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Leadership Experience • Developed Psychiatric Unit’s COVID-19 guidelines to improve patient experience and outcomes• Created Multimodal clinical program outline for treating dually diagnosed patients• Proposed departmental restructure to increase productivity and generate revenue • Diligently oversees COVID-19 employee exposure and return to work process to ensure staff safety• Developed long-range program plans, goals, objectives, and milestones for evaluating and measuring the effectiveness of major agency programs. Additionally, accounts for factors such as cost effectiveness, attainment of program goals and objectives, and compliance with legal and regulatory guidelines• Implemented daily IDR rounds, as well as biweekly nursing supervisor and monthly staff meetings• Created and implemented change of shift report which improved both formal and informal communication within the department• Responsible for the strategic direction, management and performance of all Behavioral Health and Mental Health and Wellness activities through disciplined and principled leadership• Clarifies staff roles and selects appropriate unit assignments in order to increase unit productivity• Implemented staff orientation and onboarding process• Provides leadership in exploring alternatives and determining areas for improvement in all areas of Labor and Employee Relations• Actively recruited and trained new hires which resulted in the stabilization of the unit’s master schedule • Restructured department, shift times and staff positions to maximize patient safety• Implemented scheduled mealtimes for clients during the intake process• Actively participates in admission performance improvement team • Successfully lead patient interdisciplinary treatment team in collaboration with other providers to achieve patient treatment goals • Works with senior managers to ensure their participation in quality related projects• Trained oncoming utilization review staff coordinators in appropriate insurance protocol and procedures • Effectively taught staff clinical documentation, suicide prevention, and de-escalation techniques• Efficiently performed clinical audits and inspection of on client’s chart to ensure documentation met government accrediting agency standards • Assisted in training and educate all new crisis response center mental health technicians upon hire • Skillfully created a team building environment to increase staff morale and the success of the company • Created case assignment sheets for social work team required at utilization review•
Humana
View- Website:
- kaiserpermanente.org
- Employees:
- 120876
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Manager, Pre-Authorization NursingHumanaAlexandria, Va, Us -
Manager Utilization Management / Appeals ManagementKaiser Permanente Jan 2023 - PresentRemoteResponsible for leading and managing the Utilization Management team, processes and procedures focused on appropriate Skilled Nursing Facility utilization, including appeals & denials. • Carefully ensures compliance with national, and state regulatory/accreditation requirements related to utilization management by partnering with other departments and facilitating workgroups in maintaining survey readiness to ensure that all annual requirements are met.• Successfully leads the SNF Utilization Management Department with a strong leadership presence and engagement to support the ongoing development and performance of everyone on the team.• Skillfully manages the day-to-day utilization management function of a team or teams of clinicians ensuring the accurate and timely prior authorization of designated healthcare services, including concurrent and retrospective review of authorization requests.• Runs daily, weekly, monthly, and ad hoc reports to monitor and analyze department performance, assess data against standards and goals, and identifies trends as appropriate.• Manages and oversees the utilization review management training and education program for Utilization Review staff across the region. -
Manager Case ManagementInova Health System Jan 2021 - Jan 2024NOVA Fairfax Medical Campus Falls Church, VAManager Case Management January 2021- PresentSpine and Orthopedic UnitShort Stay Unit, Medicine Unit COncology UnitMedicine Unit AMedicine Unit BMedicine Unit BSurgical UnitNeuroscience/Intermediate Care UnitNeuroscience Intensive Care UnitMedical Observation Stroke UnitMedical/Surgical Intensive Care UnitIntermediate Care UnitTrauma Intensive Care UnitTrauma Acute Care SurgeryTrauma ICU · Carefully supervises staff on the coordination and facilitation of patient care progression throughout the continuum.· Collaborates and maintains active communication with physicians, nursing and other members of the interdisciplinary care team to effect timely, appropriate patient management and reduce length of stay.· Evaluates the process of initiating plans for discharge and/or transitions of care, and ongoing case management needs for patient and/or family. -
Nurse MangerThe George Washington University Hospital Uhs (United Health Services. Inc.) Nov 2019 - Jan 2021· Provides 24/7 oversight of clinical operations on a 20-bed psychiatric nursing unit.· Responsible for overall operations and nursing practice for unit which consists of 23 + FTE’s, including a team of 1 unit-based educator and 3 clinical supervisors.· Manages $1.5 million budget while consistently meeting productivity benchmarks as outlined by organizational standards by reducing cost and improving quality of care and service.· Initiates and drafts policies, instructions, standards procedures and guides for supervisors and employee useMonitors and implements inpatient psychiatric metrics/strategies that maintain CMS and Joint Commission standards. Studies regulations, standard procedures and guides originating from SAMHSA, HHS· Coaches staff in the selection and application of appropriate problem-solving methods and techniques· In collaboration with the Nursing Director, carefully develops both long and short-range goals for the department and services that are consistent with goals and objectives of the hospital.· Works with senior managers to ensure their participation in quality related projects· Participates in the collection of patient/customer satisfaction data.· Takes appropriate interventions (based on data analysis) which result in improvement in patient satisfaction data and sustained improvement over time.
