Jone'E Polites Email & Phone Number

United States

Develop and socialize new clinical programs, workflows, and tools to care managers and care coordinators across various departments. Manage care coordination of client panel of high-risk members (referrals, reimbursements, prior authorization, vendor management) throughout the care continuum, (acute, post-acute, discharge/transitions of care).Monitor cross-departmental communications and ensure the team is aware of timely and important updates.Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, employing a variety of strategies/techniques to manage appropriately and provide timely interventions. Assess the patient's overall health and implement strategies to manage needs and provide the necessary interventions and resources. Monitoring patients with comorbidities for increased health risks, navigating to care and accessing local resources to complete care plan. Contributing to other areas of the business related to clinical care, such as development of care plans, process improvement, and audits of clinical quality and operations.Developing care plans in partnership with members and their caregivers - problems, goals, interventions - while continuously evaluating the member’s progress.

United States

Assess members to identify medical, physical, and psychosocial needs in order to prevent utilization and support member’s overall goals of care.Ensure and evaluate clinical appropriateness of care plan by incorporating assessment findings against evidence-based guidelines, clinical reasoning, clinical practice guidelines and/or best practices in the community.Provide education and coaching surrounding disease management by identifying new and preventable exacerbations or worsening chronic conditionsCreate interventions and overall plan of care for disease management pods. Including direction of the Community Health Worker’s field-based interventions.Enhance department and organization activities by identifying opportunities for improvement to existing processes.Comply with all regulatory and quality agency standards including: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Services (DHS), and accreditation bodies’ standards such as the National Commission of Quality Assurance (NCQA) as it relates to care management activities

Miami/Fort Lauderdale Area

Assess Medicare, Medicaid, Commercial, and/or and Group Account members in seven domains of functioningEvaluate member needs and requirements to achieve and/or maintain optimal wellness stateGuide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of membersHEDIS review, and responsible for verifying this and validating that the data reviewed by the HEDIS Abstractor is accurate. Extensive abstraction experience and knowledge of NCQA StandardsDetermined patient eligibility for special community programs.

United States

Performed RN duties for critically ill cardiac, cardio-thoracic, transplants, vascular, oncology, plastics, and neurological/neurosurgical patientsExperience in Level 1 center care, caring for critically injured trauma patients, critically ill cardiac arrest patients and neurological consultsResuscitate and stabilize patients, manage IV drips and titration, Art Line, CVP and Swan-Ganz transducer lines, ventilators, wound care, medications and other appropriate nursing servicesWorked Per Diem from 2016-2020

Miramar

Managed adult and pediatric hospice patientsProvides an appropriate, comprehensive and responsive plan of careProvide prevention and intervention for multiple comorbidities by listening and performing an assessmentCoordinates care for patient and cooperates in interdisciplinary team meetingsTravels to patient’s location to provide nurse care in critical or emergency events

Miami/Fort Lauderdale Area

Critical Care Registered Nurse

Master Of Science - Msn, Nursing Administration

Associate'S Degree, Registered Nursing/Registered Nurse

Activities and Societies: Treasurer of the Student Nurse Association Florida Nurse Association

Master Of Business Administration - Mba, International Business

Bachelor'S Degree, International Marketing And International Business