Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Sara Simmons

Scottsbluff

Summary

Dedicated and compassionate Registered Nurse with over 10 years of healthcare experience in a variety of medical settings, including case management, acute rehabilitation, clinic, and nursing homes. Vast experience dealing with a broad range of medical conditions. Consistently developing strong relationships with patients, physicians, therapists, social workers, insurance company liasions, and families through empathetic communication, respectful attitude and excellent customer service.

Overview

16
16
years of professional experience
1
1
Certification

Work History

PPS Coordinator/Clinical Assessment RN

Regional West Medical Center
02.2023 - Current


  • Coordinates the preadmission process and contributes to Provider clinical assessment for potential patient within the hospital as well as from external referral sources by collecting data about the patient through observation, record review, and interviews.
  • Responsible for completion of the Inpatient Rehabilitation Facility Patient Assessment Instrument and transmission of the IRF-PAI information to CMS within defined timelines.
  • Review medical records to ensure appropriate documentation occurs to support findings noted on the IRF-PAI and functions as liaison between the team, medical records personnel, coders, physicians, Medical Director and Finance to ensure accurate and timely documentation, coding and payments.
  • Research and staying current with regard to regulatory and industry changes in requirements related to admission criteria and process for Inpatient Acute Rehabilitation.
  • Coordinates and completes all pre-admission assessments in response to referrals.
  • Provide the Medical Director with accurate information regarding patient's medical condition, co-morbidities, functional/cognitive status, patient's discharge needs and plans.
  • Coordinate with Program Director and other program staff to achieve timely pre-admission assessments when multiple referrals are received.
  • Attending and participating in team conferences to communicate pertinent payer needs/requirements to program Medical Director.
  • Work with Health Information Management staff to obtain accurate ICD-10 codes for IRF-PAI.
  • Educational resource to team members, physicians, payor representatives, finance personnel, HIM personnel, and other appropriate stakeholders, regarding IRF prospective payment system and outcome measures systems.
  • Manage prior authorizations for patient's insurance and send accurate information for authorization request for inpatient acute rehabilitation
  • Update patient's insurance company with updated and accurate information regarding inpatient acute rehabilitation stay within given time frames.

Registered Nurse Surgical Case Manager

Regional West Physicians Clinic
06.2022 - 02.2023
  • Organized clinical documentation, treatment plans, and referrals.
  • Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
  • Used critical thinking to break down problems, evaluate solutions and make decisions.
  • Manage a multitude of surgical cases across different specialties including General Surgery, Urology, and Plastics and Reconstructive Surgery.
  • Collaborate with physicians, operating room staff, outpatient staff to ensure a safe and smooth process for patients receiving surgical services.
  • Submit appropriate documentation and clinical information to insurance companies for prior authorization prior to procedures being rendered.
  • Ensure patient's are medically stable for surgical procedures including helping them manage anticoagulants, receiving cardiac clearance when
    necessary, and having pertinent labs drawn prior to procedures.
  • CPT coding experience for a multitude of different surgical specialties and surgical procedures within General Surgery, Urology, Plastic and Reconstructive Surgery.

Registered Nurse

Regional West Medical Center
03.2018 - 11.2021
  • Implemented medical, behavioral and clinical team care plans and documented activities in medical systems.
  • Followed discharge plans, identified concerns and reported issues to management for decision-making.
  • Helped develop care plans for patients with complex needs and assisted patients with using rehabilitation equipment.
  • Established collaborative relationships with patients through consistent and meaningful communication.
  • Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use and disease management.
  • Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
  • Secured controlled narcotics and distributed medication on schedule to meet patient needs and minimize misuse opportunities.
  • Collected blood, tissue and other laboratory specimens and prepared for lab testing.
  • Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
  • Ability to delegate tasks to appropriate staff members.
  • Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
  • Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
  • Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
  • Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
  • Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.

Registered Nurse

Scottsbluff Care and Rehab
07.2017 - 03.2018
  • Educated family members and caregivers on patient care instructions.
  • Evaluated patient histories, complaints and current symptoms.
  • Advocated for and strived to protect health, safety and rights of patient.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Communicated with healthcare team members to plan, implement and enhance treatment strategies.
  • Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
  • Implemented care plans for patient treatment after assessing physician medical regimens.
  • Collected blood, tissue and other laboratory specimens and prepared for lab testing.
  • Managed care for multiple patients along all stages of Alzheimer's disease.

Assistant Director of Nursing

The Residency Care Center
09.2016 - 07.2017
  • Identified department issues to recommend corrective actions.
  • Established and monitored infection control programs to provide safe, sanitary environment to prevent transmission of disease and infection.
  • Developed positive employee relations, incentives, and recognition programs to promote teamwork and mutual respect.
  • Performed rounds to observe care and interview staff, residents and families.
  • Collaborated with staff, management and external groups to coordinate patient care.
  • Established new policies and updated existing policies to improve standard of care for patients.
  • Participated in management team meetings to discuss resident status, census changes and resident complaints or concerns.
  • Fostered excellence by example by "setting pace" and being hands on mentor to clinical staff.
  • Motivated and supervised multiple nurses and certified nursing assistants in delivering quality patient care.
  • Collected data for fall rates, infection control, skin issues, and admission data within facility
  • Monitored and evaluated nursing staff performance, providing feedback and guidance to support standards of care.

Registered Nurse

Heritage Estates
01.2016 - 09.2016
  • Educated family members and caregivers on patient care instructions.
  • Accurately documented treatment, medications and IVs administered, discharge instructions and follow-up care.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Communicated with healthcare team members to plan, implement and enhance treatment strategies.
  • Managed patients recovering from medical or surgical procedures.
  • Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
  • Updated patient charts with data such as medications to keep records current and support accurate treatments.

Registered Nurse

Goshen Healthcare Community
01.2015 - 06.2016
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
  • Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
  • Provided direct patient care, stabilized patients and determined next course of action.
  • Administered medications via oral, IV and intramuscular injections and monitored responses.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance
    coverage limitations.
  • Managed care for patient's along different stages of Alzheimer's disease.

Registered Nurse

Golden Living Center
10.2009 - 01.2015
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
  • Provided direct patient care, stabilized patients and determined next course of action.
  • Administered medications via oral, IV and intramuscular injections and monitored responses.
  • Implemented medication and IV administration, catheter insertion and airway management
  • Updated patient charts with data such as medications to keep records current and support accurate treatments.

Education

Associate of Science - Nursing

Western Nebraska Community College
Scottsbluff, NE
05-2013

Skills

  • Acute and Rehabilitative Care
  • Case Management and Planning
  • Insurance Plan Verification
  • CPT coding
  • IRF-PAI Assessment Information
  • Patient Assessments
  • Patient and Family Advocacy
  • Direct Patient Care
  • Patient Education
  • Organization and Time Management
  • Strong Clinical Judgement
  • Team Coordination

Certification

Basic Life Support

Timeline

PPS Coordinator/Clinical Assessment RN

Regional West Medical Center
02.2023 - Current

Registered Nurse Surgical Case Manager

Regional West Physicians Clinic
06.2022 - 02.2023

Registered Nurse

Regional West Medical Center
03.2018 - 11.2021

Registered Nurse

Scottsbluff Care and Rehab
07.2017 - 03.2018

Assistant Director of Nursing

The Residency Care Center
09.2016 - 07.2017

Registered Nurse

Heritage Estates
01.2016 - 09.2016

Registered Nurse

Goshen Healthcare Community
01.2015 - 06.2016

Registered Nurse

Golden Living Center
10.2009 - 01.2015

Associate of Science - Nursing

Western Nebraska Community College

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Sara Simmons