Jacqueline Finch Email & Phone Number

New York, Ny, Us

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. A&G works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner.

New York City Metropolitan Area

As Anthem continues to innovate, grow and regionalize, our titles have changed. Our roles have expanded. Our passion and drive remain the same. Our team continues to facilitate appeals with the objective to minimize cost and provide the best care for our community. Without our members, we wouldn't be here. Every interaction counts, every step towards building revenue is essential for the company's growth. We are here to ensure that balance. I now process appeals for the New York and New Jersey markets within the Appeals and Grievance Department at Anthem's East Region.

Greater New York City Area

Increasing exceptional quality care for our community who hold Anthem BCBS insurance while minimizing healthcare overload and high costs.

New York, New York

Provide the highest skill need care to vulnerable homebound patients within their community and homes.

Maintain communication with MD and staff during the course of the day for updates, flow adjustments, procedures (not scheduled), and other changes. Perform vital signs (blood pressure, pulse, temperature, weight, height, O2) when MA unavailable Assist MD with in-office procedure or fluoroscopic in-suiteMaintain schedule of proceduresHave knowledge of and execute Time Out, verification of last use of anticoagulants, and urgent suppliesProvide discharge instructions to patients upon completion of procedure and monitor for any events such as dizziness, motor weakness, diaphoresis, etc. Triage and gather information from a new patient and report it to MDObtain imaging reports as needed, obtain CDs, use interpreter as needed, accommodate patient if needed regarding sitting, laying position, Oxygen use, photosensitivity, etc. Process drug screen lab if neededType Imaging reports into HPI visit (MRI, CT, XR, etc. ) in EpicAnswer calls throughout the dayProcess faxes, PT referral (obtain MS signature), generate letters, send out correspondence, check emailsProcess prior authorizations for escribed medications not covered under the patient’s formulary, exceeded the quantity limit, or requiring a step therapy. Also, obtain PA for specialty medications like hyalgan, monovic, botox, qutenza, etc. At times, requires long phone use time, follow ups, peer to peer review, etc. Have knowledge of BUY and BILL versus pharmacy benefits. See follow up patiens as requested.Check for AED, Oxygen tanks, Banyan Emergency Kit, and expired medications

Bronx, Ny

SCHOOL BASED HEALTH-Intake patients in a High School clinical setting and prep them for MD or NP-Vital Signs and First Aid -Venipuncture, Specimen collection, preparation, handle results and recalls, reporting to DOH-Administer medications, upkeep of expiration and inventory including supplies, ER box-Vaccine ordering, administration, CIR maintanance, preloading immunization history-Maintaining AED, Oxygen, POCT logs-Patient Teaching and referrals to SW, Health Educator, Specialty-Practice Infection Control, Policy and Procedure adherance, Safety Precautions and Intervention, Patient Safety Goals-Communicate with pharmacy, school staff, and parents as needed-Attend all meetings snd workshops for continuing education-Cover shifts at non-school based locations such as Pediatrics and AdultSKILLSVenipuncturePatient TeachingVital SignsVaccinationsCommunicationFirst Aid

Brooklyn, Ny

CLINICAL SETTING-Administration of Injections and Vaccines-Used E Clinical Works for virtually all nursing responsibilities-Maintenance of Centralized Immunization Registry-Ordering and inventory of vaccines-Consulting with Pharmaceutical companies and vaccination updates-Obtain prior authorizations of non-formulary medications for patients-Patient teaching-not limited to OB/GYN, Vitamin B 12 deficiency, Postpartum, Vaccine Schedule, Hand Hygiene, Teen pregnancy, Child Safety, Endoscopy, Colonoscopy, Pelvic/Abdominal SonogramSKILLS-DOHMH and CDC Immunization Requirements-Medication administration-Office Management-Interdependental Communication-Nebulizer treatment-Vital Signs

451 Clarkson Avenue

Under the Charge Nurse Telemetry Unit-Administered medication using EMR-Ensured safe and accurate documentation in physical charts and computer system-Reduced falls and decreased pressure ulcer incidences for assigned units-Increased percentage of patient satisfaction by encouraging survey reports-Increased family participation and patient longevity in non-compliant clients-Executed partnerships with healthcare team, insurance companies, and case managers-Decreased hospital return by securing home care services and outpatient teaching-Created an effective and efficient office environment through operations techniqueSKILLS-Insertion and maintenance of intravenous heplock-Administration of IV fluids-Wound Care-Tracheostomy management-Telemetry monitoring-EKG processing-Patient teaching-not limited to CHF, Obesity, HTN, DM II, CAD

Brooklyn, Ny

Intake Nurse-Observe patients for Home Care Services-Process paperwork for skilled needs, RN, PT, OT, Patient and Family teaching-Maintain accurate paperwork of patient information-Establish and maintain an excellent relationship with the Social Work, Managed Care, and Administrative Nursing Departments-Liaison between Home Care agency and patient-Ensure medication, supplies, and equipment transition from hospital to home

Bushwick, Ny (Closed In 2008)

-Created office operational system to increase work load and manage time effectively-Processed payroll for entire Nursing Staff-Managed Agency Nurses and their payroll-Managed escort schedule and Ambulette services-Processed Benefit requests for all shifts-Maintained all shifts staff schedule-Maintained doctor's visit, resident's dining table, and Decubiti schedules for all shifts-Participated in in-service classes both mandatory and voluntary-Worked closely with Social Services and Recreational departments for resident satisfaction-Ordered supplied and maintained department inventory-Answered calls, screened Director of Nursing calls-Performed clerical and administrative duties i.e. filing, database management

Certificate Pending, Business

Associate Of Science (As), Nursing

Certified Administrative Professional, Office Manager Certificate, Administration

Activities and Societies: International Association of Administrative ProfessionalsCertified Administrative Professional accredited.

Licensed Practical Nurse, Nursing