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Senior Admissions Coordinator Per DiemBelmont Behavioral Health System Jan 2019 - Nov 2020Senior Admissions Coordinator Per Diem January 2019—November2020 Facilitated intake, admission, insurance benefit verification, and utilization review process, for incoming psychiatric patients.Efficiently provided ongoing clinical assessments of patients while educating patients and their families.Successfully collaborated with other medical and psychiatric facilities to ensure appropriate placement of care.Coaches staff in the selection and application of appropriate problem-solving methods and techniques, provides advice on work methods, practices and proceduresCompleted intake assessments for all clients in psychiatric crisis or suffering from substance use disorders.Carefully took vital signs, weighed patients and monitored clients in withdrawal from substance use. -
Lead Nursing Supervisor Cac / Interim DirectorPsychiatric Institute Of Washington Uhs (United Health Services. Inc.) Jun 2019 - Nov 2019Responsible for supervising and providing direct patient care related to the intake and admission of children, adolescents, and adults from the ages of 5-65+ that is congruent with the philosophy andResponsible for overall operations and nursing practice for unit which consists of 20 + FTE’s, including 2 clinical supervisors.Successfully provided supervision for the provision of all nursing care provided in the Clinical Assessment Center and participates in the hospital admission system for the purpose of coordination of patient intakes, assessments, and admissions. Competently interfaced with hospital management, physicians, staff, and patients, with licensing and accrediting agencies, family members, and healthcare treatment agencies as well as referral agencies and Emergency Departments.Coaches staff in the selection and application of appropriate problem-solving methods and techniques, provides advice on work methods, practices and proceduresSuccessfully demonstrated knowledge of intake and admissions processes, admission criteria, patient throughput, and census/bed management practices methods, techniques, and skills in integrating management systems within an intake/admissions department of an acute behavioral health care delivery setting.Effectively communicated, both orally and in writing, to senior management, physicians, groups of employees of varied technical support staff, and community organizations.Skillfully handled all telephone calls, fax referrals, and walk-ins to the hospital requesting mental health and addiction disorder services.Responsible for fiscal management, personnel management, clinical oversight, strategic planning, and education and research in addition to managing all nursing services and exercising twenty-four-hour accountability for assigned unit(s) with responsibility for the operation of all clinical and administrative aspects of the units.Works with senior managers to ensure their participation
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Manager Inpatient Utilization Review Management & AppealsKirkbride Center Core Care Dec 2014 - Jul 2018• Carefully analyzed psychiatric patient records to determine legitimacy of admission, treatment, and length of stay in health-care facility to comply with government and insurance company reimbursement policies. • Works with senior managers to ensure their participation in quality related projects• Responsible for overall practice and policies for the unit utilization department, which consisted of 15 + FTE’s, and 1clinical supervisor.• Competently presented a variety patient clinical information for Acute, Sub- Acute, 23-hour observation care, Detox, Short, and Long-term Rehab authorization reviews with insurance providers for precertification and continued inpatient care. Organized, manages, assesses, reports and monitors cost effective mental health and wellness services to ensure optimal financial and operational performance• Monitors and implements inpatient psychiatric metrics/strategies that maintain CMS and Joint Commission standards. Studies regulations, standard procedures and guides originating from SAMHSA, HHS• Successfully obtained reimbursements of hospital health care costs for inpatient treatment for up to 100,000 in revenue. • Effectively analyzed insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients. • Coached staff in the selection and application of appropriate problem-solving methods and techniques provides advice on work methods, practices and procedures.• Investigates new nursing techniques, practices, equipment and products.• Consults with pharmacists and medical staff concerning control and administration of medications related to policies and procedures.• Coordinates intra and inter departmental matters necessary to expedite the projects.
