Patricia Long

Work collaboratively with a multidisciplinary team to ensure progression of care. Interqual to establish medical necessity and appropriateness of treatment. Ensuring CPT codes and insurance authorization are appropriate for admission status. Preceptor for new staff and PRN RN Case Managers. Assess and establish appropriate patient centered goals. Refer clients to appropriate post-acute care services. Collaborate with a multidisciplinary team to ensure progression of appropriate care.

Travel throughout Austin Market St David's Hospitals (total of 6 facilities). Work collaboratively with a multidisciplinary team to ensure progression of care. Interqual to establish medical necessity and appropriateness of treatment. Ensuring CPT codes and insurance authorization are appropriate for admission status. Preceptor for new staff and PRN RN Case Managers. Assess and establish appropriate patient centered goals. Refer clients to appropriate post-acute care services. Collaborate with a multidisciplinary team to ensure progression of appropriate care.

Work with management to help create duties for this role. Communicate with all departments to ensure tests and treatments were performed timely to ensure adequate progression of care. Interqual review to ensure admitting status is appropriate and medically necessary health care services. Identify potential quality issues to aid in progression of care. Completes data entry and correspondence as necessary for each review. Collect delays and barriers to care, generated reports for continued monitoring.

Assist to ensure service members are medically ready to deploy for MS Army National Guard. Initiate, track, and manage electronic records for service members with injuries or illness. Review PHA's for accuracy and completion with service members.

Assessed 30 - 40 clients or charts daily for discharge needs and establish needed post-acute services. Communicated with multidisciplinary teams to help ensure patients receive appropriate and safe discharge plans. Interqual reviews throughout hospital setting to determine appropriate admissions status and medical necessity. Established CM role in surgery department to educate surgical clinics on proper admission orders, importance of proper CPT codes prior to admission. Developed processes and spreadsheets to improve the surgery teams tracking and follow through on appropriate orders and insurance authorizations.

Audited charts and reviewed clinical documents to verify accuracy. Educated staff on proper documentation for insurance approvals. ICD 9 Coding Managed daily/weekly schedules of a multidisciplinary team to ensure adequate coverage of patients throughout three counties. Triaged patient calls helped establish if patient needed to additional staff visits. Provided needed support to team in field by educating, following up with additional needs, and providing coverage when short staffed.