and to identify other education opportunities
- Compiles, creates and delivers education to physicians and other key healthcare providers
- Provides ad hoc education upon request
- Demonstrates knowledge of Official Coding Guidelines and the DRG Classification System to insure compliance with such regulations as they relate to the CDI function
- Achieves and maintains a minimum accuracy rate consistent with Facility, Division, or Corporate program requirements
- Participates in the analysis and trending of statistical data to identify opportunities for improvement
- Represents the CDI function in other facility quality/monitoring activities
- Demonstrates proficiency in current and emerging technologies
- Completes all mandatory and assigned education by established deadlines
- Attends scheduled meetings and continuing education programs
- Seeks learning opportunities in areas of self-defined needs
- Independently takes prompt proactive steps toward problem resolution
- Associates Degree in Nursing required, BSN preferred
- 5-7 years in Case Management, Quality Review and/or other related clinical experience in an acute care environment
- Current RN license required
- Critical Care, ER, or OR experience preferred
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Dictation Specialist / RN Resume Examples & Samples
- Reviewing and filing all dictated reports
- Ensuring the accurate and timely completion of discharge summaries
- Dictating discharge summaries for physicians
- Demonstrate knowledge of discharge summary requirements as established by SSBTS's rules and regulations
- Assist internists and provide clerical support to the Medical Records Dept
- Assemble and audit discharged patient records and abstract information and data
- Follow SSBTS time and attendance policy
- Will adhere to all safety policies and safe work practices
- Will adhere to all hospital policies and procedures
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Hedis Clinical Practice Specialist Rn-northern MO Resume Examples & Samples
- Supports quality improvement program studies requesting records from providers, maintaining databases, and researching to identify members' provider encounter history
- Knowledge of one or more of: clinical standards of care OR preventive health standards, OR HEDIS, OR NCQA, OR governing and regulatory agency requirements, and the managed care industry
- Bilingual - English / Spanish
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Hedis Clinical Practice Specialist RN Resume Examples & Samples
- Educates providers and office staff on proper coding and billing practices, HEDIS and state - mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria. Solicit identification of barriers the office faces in providing care to members
- Performs annual medical record evaluation, follow - up education, practitioner intervention, measurement (QI 13) as required
- Must be able to travel up to 75% of the time to client and / or patient sites within a designated area
- Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft Outlook, and Internet browsers
- Experience working in Medicaid and / or Medicare health care and insurance industry, including regulatory and compliance requirements
- Ability to interact with medical staff, peers, and internal company staff at all levels
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Licensing Specialist Rn Endorsement Resume Examples & Samples
- Considerable experience working within an office environment
- Considerable knowledge of office procedures and practices, including automated/hard copy file maintenance is required
- Working knowledge of licensing principles and practices within a regulatory office environment
- Demonstrated ability or have the ability to develop a considerable knowledge of state laws, regulations and policies pertaining to licensing or regulation of professions
- Ability to apply this information in response to customer contacts, via phone or written correspondence
- Ability to problem solve, work independently and research relevant documentation to ensure quality service
- Strong ability to effectively and tactfully communicate orally and in writing
- Demonstrated interpersonal skills and ability to work cooperatively with others in a team environment
- Strong data entry skills and skills in the use of personal computers/automated information systems; and
- Skill in using Microsoft Office Suite
- Previous experience as a licensing specialist in a regulatory office environment is strongly preferred
- Some college coursework in business or equivalent curricula to include office practices, data entry or information systems
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Rn-denial Specialist Clinical Resume Examples & Samples
- In conjunction with and following established Case Management Standards submit requests for authorizations Pre-Discharge/Time of Service
- Perform concurrent reviews and Peer-to-Peer reviews with payor
- Investigate all concerns for improper billing/coding practices and when necessary recommend corrective action
- Review and perform all retrospective inpatient authorizations of days of stays
- Reviews, investigates and appeals all clinical level denials such as not medically necessary surgeries, inpatient stays or levels of care
- Communicates results of audit/review results timely
- Audit Medical Records to retrieve clinical information requested from payors, governmental agencies, etc
- Responsible for working the APC/Cross Dependency and Alert items on daily reports that pertain to billing/coding
- Draft (in conjunction with a physician reviewer when indicated) appeal letters
- Review clinical documentation relative to approaching/potential stop loss accounts
- Assist and conduct audits as requested pertaining to the review of clinical documentation
- Working knowledge of all facets of insurance claim filing, requirements and regulations
- Proficient with department software, analytical tools (Excel, Access, Power point), basic coding and billing knowledge, and revenue cycle operational policies
- Works with SSC and ancillary areas to understand denial/appeal management processes, APC, Cross dependency and alert edits/rejections
- Identifies trends with denials and provides communication and education to all necessary parties
