UPMC Jefferson Regional Home Health - Clinical Compliance Supervisor Resume Example

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Jacob Jones
XXX XXXX XXX XXX, Cheswick, PA 15024
Ph: XXXXXXXXXXXX
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Professional Summary

Highly trained RN with strong clinical abilities and a successful career in both Hospital  and Home Health. Proactive and organized with passionate commitment to first-rate patient care. Licensed in Pennsylvania  with expertise in home health care. Enthusiastic  with 25+  years of specialization in  home health. Able to learn new tasks quickly and proficient in growing key customer relationships. At all times will represent establishment with friendly, professional demeanor.

Certified  in ICD-9 and OASIS C with expert knowledge of medical terminology and HIPPA compliance. Highly trained and with strong clinical skills  with established career working in hospital  and home health settings. Support quality patient care and education.

Skills
  • Judgment and Decision Making
  • Customer and Personal Service
  •  Education and Training of clinical management and staff
  • Critical Thinking based on changes in regulation and reimbursement
  • Monitoring documentation and complaints for trends
Experience
Clinical Compliance Supervisor Feb 2005Jul 2015 UPMC Jefferson Regional Home Health Seven Fields, Pa  Responsible for review of clinical documentation for compliance with regulatory, HIPAA, and re-imbursement requirements. Responsible for review of clinical documentation prior to submission to regulatory and oversight bodies such as Medicare. Provide education to clinical management and staff based on review of documentation, Responsible for providing education to clinical management and staff regarding changes in regulation, HIPAA, or Joint Commission. Submitted clinical documentation for payer eligibility, to fiscal bodies such as Medicare at ADR, Redetermination, Reconsideration and ALJ.
Oversight of Complaints from patients, physicians, and both internal and external sources.

Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.

After needs are identified work with clinical team to coordinate and communicate the needs of individuals, families, or communities, including assessment of individuals' home to identify potential health or safety problems.Perform administrative  functions, such as taking responsibility for direct oversight to the Clinical Compliance Coordinator positions, policy review and preparation for State, Joint Commission and other auditing and oversight bodies.
Preparation and oversight of bi-annual staff competencies.

Clinical Compliance Coordninator Oct 2000Feb 2005 UPMC Jefferson Regional Home Health Seven Fields, Pa
  • Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.
  • Provide or arrange for training or instruction of auxiliary personnel or students.
  • Engage in research activities related to nursing.
  • Provide review of clinical documentation and provide education based on findings to staff and clinical management.
Qualiity Assurance Utilization Review Nurse Apr 1997Oct 2000 UPMC Home Health Pittsburgh, Pa
  • Analyze documentation to detect deficiencies, duplicated effort, fraud, or non-compliance with laws, regulations, and management policies.
  • Prepare detailed reports on audit findings.
  • Consult and coordinate with clinical management and staff  to assess, plan, implement, or evaluate patient care plans including OASIS compliance and ICD-9 coding for appropriate reimbursement.
  • Direct new or  less-skilled nursing or healthcare personnel in proper documentation.
  • Observe nurses and visit patients to ensure proper nursing care.
  • Provide education at bi-annual competencies.
Home Visit Staff Nurse RN Sep 1988Apr 1997 Hospital Home Health Pittsburgh, Pa
  • Monitor, record, and report symptoms or changes in patients' conditions.
  • Maintain accurate, detailed reports and records.
  • Record patients' medical information and vital signs.
  • Modify patient treatment plans as indicated by patients' responses and conditions.
  • Direct or supervise less-skilled nursing or healthcare personnel or supervise a particular unit.
  • Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.
  • Monitor all aspects of patient care, including diet and physical activity.
  • Perform physical examinations, make tentative diagnoses, and treat patients en route to hospitals or at disaster site triage centers.
  • Instruct individuals, families, or other groups on topics such as health education, disease prevention, or childbirth and develop health improvement programs.
  • Assess the needs of individuals, families, or communities, including assessment of individuals' home or work environments, to identify potential health or safety problems.
Staff RN Step Down Cadiac May 1980Aug 1988 Saint Margaret Hospital Aspinwall, Pa
  • Plan, provide, or evaluate educational programs for nursing staff, interdisciplinary health care team members, and community members.
  • Participate in the development, review, and evaluation of nursing practice protocols.
  • Supervise and monitor unit nursing staff.
  • Assist physicians with procedures such as bronchoscopy, endoscopy, endotracheal intubation, and elective cardioversion.
  • Coordinate patient care conferences.
  • Document patients' treatment plans, interventions, outcomes, or plan revisions.
  • Compile and analyze data obtained from monitoring or diagnostic tests.
  • Monitor patients' fluid intake and output to detect emerging problems such as fluid and electrolyte imbalances.
  • Administer blood and blood products, monitoring patients for signs and symptoms related to transfusion reactions.
  • Advocate for patients' and families' needs, or provide emotional support for patients and their families.
  • Conduct pulmonary assessments to identify abnormal respiratory patterns or breathing sounds that indicate problems.
  • Document patients' medical histories and assessment findings.
  • Prioritize nursing care for assigned critically ill patients based on assessment data and identified needs.
  • Set up and monitor medical equipment and devices such as cardiac monitors, mechanical ventilators and alarms, oxygen delivery devices, transducers, and pressure lines.
  • Assess patients' pain levels and sedation requirements.
Med-Surg Staff RN May 1976May 1980 Youngstown Hospital South Side Youngstown, Oh
  • Monitor, record, and report symptoms or changes in patients' conditions.
  • Maintain accurate, detailed reports and records.
  • Record patients' medical information and vital signs.
  • Direct or supervise less-skilled nursing or healthcare personnel or supervise a particular unit.
  • Consult and coordinate with healthcare team members to assess, plan, implement, or evaluate patient care plans.
  • Perform administrative or managerial functions, such as taking responsibility for a unit's staff, budget, planning, or long-range goals.
Education
Bachelor of Science : Nursing Jun 1981 Vernell Universtiy Online pa
Associate of Science : Nursing Apr 1976 Youngstown State University Youngstown, Oh
High School Diploma Jun 1972 Cardinal Mooney Youngstown, Oh
Jun 1972 Saint Dominic Grade School Youngstown, Oh

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About this resume

Clinical Compliance Supervisor FROM Cheswick , Pennsylvania RESUME

This is a resume for a Clinical Compliance Supervisor in Cheswick, Pennsylvania with experience working for such companies as UPMC Jefferson Regional Home Health and UPMC Jefferson Regional Home Health. The grade for this resume is 0 and is one of hundreds of Clinical Compliance Supervisor resumes available on our site for free. Use these resumes as templates to get help creating the best Clinical Compliance Supervisor resume.

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School Attended
Vernell Universtiy Online