Quality Assurance Supervisor Resume Glen Allen, VA - Hire IT People

PROFESSIONAL EXPERIENCE

Telephonic Nurse Care Coordinator

Confidential, Richmond, VA

Confidential, Glen Allen, VA

Quality Assurance Supervisor

Responsibilities:

Review Field Case Manager cases and reports to ensure compliance wifin the guidelines of the insurance carrier. In - service education as needed to teach/review guidelines. Report, billing and coding corrections as required to maintain customer contract parameters. Creation of viable, condensed guideline summaries to assist the Field Case Managers to remain wifin contract guidelines. Internal quality assurance of over-all case to ensure company requirements for documentation are met or exceeded.

Field Case Manager

Confidential

Responsibilities:

Medical case management of Workman’s Compensation claims to include physician visits for face to face wif physician for plan of care, follow-up for records, facilitating communication between all parties utilizing various media to ensure case progression toward return to work goal, record review, claimant education on medications and pain management, setting up of Independent Medical Exams, Commission appearance when subpoena received, and home visits for planning and preparation on long term claims/catastrophic claims. Co-worker training as requested.

Registered Nurse Start of Care Nurse

Confidential, Richmond, VA

Responsibilities:

Completion of initial skilled assessment of patient for admission to homecare or upon return from readmission to hospital, including required consent forms, Medicare/Medicaid and private insurance data set collection, frequency of visit determination if not specified, skilled care as needed, and follow-up for/orders for services assessed to be necessary for homecare. Supervise LPN, HHA as needed, case management as needed. Point of care charting utilized. Co-worker training as requested.

Registered Nurse Case Manager

Confidential, Richmond, VA

Responsibilities:

Care of homebound patients receiving skilled home health care services from a variety of disciplines; skilled nursing assessment and care provided as required to include, but not limited to physical assessment, IV site care (peripheral, PICC and port) and medication administration, wound care, education regarding disease process, tracheostomy/ gastrostomy/colostomy/ileostomy/urostomy education and care, nutrition, external drain management, in home safety and disaster planning. Coordination of care wif physicians, medical/pharmaceutical supply companies as needed. Diagnostic coding, OASIS and private insurance plan of care. Supervise LPN, HHA as needed. Case management of 10-35 patients. Co-worker training as requested.

Clinical Supervisor,

Confidential, Richmond, VA

Responsibilities:

Supervision of clinical staff to include scheduling, education, annual competencies, annual evaluations and supervisory field visits. Review of all paperwork (OASIS and private insurance), coding diagnoses, follow-up for authorization wif private insurance companies and Medicare compliance surveillance. Liaison between the corporate office, patients, physicians and clinicians. Referral intake. Patient care as needed. Training of staff as needed.

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Quality Assurance Supervisor Resume

Glen Allen, VA

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