- Communicates with all parties in a professional manner to alert specific problem issues
- Ensure confidentiality of all patient accounts by following HIPAA guidelines
- Adheres to compliance of CMS and other payor guidelines
- Attend in-services, education sessions and department meetings as scheduled
- Licensed as an RN, LPN or LVN (must possess and maintain a current nursing license)
- Bachelor’s degree desirable, but equivalent job experience will be considered
- Coding Certification – AAPC or AHIMA
- At least 3 years of experience as a case manager is desired or at least 3 years providing discharge planning and care planning in a clinical setting
- At least 2 years of relevant or related experience with medical necessity appeals at all levels
- Working knowledge of the revenue cycle
- Working knowledge of medical terminology and/or insurance claim filing experience
- Detail oriented, analytical and ability to problem solve
- Working knowledge of Microsoft Word and Excel or equivalent
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Clinical Documentation Specialist RN Resume Examples & Samples
- Facilitates concurrent modifications to clinical documentation supporting compliant and accurate documentation of medical conditions being monitored and treated during the inpatient stay
- Demonstrates knowledge of DRG payer issues, documentation opportunities and coding guidelines
- Communicates with the individual physicians and medical staff to facilitate complete and accurate documentation of the inpatient record
- Improves the overall quality and completeness of clinical documentation through daily review of medical records and ensures accuracy and completeness of clinical documentation used for measuring and reporting physician and hospital outcomes
- Conducts follow up reviews of clinical documentation to ensure points of clarification have been recorded in the patient's chart. Reviews clinical issues with coding staff and nurses to ensure appropriate inpatient technical diagnosis and procedural coding
- Educates internal customers, including physicians, nurses and other members of the healthcare team regarding clinical documentation opportunities, coding and reimbursement issues, as well as performance improvement methodologies
- Is accountable for gathering and analyzing information pertinent to the documentation process, findings and outcomes in compliance with coding and regulatory guidelines
- Maintains thorough and current knowledge of clinical care and treatment of assigned patient populations to critically assess appropriateness of documentation
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Breast Care RN Specialist Resume Examples & Samples
- Responsible for coordinating and tracking breast health services including screening, diagnosis, and treatment by radiology and surgery
- Tracks all "medical center" performed normal and abnormal mammograms, surgical consults, biopsies, and mastectomies for breast health outcomes
- Works with leadership of Women's Health to develop methods to incorporate Breast Health Tracking for Network members who are cared for outside the medical centers
- Facilitates required diagnostic and follow-up care appointments for women in Breast Health Tracking per MQSA/FDA standards
- Collaborates with physicians various methods to communicate to members the results of screening, diagnoses, and required follow-up for breast health tracking via telephone calls, letters, and educational material
- Documents in Breast Health Computer System all appropriate information for Breast Health Tracking. Runs various reports from the BH Computer System for physicians, radiology, health care teams, QA dept
- Communicates and consults with the Radiologists and Surgeons regarding member treatment plans and/or for member information and questions
- Disseminates educational material to members regarding importance of preventive care and specific information about breast health issues both normal and abnormal findings
- Develops, implements, and monitors a comprehensive patient self-help education program addressing patient's understanding of risk factors, level of knowledge of signs and symptoms of abnormalities of the breast
- Participates in the evaluation of patient and practitioner satisfaction survey of Breast Health Tracking Program
- One (1) year of recent experience in women's health arena required
- One (1) to two (2) years of case management or similar experience preferred
- BSN or health related field preferred
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Patient Transition Specialist, RN Resume Examples & Samples
- Ensures compliance with all state, federal, and CHAP referral/intake regulatory requirements
- Directs the implementation of improved work methods and procedures to ensure patients are admitted in accordance with policy
- Establishes and maintains positive working relationships with current and potential
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RN, Professional Development Specialist Resume Examples & Samples
- Provides and facilitates training and educational programs for clinical and medical office staff across the KPGA Region
- Designs training curriculum (manuals, presentations, e-learning) using instructional design and adult learning principles
- Conducts learning needs assessment of the clinical staff to identify gaps and target training / educational initiatives
- Researches and writes evidence-based clinical lesson plans that include measurable objectives and teaching strategies appropriate for the adult learner
- Employs high quality delivery and presentation skills in a classroom environment, using audiovisual and technical equipment skillfully
- Conducts individual coaching and feedback to support reinforcement of learning
- Minimum one (1) year of experience in a teaching / training environment
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Clinical Services RN Specialist Resume Examples & Samples
- Perform all phases of therapeutic apheresis procedures, ensuring safe and appropriate care of patient in both inpatient and outpatient settings
- Assess patient status relative to therapeutic apheresis, prior and during procedures, utilizing nursing process. Patient assessment to include laboratory testing results and other clinically significant procedures
