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CARLIE Fremont
309 Pinehurst View Dr §Grayson, GA 30001 §H-770-979-9876
M-917-407-1230 § carlie@comcast.net
Education
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CARLIE Fremont309 Pinehurst View Dr §Grayson, GA 30001 §H-770-979-9876
M-917-407-1230 § carlie@comcast.net
Professional Experience
Mckesson-alpharetta, ga
|
2010
to Present
|
HOM/HEO/HEN
Implementation Consultant
Key Results:
·
Provided extensive clinician informatics
expertise and support in the implementation and consulting service to the
McKesson customer base for Horizon Clinicals Order Management and Horizon
Expert Orders software.
·
Ensured customers are properly educated,
trained and advised on the clinical aspects of McKesson’s products and
capability of implementing the Horizon Clinicals Health Care Solution within
their organizational framework.
·
Planned, conducted and directed the analysis
of clinical/healthcare business problems to be solved with clients via
automated systems and/or business processes
·
Responsible for designing, developing,
modifying and evaluating programs, applications software, and /or services for
clients.
·
Recommend changes in software development,
business processes, maintenance and/or systems standards.
·
Partnered with clients and/or business users
to identify, evaluate, and develop products, procedures and/or systems which
are cost effective and meet business needs
·
Thorough understanding of Meaningful Use per
mandate and ARRA requirements that must be met for organizational adoption of
CPOE.
Dept of Veterans Affairs- Atlanta, GA
|
2008
to Present
|
Charge
Nurse
Key Results:
§
Handle department operations; supervise
staff of 6-8 including LPN and CNA, identify staffing needs, ensure bed flow
management, admissions and discharges. Evaluate, counsel and document
performance of nursing staff within department.
§
Handle nursing functions within
the ER for adult and critically ill patients to include assessment, evaluation,
treatment, coordination and consulting in patient care.
Wellpoint-Atlanta, ga
|
2007
to 2010
|
Nurse
Case Manager Sr. /Team Lead
Key Results:
§
Conducted assessments to
identify individual needs and specific care management plan. Identified and monitored
LOS and variances affecting discharge planning. Collaborated and developed
specific goals with Medical staff and families on discharge plans.
§
Conducted hospital reviews, identified
reasons for readmissions and collaborated on strategies to reduce readmission
rate. Identified and referred cases to Physician Advisor to support timely
progression and appropriate discharge planning according to federal and state
guidelines.
§
Provided discharge planning in
collaboration with community resources to meet needs. Assessed level of continuing
care such as NH placement, home health care, etc. Arranged financial assistance by making
agency and community referrals.
§
Assisted and developed
departmental SOP and DJA. Chaired and scheduled meetings, as well as presented
cases for discussions at grand rounds and care conferences to over 75+ medical
personnel. Participated in interdepartmental and cross band workgroups in
developing disease specific policies. Participated in departmental audits to
ensure compliance.
| United
healthcare– Atlanta, GA |
2006
to 2007
|
Risk
Manager
Key Results:
§
Assessed, planned, implemented
and coordinated the overall plan of care for patients and families to optimize
member health care and facilitated access to services. Performed utilization
and concurrent review to determine medical appropriateness of inpatient and
outpatient services following evaluation of medical guidelines and benefit
determination.
§
Identified
gaps and barriers with complex and chronic care needs. Coordinated with Medical
Director and other team members on development of care plans. Monitored and
evaluated effectiveness of care plans post discharge.
Identified
gaps and barriers with complex and chronic care needs. Coordinated with Medical
Director and other team members on development of care plans. Monitored and
evaluated effectiveness of care plans post discharge.
AMERICAN MOBILE-SAN DIEGO, CA
|
2004 to 2007
|
Travel ER RN
Key Results:
§
Traveled nationally on short
term assignments to help supplement staff. Performed all nursing duties in
accordance with state and facility policies and procedures. Handled nursing
functions within emergency room and ICU for adult, pediatric, trauma and
critically ill pts.
GRADY MEMORIAL HOSP-ATLANTA, GA
|
2004
to 2007
|
Staff Emergency Room Nurse
Key Results:
§
Handled nursing functions to
include caring for emergent, non-emergent, acute and chronically ill patients.
Conducted head to toe assessments-knowledge of normal vs. abnormal findings.
Identified and managed life-sustaining physiologic functions in unstable
patients.
§
Established care plans,
provided direction to ancillary staff, administered medications, initiated,
maintained and discontinued intravenous lines. Observed patients and consulted
with physicians.
DeKalb Medical Center-ATLANTA, GA
|
2004
to 2006
|
Clinical Documentation Specialist/Utilization Review
Key Results:
§
Facilitated completeness and
accuracy of medical record documentation with physicians, nursing staff and
medical records coding staff through concurrent auditing, clinical abstracting
and evaluation of medical records.
§
Facilitated accurate clinical
documentation to ensure appropriate DRG classification for level of service
rendered. Updated DRG worksheet to monitor any changes and conferred with
physicians in order to assign accurate DRG. Ensure clinical verbiage supports
severity of illness.
§
Analyzed clinical status of
patient and current treatment plan to identify potential gaps in documentation.
Monitored activities and communicate differences to ensure compliance with
Federal and State payor regulations. Consulted with Case Managers to ensure
supported documentation can validate current diagnosis.
§
Conducted utilization review
for in-house patients based on established treatment criteria. Maintained
knowledge of UR requirements for each payor and provided clinical information
requested by Managed Care companies as part of concurrent review and
contractual agreements.
§
Coordinated arrangements for
other services (DME, SNF, Home Health, Hospice, etc) and provided education as
needed to manage care companies regarding clinical interventions, rationale for
treatment and continued stay.
KINGSBROOK JEWISH MEDICAL CENTER-BROOKLYN, NY
|
2003 to
2004
|
Emergency Room RN
Key Results:
§
Handled nursing functions to
include caring for emergent, non-emergent, acute and chronically ill patients.
Conducted head to toe assessments-knowledge of normal vs. abnormal findings.
ELDERPLAN-BROOKLYN, NY
|
2000 to 2004
|
Case Manager
Key Results:
§
Performed assessments to
identify individual needs and established plan of care. Implemented care plans
by facilitating authorizations/referrals as appropriate. Coordinated internal
and external resources to meet identified needs.
§
Coordinated implementation of
services such as respite care, hospice placement, DME supplies and other
community resources. Assisted in provider, claims and service issues.
Negotiated rates of reimbursement.
§
Functioned as preceptor and
trainer for new staff members. Expert
user and trainer in electronic clinical documentation pilot program.
Collaborated with IT personnel in troubleshooting and streamlining process
flows of electronic system to maximize performance.
Education
RUSH UNIVERSITY-CHICAGO, IL
|
2011
to 2013
|
MSN/FNP
LICH-SCHOOL OF NURSING-BROOKLYN, NY
|
2002
to 2003
|
AAS/Nursing
ST. JOHN’S UNVERSITY-JAMAICA, NY
|
1994
to 1999
|
BA Psychology
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