Melissa S

Dedicated Registered Nurse with over 20 years of experience in diverse healthcare settings, including extensive work in remote home health. Proven ability in clinical documentation review, quality assurance auditing, and ensuring regulatory compliance with Medicare, Medicaid, and HIPAA. Skilled in case management, patient education, and leading remote nursing teams. Eager to leverage expertise in patient advocacy and efficient healthcare delivery to provide exceptional remote nursing care.

Registered Nurse / Assistant Clinical Manager - Age in Place Home Health Services - Huntington, IN

(2023-02)

• Directed reviews of clinical documentation, evaluating patient records to confirm adequate support for home health services based on established coverage criteria.
• Detected and highlighted documentation deficiencies, generating clear, uniform written summaries of review outcomes.
• Handled and processed Medicaid prior authorizations for home health services, ensuring prompt approvals and complete adherence to payer requirements.
• Executed quality assurance audits of patient records, reviewing clinical documentation for precision, thoroughness, and compliance with Medicare, Medicaid, HIPAA, and OSHA regulations.
• Tracked and assessed staff performance and quality indicators as part of continuous QA efforts, identifying opportunities for enhancement and implementing corrective strategies.
• Managed extensive communication flows between nursing personnel, healthcare providers, and patients using electronic tools in a fully remote operational environment.
• Analyzed care plans and policies to ensure the delivery of superior, financially sound health services that align with both organizational and regulatory mandates.

Registered Nurse / Case Manager - Home Health Care Solutions - Avon, IN

(2013-02 - 2023-02)

• Provided comprehensive home health care to a full caseload of patients, encompassing thorough assessments, personalized treatment plan development, and precise documentation in EHR systems.
• Led and supervised a team of home-based nurses, overseeing the care delivery of LPNs and support staff through remote delegation and monitoring.
• Instructed patients and their caregivers on home care protocols via virtual and phone consultations, following established telehealth guidelines.
• Maintained rigorous adherence to HIPAA regulations and ensured the accuracy and consistency of clinical documentation.
• Closely observed patient status and relayed assessment data to physicians and multidisciplinary care teams.
• Prevented infection by consistently applying effective wound care and aseptic practices.
• Mentored and onboarded new nursing staff on critical clinical skills and professional conduct.

Registered Nurse - Bowen Center - Huntington, IN

(2011-12 - 2013-04)

• Administered medications and closely monitored patients for adverse reactions or side effects within a behavioral health setting.
• Completed detailed patient intakes, gathering comprehensive medical histories and current complaints.
• Collaborated with an interdisciplinary team to organize and implement individualized patient care plans.
• Provided treatment to patients with mental health conditions in collaboration with a multidisciplinary clinical team.

Registered Nurse - Parkview Huntington Hospital - Huntington, IN

(2002-11 - 2012-01)

• Offered direct bedside nursing care to patients experiencing acute and chronic health issues in Medical-Surgical, Pediatrics, ICU, Telemetry, Postpartum, and Nursery units.
• Dispensed medications and closely monitored patients for any signs of reactions or side effects.
• Guaranteed precision, quality, and regulatory compliance of patient care by meticulously documenting all information in the Electronic Medical Record (EMR).
• Coordinated patient movement through admission and discharge procedures for designated units.
• Facilitated the clinical training and professional development of student nurses, interns, and recent nursing graduates.

Associate of Science - Nursing - University of Saint Francis