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Master’S Level Clinician Acii / Senior Case ManagerFriends Behavioral Hospital (Crisis Response Center, Admissions) Jul 2011 - Dec 2014• Successfully made psychiatric referrals for all clientele that did not meet inpatient admission criteria. • Carefully trained and educated all new crisis response case managers upon hire.• Efficiently lead team members and helped in the delegation of case management assignments. • Reviewed charts for compliance to assure that quality standards are being met. • Monitors and implements inpatient psychiatric metrics/strategies that maintain CMS and Joint Commission standards. Studies regulations, standard procedures and guides originating from SAMHSA, HHS• Performed assessments needed for disposition planning and arranging the appropriate after care services. • Carefully presented Acute, Sub-Acute, and 23-hour patient clinical information for precertification with insurance provider for inpatient admission. • Provided education, support, leadership, and guidance during times of workplace crisis or events. Lend support, leadership and/or sponsorship to cross departmental/facility initiatives to create a culture of mental health and wellness• Coached staff in the selection and application of appropriate problem-solving methods and techniques, provides advice on work methods, practices and procedures.• Completed intake assessments for all clients in psychiatric crisis or suffering from substance use disorders. • Assisted community members, and local law enforcement officers in filing involuntary 302 petitions with the Office Of Mental Health for individuals in crisis.• Assisted in safe restraints for any patients during psychiatric codes and emergencies.Other duties include personnel management, budget and fiscal management, contract oversight, manages peer review process, defines and implements Continuous Quality Improvement, ensures health care services met American Correctional Association and State accreditation standards, ensures c
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Lead Crisis Response Center Mental Health TechnicianLead Crisis Response Center Mental Health Technician Jul 2011 - Dec 2014• Assisted in the training of all new crisis response center mental health technicians upon hire.• Assisted community members, and local law enforcement officers in filing involuntary 302 petitions with the Office Of Mental Health for individuals in crisis. • Deescalated aggressive individuals, in addition to assisting patients with daily living. • Coaches staff in the selection and application of appropriate problem-solving methods and techniques, provides advice on work methods, practices and procedures• Carefully took vital signs, weighed patients and monitored clients in withdrawal from substance use. • Conducted, examined, and recorded results of patient’s urine drug screens.• Resourcefully created staff and patient care documents in order to make admission process more effective. • Safely restrained suicidal and homicidal patients in acute physical and emotional distress.
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Forensic Intensive Recovery Case Manager (Independent Contractor)Phmc (Public Health And Management Corporation) Jun 2010 - May 2012• Provided case management services to chemically dependent populations with a caseload of up to72 clients. • Maintained client’s records in accordance with agency fee for service standards, managed care, and licensing requirements, in addition to assisting clients to enroll in vocational services.
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School Therapeutic Staff Support (Independent Contractor)Progressions Behavioral Health Services Inc. Jun 2010 - Jan 2012• Constantly supplied one-on-one interventions for a child or adolescent with a serious emotional disturbance. • Carefully assisted clients in a community setting, as well as supported the client’s family members.
Jose Amaro Education Details
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Nursing -
Clinical Psychology -
Psychology
Frequently Asked Questions about Jose Amaro
What company does Jose Amaro work for?
Jose Amaro works for Humana
What is Jose Amaro's role at the current company?
Jose Amaro's current role is Manager, Pre-Authorization Nursing.
What is Jose Amaro's email address?
Jose Amaro's email address is jo****@****ova.org
What schools did Jose Amaro attend?
Jose Amaro attended Gwynedd Mercy University, Holy Family University, Temple University.
Who are Jose Amaro's colleagues?
Jose Amaro's colleagues are Rizwana Chaudhry, Rhonda Hamilton, Daisy Ditico, Jill M., Perla D, Jim Gillispie, Reginald Thompson.
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Jose Amaro
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