PruittHealth (PH) was the 14th largest skilled nursing provider in the U. S. providing exceptional care across a wide spectrum of services including: skilled nursing care, assisted & independent living, home health care, end-of-life hospice care, rehabilitation, pharmacy/infusion services & more.

• Managed eleven PH facilities with a case load of up to 100+ patients
• Facilitated initial & retrospective reviews by extensive clinical evaluation & InterQual to establish patient appropriateness for SNF admission
• Utilized protocols & Medicare guidelines to ensure appropriate utilization of services for specific patient populations.
• Performs telephonic & electronic review of clinical data for medical necessity & appropriateness of care to complete & oversee insurance updates & appeals processes
• Communicated with several agencies, insurance companies, case management companies & peer review companies to ensure payment for services provided
• Notified the resident &/or responsible party of discontinuation of skilled services per Medicare guidelines & issued Notice of Medicare Non-Coverage (NOMNC)

• Responsible for daily rounds at referring facilities, including two 350+ bed hospitals & two LTACs
• Established & maintained positive relationships with referral sources to promote services by providing superior customer service
• Communicated information effectively & efficiently to physicians, supervisors, facility administrators, pharmacists & any pertinent personnel
• Managed the referral process by responding to electronic & verbal referrals in a timely manner
• Facilitated the gap between hospital stay & the next steps after surgery, injury or illness by identifying the appropriate payer source (commercial insurance, medicare, medicare replacement plans, medicaid & self-pay) & completing the prior authorization process, benefits verification & pre-admission requirements for each referral
• Evaluated patient clinical information in order to obtain insurance approval as well as to match patient needs with the appropriate facility & services
• Collaborated with patients, families, care managers, multidisciplinary providers, benefit specialists, behavioral health specialists, pharmacists, vendors, & social services to ensure seamless transfer to the facility & to enhance member satisfaction, conserve time & resources, identify barriers, improve outcomes & reduce avoidable readmissions
• Achieved individual monthly admissions quota as well as proposed company & census objectives
• Applied clinical & business skills to build strategies for identifying & growing new business

• CRMC is a 99-bed acute care hospital with a 10-bed ICU.
• Provided patient care through assessment, planning, implementation & evaluation for the following patient care populations: geriatrics, adult, & adolescents
• Responsible for the delivery of safe, therapeutic & cost effective nursing care
• Provided & planned comprehensive patient care by participating as a collaborative member of the healthcare team, relating effectively with other shifts for continuity of care, maintain satisfactory relations with other departments-nursing units & provide thorough education
• Adhered to the rules & regulations of all local, state & federal agencies
• Maintained an atmosphere that ensures the mission, vision, values, code of conduct, goals, policies & standards of all accrediting bodies are consistently supported & enforced
• Delivered excellent communication, teamwork & customer service
• Performed/assisted with procedures: bronchoscopy, thoracentesis, chest tube placement/management
• Hemodynamic monitoring: arterial line, central line, swan gans catheter, cardiac output, cvp
• Cardiac rhythm analysis & arrhythmia recognition interpretation of lab results
• Respiratory ventilation: intubation, weaning, interpretation of arterial blood gas
• Chest tube placement & management
• Assisted with bronchoscopy & thoracentesis
• LifeLink organ procurement
• ICP monitoring, ventriculostomy & ventricular drain management
• NIH stroke protocol & TPA administration
• Therapeutic hypothermia
• Code procedure protocol, rapid response team
• IV therapy: critical drip management, administration of meds/TPN, blood products, starting IVs
• Wound & pain management
• Interpretation of lab results
• Floated among all critical care areas
• Documented care provided on paper, in Cerner, Meditech, McKesson, Soarian & on paper

• GSMC was a 333-bed acute care hospital, including an MICU & SICU.

• AMC was a Level 1 Trauma Center, including an MSICU, VICU, & CVICU.

• VRBH was a 312-bed regional health care system, including a CCU & CVICU.

• MH was a 418-bed acute care, for-profit hospital, including a CCU & CVICU.

BH was a 481-bed non-profit community hospital, including a CCU, MSICU & SICU.

• HCH was a 559-bed non-profit Catholic hospital, including an MSICU, Neuro ICU & CVICU.

• PGH was a 360-bed acute care, teaching hospital, including a CCU, ICU & SICU.

• SFH was a 376-bed non-profit Catholic hospital, including an ICU & MSICU.

• FHFM was a member of the Adventist Health System & a non-profit general medical & surgical hospital with approximately 175 beds, including a 21-bed MSICU.

• SGMC was a not-for-profit, 330-bed acute care hospital providing a number of services including a 20-bed MSICU.
• Floated among all critical care areas: IMCU, CPU, CICU
• Recognized for exemplary customer service & team spirit by receiving extra mile awards
• Served as a preceptor to new RNs/orientees in the ICU
• Including above responsibilities & duties

• Served tables at a locally owned, fast-paced fine-dining restaurant in Germantown, TN
• Acted as head server, trained new employees, closed down the restaurant at the end of the shift
• Prepared room for dining by clothing tables & setting decorations, condiments, candles, napkins, service plates & utensils
• Provided detailed descriptions of menu items, made suggestions & properly opened/poured wine at tableside
• Transmitted orders to bar/kitchen by recording patrons' choices & special requests
• Maintained table setting by removing courses as completed replenishing utensils/drinks/water observing the dining process
• Obtained revenues by upselling totaling charges issuing bill accepting payment delivering bill & payment returning change/credit card/signature slip to patrons
• Protected establishment/patrons by adhering to sanitation, safety & alcohol beverage control policies

Integrated customized supply management solutions that enabled healthcare professionals to deliver exceptional care. These solutions optimized supply purchasing & materials management. Planned & implemented business strategies, built strong customer relationships, anticipated emerging market needs & helped my customers gain a competitive advantage. Implemented profitable sales growth, increased market share & produced greater income.

• Developed strategies & marketing techniques to establish & maintain a new territory
• Grew sales from $0 to approximately $825K/year
• Worked with 3000+ manufacturers & group purchasing organizations to negotiate pricing
• Deep focus on customer retention & satisfaction
• Prepared bids, quotes & contracts for customers
• Participated in office set-ups, purchasing & delivery process
• Determined laboratory needs for physician offices & provided equipment & testing for offices
• Promoted injectable pharmaceutical products to physicians
• Responsible for managing time & meeting sales quotas

Sought, led & managed business development & operation initiatives for Network Provider relations of over 750 physicians & office staff. Business led on multi-faceted development projects & responsible for & recruiting providers. Participated in the full spectrum of the management process, including: staff, product & service development, sales pursuit & major provider account management. Specific responsibilities included:

• Assisted in network provider credentialing
• Established & maintained provider directories
• Provided educational opportunities to client companies, practitioners & office staff
• Responsible for daily account & program maintenance
• Scheduled & performed site visits to evaluate & suggest recommendations for updating OSHA & JCAHO regulatory compliance

• Served tables at a locally owned, fast-paced restaurant
• Same responsibilities & duties listed in Server position above

• Served tables at a locally owned, fast-paced fine-dining restaurant
• Same responsibilities & duties listed above

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