To obtain a position that will showcase my skills and diverse background in the healthcare industry while allowing my continued professional growth and goal attainment within the company's vision. Background Qualifications: -Detailed oriented, with extensive experience in case management at the Ltach and SNF levels of care -Ability to work in high stress positions dealing with peers, patients, families, medical staff, and payors - Able to work independently, skilled in effective time management, able to meet established deadlines -Diverse experience in several areas of nursing including supervisory roles and various patient care levels including acute care hospital, Ltach, SNF, assisted living, and home care -Extensive hospital based marketing experience with achieving increased referrals, insurance contracts and admissions to facilities within the company's network -Extensive knowledge of medicare/CMS, Medicaid, medicare advantage, worker's comp, and commercial insurance programs - the criteria needed for qualifying at various levels of care and guidelines needed to facilitate patients to the next appropriate level of care -Well versed and comfortable with medicare, Medicaid and insurance denials and appeals process and preparing documentation to facilitate the appeal and support payment -Works closely with DRG codes and timeframes assigned by the payor source, so that patient stays fall between designated dates to ensure maximization of their benefits as well as preventing short and long stays while preserving revenue while advocating for positive patient outcomes -Ability to anticipate and set up complex discharge needs and services

Highlights:

• Dialysis
• Management
• Pulmonary
• Utilization Management
• Insurance
• Medicare
• Assessments
• Documentation
• Marketing Management
• Referrals