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Linda
Bearer64@gmail.com
330-607-0467
198 Edgemont RD
Ligonier, PA 15658
21 years experience W2
0
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Average rating
6
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Summary

  • Licensed Practical Nurse with 35+ years experience
  • Both skilled patient care and management which includes many diversified responsibilities

Experience
Jan 2020 - present
Private duty nursing-Per Diem
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Excela Health
Dec 2020 - Apr 2021
Harmony Home Health, Irwin, PA
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Home Care Nurse
Medical Devices
Jan 2019 - Dec 2019
Nursing
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Home Care Nurse
Medical Devices
Jul 2015 - Jan 2018
  • Physical assessments
  • Wound care
  • Medication and disease process teaching
Nursing
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Jan 2015 - Jan 2016
HEDIS review
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Care Manager
Jan 2015 - Jul 2015
  • Personal health assessment
  • Medication management
  • Disease management teaching
  • Coordination of care
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DRG Clinical Documentation Specialist
Medical Devices
Mar 2012 - Mar 2014
Barberton and Wadsworth DRG Clinical Documentation Specialist
  • Reviews all DRG paid accounts concurrently on nursing units to assure appropriate principal and secondary diagnosis affecting reimbursement.
  • Using extensive clinical, coding and compliance knowledge to educate coding management and staff, physicians and ancillary departments of clinical documentation needed to support coding guideline and DRG appropriateness.
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Medical Devices
Sep 2006 - Oct 2009
Clinical Case Manager, Utilization Review Nurse
  • Case Managed Medicaid/Medicare hospitalized members while focusing on patients to evaluate and interpret clinical and utilization data
  • Identified areas of improvement and focused on interventions to improve outcomes in the most appropriate timely and cost effective manner
  • Detailed oriented in the responsibility for the performance of utilization review services including concurrent utilization review with DRG validation and initiating discharge planning with hospital social workers and nursing staff at time of admission
  • Interfaced with proven communication skills in working with internal and external agencies/representatives to the utilization process including, Hospice and home health agencies, DME, providers, skilled nursing facilities and LTAC providers, hospitalization medical management directors, social service workers, nursing staff and BCHP medical directors
  • Conscientious for accurate completion of case data in CCMS managed care system as well as the accurate and timely generation of required correspondence/review notification
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Utilization Nurse
Medical Devices
Nov 2000 - Jan 2007
  • Case Management
  • Correspond with private and public insurance companies including MMO, Aetna, United Health Care, and Medicare/Medicaid
  • Interact with home health agencies, physicians, hospital discharge planners, and clinics
  • Pre-certification and pre-authorization case load of 100 +
Case Management Home Health Medicaid Medicare Nursing Utilization Review
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Edit Skills
Non-cloudteam Skill
Education
Practical nursing
Johnstown School of Practical Nursing
Nursing classes
Excelsior College New York
Certifications
Licensed Practical Nurse with 35+ years experience
LPN License
IV/Infusion therapy certified LPN
CPR certification
Skills
Nursing
2019
10
Case Management
2007
7
Home Health
2007
7
Medicaid
2007
7
Medicare
2007
7
Utilization Review
2007
7