Nursing Educator, Director of Nursing, Team Manager Managed Care

COMPANY	POSITION HELD	DATES WORKED
VNSNY	Team Manager	11/2012 - 5/2014

SCHOOL	MAJOR	YEAR	DEGREE
Lehman College	Nursing	2014	Certification Degree
mercy College	Nursing	2012	Bachelor Degree
Mercy College	Nursing	2012	Master Degree
New york Inst of Technology	Human Resources	1988	Master Degree

Highlights:

Excellent verbal and written communicator with Master’s degree in Nursing Education (MSNE) and pending Doctor of Nursing Practice (DNP), with diverse nursing management and healthcare administration experience in diverse clinical environments – behavioral health, acute care, sub-acute, emergency care, and long term care (LTC) settings. Extensive staff development and training in above areas plus interpretation / application of Collective Bargaining Agreement provisions. • Direct experience with JCAHO and CMS surveys, medical credentialing & privileging, HR policy reviews, labor / employee relations. • Demonstrated ability to develop and implement readily understandable and enforceable policies and procedures governing nursing practice, human resources and issues / management of staff of diverse ethnic and cultural backgrounds. • Experience as administrator on duty for three urban Psychiatric Hospitals, including responsibility for medical, administrative support and nursing emergencies. • Early background teaching complex nursing case management at London University. Strengths:

Companies I like:

United health care, MJHS, Isabella, Premier

• New York
• Managed Care
• Nurse Pracitioner
• Nurse Manager
• Nurse Educator
• Connecticut

Manage nursing staff of 18 delivering high-quality and cost-effective per diem home health and community-based long term care services using staff and contract nurses in capitated reimbursement rate model. Develop staff via coaching, self-development plans, and building accountability. Coordinate care and manage delegation of assignments based on staff ability and patient care needs. Drive outreach to promote program growth and awareness with staff, community agencies, and health care providers. Review care management issues with interdisciplinary team for problem-solving, early identification and response to quality issues / complaints, authorization approvals (high-hour HHA placement, high cost prescriptions, out of network services). Build ongoing care management via collaborative assessment, planning, facilitation and advocacy for options / services to meet member health needs. • Led project improvement initiatives credited with helping improve metrics including length of care needed, time on special needs, satisfaction surveys (numbers confidential). • Established processes that achieved 100% compliance with clinical standards, state and federal regulations, and MLTC / LHCSA requirements. • Cited for improving quality of services, access and utilization in capitated reimbursement model. • Played key role in resolving member issues by investigation, reporting, response recommendations.