Rachel Smith Email & Phone Number

Case/Care/Resource Management.

Non-profit facility ED Care/Resource Management compliance using Interqual Criteria. Initiate working DRG assignment using 3M upon admission. Problem solving Social Services issues encountered in the ED dept upon presentation for treatment with recommendation and referral to appropriate agencies.

Independent Care/Resource Management for CommunityVolunteer services; for those in need of transportation for medical appointments, chemotherapy, pharmacy, free baby-sitting services for parents needing to travel for medical purposes to assist loved-ones or for themselves etc. There are so many unmet needs within our communities that go unnoticed and overlooked. Simple needs like transportation issues, caregiver issues, unraveling the beurocratic red tape to get problems solved more often than not leads to the frustration of not being able to define the next step in a need process and is the leading cause for failure in our community patient population. Hospitals must have an action plan in place to address these issues as well; when patients present with ongoing social needs in the ED or other referral sources.

Program/clinical services focused individual with a proven record for leadership in motivating individuals to achieve goals, while optimizing client relationships, strategizing for financial needs and staff personal growth. Background includes but is not limited to Hospice, LTC, LTAC, education, case management, UR, marketing and sound business principles. Proficient in computer skills (I.e. Word, Office, PowerPoint, Excel).

Executive Director/Program Management:Hospice program/clinical services management (start-up) direction of all staff/employee relations; including all ancillary services. Awarded “Center of Excellence” for exceptional performance in regulatory compliance (98% consistent), quality management (PI), COPs, SOP’s, safety, staff/community education, center growth/marketing and EBITDA benchmarks. Nominated corporate mentor for mirror employees to educate and support. Survey readiness. Implemented outreach programs (in-service) for staff education related to Hospice policy/procedures/appropriate levels of care, HR competencies and staff orientation; community education through marketing opportunities throughout the entire continuum. Actively implemented/enforced /maintained all regulatory changes with 98% benchmark attainment.; CHAP’s participation to lead by example through organizational excellence and quality performance. Implemented Cerner Project for regulatory compliance/billing. Approvals of all billing and use of ICD-9 and CPT coding to establish billing appropriateness and maintain PPD budget requirements. Direct financial reporting to CFO and RDOO.Active participant in the Mississippi Bridge Grant Program @ USM for community education/outreach and needs engaging with State and Local Officials; community business to promote Hospice services and understanding. Partnership with ADP for community relations.

Director Case Management/Social Services:Implemented Case Mgt. program for start-up facility to accurately forecast all aspects of utilization review, discharge planning and DATA driven processes for Quality Management ; and to comply with all regulatory agencies and Corp. benchmarks., customer satisfaction. Maintained 98% benchmark review.Team Leader for all clinical reviews and needs/risk management/quality management related to client appropriateness and needs as well as LOS issues and needs.Actively participated with management team with relevant input for budget projections, growth, preparedness and execution. Reporting and support to CEO/COO.Clinical Liaison to host hospital for client/facility relationships and referral appropriateness.Liaison for client needs when transitioning on the healthcare continuum (referrals to lower levels of care).

Allied Health/Transitional Instructor; public school system

High School

Nursing, Nursing

Education