- Coordinate closely with physicians and nurses at a variety of hospitals to arrange therapeutic apheresis treatments and facilitate coordinated care
- Evaluate patient medication for compatibility and safety of apheresis procedure and determine when to contact the physician
- Assemble, restock, QC and maintain supplies and equipment in a state of readiness to maintain a clean, safe and efficient work environment
- Registered nurse with current state licensure as required
- A minimum of one year experience in medical/surgical or critical care nursing is required
- Good verbal communication skills and the ability to effectively discuss procedures and medical issues with patients, families, and physicians
- Previous apheresis or dialysis experience is preferred
- Customer service experience, effective verbal communication and public relation skills are preferred
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RN Specialist Resume Examples & Samples
- 1) Receives referral and leverages clinical and condition pathway knowledge for outreach stratification
- 2) Conducts clinical assessments with members and providers; gathers, analyzes, synthesizes and prioritizes member needs and opportunities
- 3) Collaborates and communicates with the health care team; e.g. member, family, designated representative, health care provider on a plan of care that produces positive clinical results and promotes high–quality, cost effective outcomes
- 4) Identifies relevant BCBSMN and community resources and facilitates program and network referrals
- 5) Monitors and evaluates plan of care over time
- 6) Ensures member data is documented according to BCBSMN application protocol and regulatory standards
- 7) Maintains outstanding level of service at all points of customer contact
- 8) Understands divisional goals of assigned condition and market segment(s) including clinical and service availability
- 9) Collaborates and coordinates with team members to facilitate day to day functions and enhance the overall operation of the department
- 10) 10 CEU’s per year within specialty area for knowledge base maintenance OR current certification in clinical specialty. Based on learnings, provide educational sessions for care management teams
- 11) Engage providers telephonically in reviewing and understanding treatment plans, including alignment with benefits and medical reimbursement policies to facilitate optimal treatment plans, care coordination, and transition of care between settings
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Trauma RN Data Specialist Resume Examples & Samples
- Bachelor of Science in a clinical, health-related field
- Minimum of 3 years experience in acute care environment (ED/ICU)
- Georgia Registered Nurse License
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RN Admissions Specialist Hospice Resume Examples & Samples
- Receives and processes requests for screening patients regarding Hospice services to facilitate patient admission to the program
- Facilitates meeting with referred patients/families, hospice team members and facility care management staff to review Hospice philosophy, services and reimbursement issues
- Responds to emergency situations in the home identified during screening process
- Review patient medical record and history and consult with Medical Director/Hospice physician to determine hospice eligibility
- Collaborates with Clinical Managers for assignment to complete intake assessments
- Obtains pertinent data and signatures to complete admission process and applies insurance information appropriate for each referral
- Confirms appropriateness/authorization along with initial orders for
- Hospice care with primary physician and determines ICD codes
- Forwards completed forms and consents to Hospice Intake staff to initiate medical record
- Reviews patient medications consulting with Medical Directors
- Requests needed medications from pharmacy and documents medications in the patient's medical record
- Orders DME according to patient's need and in consideration of the environment
- Coordinates and follows-up with insurance verification of services
- Maintains communication with Interdisciplinary team members
- Communicates regularly with Program Director and Intake/Admissions Manager regarding concerns identified in intake process
- Provides interdisciplinary team members with pertinent information regarding patient/family in the intake process
- Develops relationships with referral sources
- Collaborates with Program Director and Intake/Admissions Manager to establish plans regarding issues from physicians, discharge planners and other referral sources
- Identifies and reports to Program Director and Intake/Admissions Manager contributing barriers to patient referrals
- Facilitates hospital discharge/hospice admission with hospital care management team
- 1 to 3 years experience required
- 2 years of Med- Surg/Home Care/Hospice experience preferred
- Knowledge of third-party reimbursements (Medicare, MA, Private insurance.), Demonstrates ability to determine hospice eligibility through performance of patient assessment and review of medical record/history
- Knowledge of ICD-9 codes and NHPCO diagnosis worksheets
- Critical Thinking: Gathers and integrates critical information, recognizing and addressing underlying assumptions of others, to arrive at effective solutions
- Breaks down problems into simple tasks or activities
- Analyzes relationships among several parts of a situation
- Decision Making: Makes timely, informed decisions that take into account the facts, goals, constraints and risks
- Patient Advocacy: Gathers information that reflects the patient's perspective
- Advocates and brings resolution to customer concerns
- Effective in mediating with third party payers on behalf of the patient
- Problem Solving: Identifies problems
- Determines accuracy and relevance of information
- Utilizes appropriate tools and staff resources along with sound judgment to generate and evaluate alternatives, and to make recommendations
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Clinical Documentation Specialist / RN Resume Examples & Samples
