• Receives referrals and ensures appropriate clinician and|or therapist(s) assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits
• Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance to physician orders
• Oversees and assures development, implementation, and updates to individualized patient plan of care, as appropriate
• Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates|new orders to clinicians. Uses coordination notes to document, as needed and appropriate
• Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians with recommendations, as appropriate
• Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers
• Follows-up on lab and other clinical diagnostic test, physician contact, and significant changes in patient condition to ensure adequate physician notification, follow-up, and needed plan of care modifications and communicates such to clinicians
• Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary
• Assists clinicians in coordinating transfer and discharge of patients from agency services as indicated by physician
• Receives report from field clinicians prior to scheduled days off on patient status and ongoing needs
• Processes new orders and updates visit frequency, as appropriate, when on-call RN takes supplemental verbal orders which alter frequency going forward
• Writes and processes orders when taking verbal orders directly from physician and communicates such to field clinicians
• Reviews clinician visit notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff. Takes necessary action to correct adverse findings and communicates trending to branch manager
• Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences
• Assists in orientation of new agency personnel
• Provides direction and leadership to clinical team members in collaboration with branch director
• Assures compliance with and ensures timely follow up on daily clinical and coding edits
• Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients
• Participates in on-call rotation
• Follows-up with On-Call events daily
• Receives report from weekend and after-hours clinicians admitting new patients
• Directs team in adherence to and participates in Episode Management process
• All other duties as assigned

Provided coverage for 8 different positions between Homecare and Hospice, including taking Manager on-call duty biweekly.

Homecare Manager on-call

• Responsible for all problems that occur after hours and on weekends for that week
• Supervised and managed daily activities of clinical team consisting of nurses and support staff
• Managed schedule, referrals, and any admissions for that week or over weekend
• Managed all referrals
• Took all calls regarding patient care, visits, scheduling new patients, and entering orders
• Managed all referrals for Homecare through Lourdes
• Managed all Lourdes Homecare and Hospice referrals
• Reviewed all charts to ensure quality measures have been met
• Reviewed coding on profile, Oasis visits , and 485 to ensure proper things have been documented for full reimbursement
• Created Certificate of Terminal illness
• Code chart to create Admission and Discharge forms that Medicare reviews for reimbursement
• Manage all referrals that come in
• Work with admission team to schedule admissions
• Collect information to present to MD's
• Facilitate all communication for admission team to follow for all new hospice patient's
• Coordinate communication between Homecare and Hospice with 15-20 practitioners within Lourdes Medical Pavilion office building
• Verify insurance on all potential and current patients to ensure proper payment and reimbursement

• Managed care of 4 or more ED patients and oversaw LPN's and ED tech's
• Assessed and initiated care under direction of MD based on acuity
• Facilitated communication between physician and patient
• Coordinated care between departments
• Stared lines, obtained lab work, foley catheter insertion, NG tube placement, port access, assess effectiveness of treatment and recognition of change in condition

• Managed care of 4 to 6 patients on a daily basis
• Oversaw nursing assistants assigned to team
• Able to effectively communicate to physicians, management, nurses, peers, patient and their families
• Highly organized, flexible, adaptable and ready for new challenges.