• Daily review of care management data to identify and initiate outreach. • Coordinate with patient and physicians for specific patient care needs and communication. • Complete Transition of care activities for patients on the ACO care management inpatient census. • Identify patients at risk, assess to determine the level of risk (low,moderate,high) and provide recommended action and engagement to ACO patients and physicians. • Coordinate with Tenet hospital case management teams as needed for ACO member care or transition needs. • Conducts case/disease management for patients as required and makes referrals where necessary. • Identifying and referring complex patients to disease management programs and community resources as needed. • Identification and reporting over and underutilization.

Assigned to the Emergency Room, Observation, ICU, Telemetry, and medical/surgical units and played a key role on multidisciplinary team of hospitalist, surgeons, RNs, social workers and ancillary staff. Actively participated in development and implementation of individual treatment plans for patients with broad range of medical issues. Ensure that doctors’ orders are effectively carried out, including testing, medical procedures, consultations and stat orders. Arranged for out of hospital accommodations for patients that included Hospice , Home Health, and DME services and any community based services such as low cost clinics and pharmacy assistance programs thru out the city that is needed for the patients safe discharge home.

As a clinical liaison, I was responsible for developing census as defined through targeted goals of the business plan and developing referral relationships within the geographic territory with an emphasis on face-to-face contacts. In addition, l assist with coordination of referral to admission conversion process and represent Acuity Specialty Hospital in community-related activities. In addition, I utilized market analysis data in individual territory identifying new business and potential opportunities. I recognized barriers to admission, responded appropriately and followed up on admissions variables. I provided in-services and professional presentations for referral sources, community groups and other organizations, regarding Acuity services, programs and outcomes. I understand healthcare operations, legal guidelines, competitive analysis, and market place trends.

cultivate referral relationships, manage assigned territory, and complete patient assessments. Work with business development team members including the admissions manager and admission staff, as well as nursing and other internal and external staff to facilitate the referral conversion. To develop and maintain excellent relationships with all prospective patient, family members, physicians, ICU and floor nurses, discharge planners, case managers. To coordinate and complete on-site pre-admission assessments on potential patients. To orient patient and/or family to facility services, including length of stay. Educate, support, and serve as a resource to family members of current, past and potential patients.

To provide a variety of home health, senior care, hospice, palliative care, pediatric care and healthcare staffing services. Utilizing case management experience to coordinate with clinical partners to ensure communication between facility/physician and timely admission of patients.

Responsible for strategic planning and execution of cardiology marketing activities for assigned territory. Work with clinical partners to ensure physician communication and timely patient admission. Promote Encompass cardiac programs to cardiology clinics and hospitals in the San Antonio area. To promote Encompass Home Health mission statement of "A Better Way to Care".