- Knowledge of regulatory documentation requirements as specified by federal, state, payer and other agencies
- Review of records against B-Tag standards and other appropriate criteria sets and clinical guidelines
- Conducts medical necessity reviews in real time with immediate feedback and corrective actions
- Utilizes software applications for data collection and analysis to produce and distribute reports
- Works with Risk/PI Director on preparing and submitting B-Tag reports to the Quality Council with related Action Plans
- Works with Intake, Medical, Nursing. Clinical and Utilization Management staff to ensure that medical necessity criteria are met and are clearly documented
- Assists staff with identification of deficiencies with clinical records and assists in training for improvement
- Provides ongoing in-services on all shifts specific to chart audit deficiencies
- Attends treatment team meetings on a rotating basis to ensure the team is following the treatment planning process with clearly written behavioral
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RN CDI Specialist Resume Examples & Samples
- Record Review: Completes initial medical records reviews of patient records within 24-48 hours of admission for a specified patient population to: (a) evaluate documentation to assign the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate MS-DRG assignment, risk of mortality and severity of illness; and (b) initiate a review worksheet
- Conducts follow-up reviews of patients every 2-3 days to support and assign a working or final MS-DRG assignment upon patient discharge, as necessary
- Collaborates with case managers, nursing staff and other ancillary staff regarding interaction with physicians regarding documentation and to resolve physician queries prior to discharge
- Assist in training department staff new to CDI
- CDI: Communicates/Completes Clinical Documentation Improvement (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution
- Regular and reliable attendance and time reporting per Conifer
- Telecommuting program requirements
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RN Regional Clinical Specialist Resume Examples & Samples
- Five (5) years of experience in delivery and administration of correctional medical
- Five (5) years administrative, management and supervisory experience in correctional nursing
- Organizational experience in operations and planning
- Experience in understanding and managing budgets and analyzing contracts
- Assumes the role of site leadership within operations as needed
- Monitors the implementation and effectiveness of procedures and programs throughout the company
- Evaluates statistical data, programing needs and problems throughout the company, assists in planning of the nursing orientation, nurse in-service training, and continuing education within the company, program needs and makes recommendations for improvements
- Develops, utilizes, revises, interprets, and ensures compliance with CCS and facility policies and procedures, ACA, NCCHC, maintains professional relationships within the company
- Demonstrates knowledge and performance of nursing policies and procedures: Supports philosophy, objective and goals of nursing program. Accepts assignments and performs other related duties as required or assigned by the Company. Preforms in accordance with the Nurse Practices Act and Nursing Code of Ethics
- Promotes good working relationships among nursing staff and between other disciplines and departments and with patients, and a good working relationship with Regional Managers, facility administration, CCS employees, correctional personnel, contracted providers and outside agencies
- Assists in ensuring adequate staffing at institutions to meet the needs of the inmate population as well as adhering to staffing plans
- Completes and submits daily, weekly, monthly and annual reports in a timely and accurate manner
- Monitors in-patient hospitalizations closely with utilization management for assigned sites
- Assists in monitoring all sentinel events and potential catastrophic illnesses and explores/utilizes all appropriate means of limiting both CCS and contractor's liabilities
- Meets with designated wardens, deputy wardens, and facility administration on a regularly scheduled basis and serve as backup to H.S.A.s to participate in MAC/QI/P&T and other required meetings as needed
- Ensures, where available, NCCHC accreditation of the medical program by ensuring the presence of the required level or organizational efficiency and the provision of approved and appropriate medical services
- Identify problem areas of operations and propose solutions. Conducts ongoing evaluation of services and health care programs, proactively identifies potential problems and assists in developing corrective action plans
- Accepts on-call status
- Attends seminars, workshops, and conferences
- Must be able to travel overnight for two to ten days or more as may be required by division/region needs
- Promotes Quality Improvement standards by actively participating in the quality care screen audits
- Post Orders, if applicable, per site contract
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Sepsis Specialist RN Resume Examples & Samples
- Performs detailed case reviews and root cause analyses for major deviations from protocol
- Reviews and develops critical care policies, procedures, and protocols as appropriate
- Develops and manages to project plan, ensuring that project plan aligns with program plan
- Helps identify, recruit and lead the project team to ensure stakeholder representation, as well as project support staff from other departments (e.g., mission integration, human resources, change management, IT, communications)
- Ensures appropriate and timely communication and performance reporting with affected stakeholders and partners. (internal and external)
- Ensures demonstrable success criteria before moving project to the next phase (i.e., toll gates)
- Follows change control process if changes required to scope, timeline, resources and/or budget
- Prepares for and conducts team meetings
- Ensures knowledge and visual program management for program that is updated routinely and utilized for performance improvement related to focused clinical outcomes like sepsis.
