Taffe G.

Responsible to provide care directly to the resident and supervise the direction of care by a certified nursing assistant to ensure that the highest practical well-being is maintained by the resident. Observe, assess, and report resident conditions/changes and document in accordance with the facility's clinical policies, procedures, and state/federal guidelines and regulations. Receive, transcribe, and execute physician's orders. Ensure implementation of resident's care plan as directed. Administer medications and treatments as prescribed. Perform other duties as assigned by supervisor.

Responsible to provide care directly to the resident and supervise the direction of care by a certified nursing assistant to ensure that the highest practical well-being is maintained by the resident. Observe, assess, and report resident conditions/changes and document in accordance with the facility's clinical policies, procedures, and state/federal guidelines and regulations. Receive, transcribe, and execute physician's orders. Ensure implementation of resident's care plan as directed. Administer medications and treatments as prescribed. Perform other duties as assigned by supervisor.

Responsible to provide care directly to the resident and supervise the direction of care by a certified nursing assistant to ensure that the highest practical well-being is maintained by the resident. Observe, assess, and report resident conditions/changes and document in accordance with the facility's clinical policies, procedures, and state/federal guidelines and regulations. Receive, transcribe, and execute physician's orders. Ensure implementation of resident's care plan as directed. Administer medications and treatments as prescribed. Perform other duties as assigned by supervisor.

Processed incoming referral requests Research issues utilizing multi-systems and clinical assessment skills Made decisions regarding health care services and care provided to members in approving/Denying/Voiding member referral requests Request and review medical records, notes, and other related information as appropriate Evaluate the medical necessity and appropriate levels of care needed per member request Use formulated conclusions per protocol and collaborate with Medical Directors and other team members in determining my response Assure timeliness and appropriateness of responses per state, federal and Humana Healthcare guidelines Prepare summaries, correspondence and documents information for tracking data using word/OneNote Microsoft tools Assist in the preparation of narratives, graphs, flowcharts, etc. for presentations used for new hires labeled as well documented cases for medical directors and audits Verify insurance benefits and the CMS - Centers for Medicare & Medicaid Services, guidelines (Medicare and Commercial plans). Perform other duties as assigned by supervisor.