- Proficient in use of the electronic medical record and other approved support documentation sources
- Excellent interpersonal relationship skills and ability to work with and influence others
- Highly organized and efficient
- Proficient understanding of healthcare terminology and care delivery processes in inpatient and outpatient settings
- High Level proficiency of MS applications (e.g., PowerPoint, Excel)
- Ability to analyze data, consciously recognize any errors present and develop executive summaries based on interpretive findings; demonstrated ability to execute analytical thought processes
- Strong quantitative analysis, root cause analysis, logical structuring and business case development skills
- Ability to work well independently and as part of a team; excellent networking and relationship-building skills
- Ability to translate data and findings into information and display it in a useful manner for constituents
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Hc Specialist Supervisor Rn Resume Examples & Samples
- Identifies opportunities to further assist customer needs with Meridian At Home services and continually supports growth of all product lines
- The Home Care Specialist Supervisor functions as a team supervisor and as a clinical resource for the team and ensures open communication to operations
- Responsible for processing all assigned incoming referrals for Meridian At Home product lines (Home Health, Infusion, Hospice, Private Pay and Technology) by utilizing the team model
- Responsible for assessing patient eligibility for the specific program by performing a review of all clinical and insurance information, obtains necessary documentation to support clean billing, requests completed face to face document (if not yet obtained), and assures adherence to regulatory requirements
- Accountable for clinically complete referrals initiated by team members and process all assigned referral efficiently and accurately
- Responsible for distributing work evenly among team members
- Acts as a Liaison between MD offices and external facilities demonstrating customer service skills while assuring clinical documentation to support home care referrals
- Responsible to maintain all assigned reports
- Assures team meets 95% audit accuracy for assigned referrals
- Registered nurse for 2 years
- Infusion and or Hospice experience preferred
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RN Infection Control Specialist Resume Examples & Samples
- Knowledge of infectious diseases and proper techniques and care to use to minimize risk
- Skill in coordinating risk assessments and communicating protocol to follow
- Ability to effectively present information and respond to inquiries or complaints from employees, patients and/or their representatives, and the general public
- Ability to comprehend and apply principles of statistical theory
- Ability to interpret and deal with several abstract and concrete variables
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Wound Specialist RN Resume Examples & Samples
- Certified in CWOCN
- Current and in good standing RN, license in Washington State
- Current CPR certification and negative TB screen
- Daily access to an insured, reliable vehicle
- Clinical expertise established in Home Health, or Outpatient care
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Advanced Rn Practitioner Specialist Resume Examples & Samples
- Intermediate to Advanced computer skills and knowledge of computer programs(Microsoft Word, E-mail, Internet and Excel)
- Ability to establish and maintain effective working relationships, customer service skills, communicate verbally in a courteous and effective manner
- Knowledge of Health Management System – Clinical Information System
- Knowledge of nursing principles, practices and techniques
- Knowledge of Electronic Health Record
- Knowledge of Electronic Lab (Emdeon)
- Knowledge of Electronic Prescribing(E-scribe)
- Ability to effectively interview and assess the health social needs of clients
- Ability to perform a complete physical assessment and evaluation for patients appropriate to training
- Ability to initiate treatment plan according to established protocols
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Advanced Rn Practitioner Specialist Resume Examples & Samples
- Knowledge, skills and abilities, including utilization of equipment, required for the position
- Knowledge of the principles and practices of program management and delivery of mental health services
- Knowledge of mental health, psychiatric principles, practices and techniques
- Knowledge of human anatomy and physiology
- Ability to perform complete psychiatric and mental health assessments of patients
- Ability to manage mental health disorders and care of patients
- Ability to identify and evaluate illnesses and/or disorders
- Ability to compile and evaluate mental health assessments, medical histories and other clinical and laboratory data
- Ability to initiate diagnostic laboratory tests and evaluate the results
- Ability to prescribe/alter and administer appropriate medications for specific illnesses
- Ability to work with patients having a variety of mental psychiatric disorders and physical problems
- Ability to plan, organize, and coordinate work assignments
- Ability to apply the consultative process in problem-solving activities
- Ability to develop and implement various program monitoring methodologies and techniques
