Sherri Wilson Email & Phone Number

United States

United States

Doing part-time preventive weekly Covid-19 testing at local schools.

Mesa, Az

Phoenix, Az

*Coordination of care for patients with chronic kidney disease stages 3-5 needing education classes (MIPPA). Identify patients who have not yet been scheduled and reinforce importance of education to avoid further complications.*Travel to various AKDHC offices to set up the MIPPA courses, interaction with patient and provider. Schedule patients for Ancillary services such as Nutrition and Vein Mapping based on patient needs and physician recommendation. *Schedule patients with chroinic and/or end stage renal disease for fistula/graft creations, interventions (ie; venograms, thrombectomies, HD catheter removal/replacement, etc) related to dialysis access.*Educate patients who are close to dialysis or already on dialysis the importance of obtaining a permanent access and/or maintaining their access by being proactive with follow-up venograms to help prevent emergent situations.*Refer patients to outside vascular surgeons when indicated. (ie; complex patients needing anesthesia in a hospital setting, or by patients choice)*Schedule interventions for the Flagstaff and Chandler surgery centers.*Take incoming calls assisting dialysis center staff, AKDHC office staff, patients with their questions and scheduling needs.

Phoenix Area

Part-time per-diem contracted staff LPN doing preventative health screenings as a health coach, or blood pressures, height/weight, BMI for various employer groups.

Phoenix, Arizona Area

CRS Clinical Liaison for Phoenix MSIC (approximately 15,000 enrolled members)1/2009 - 7/2011 Arizona Physicians IPA-CRS line of business under United HealthCare/Community and State Phoenix, AZ*Resource for APIPA-CRS staff, all AHCCCS plans, providers, families and members in guiding them through the CRS maze by answering their questions and directing them to the appropriate contact person within the organization, (prior authorization, member services, claims, medical director, etc). *Coordination of care for members receiving out-of-state services, have been redirected back to CRS via ‘409’ process, non-health plan requests, ‘NOA’, (notice of action), etc. *Review of those member’s charts who are aging out of CRS, (turning 21), within 90 days and completion of the ‘ETI’ form. This is done monthly (25-45/month). *Review and organization of initial service plan forms received back from the MSIC to enter initial appointments as they occur. (Average of 250-500 newly enrolled members every month). About 40-50% of these members are assigned outside of the MSIC and calls are made to obtain appointment information, needed records, from these providers. *Assist with entering 90 day service plans into the CRS database as indicated. *Analyze/extract data from various spreadsheets (initial appointments, MSIC activity reports, (appointment information), as needed to assist in doing various jobs/requests. *Pull medical records from health records dept as requested for information needed by medical director, case managers, QM nurses, etc. *Created a form for all liaisons to utilize as a communication log that can be printed/saved in member’s chart and saved in the APIPA-CRS database. *Assist with medical eligibility, (review/make determinations of new applications), as needed. (This includes adding appropriate diagnosis codes). *Compliance with state regulators, (CRSA, AHCCCS).

'QM CRS (Children's Rehabilitative Services) Coordinator'- AHCCCS (Medicaid) Healthplan. *Ongoingeducation of members, co-workers and providers of state guidelines regarding CRS (Children's Rehabilitative Services) to ensure compliance by having qualified individuals enrolled in CRS. *Develop and present Internal and external inservices. *Create educational tools to assist in educating providers/health plan staff. *Identify and redirect high dollar hospitalizations/ DME/ surgeries from the health plan to the proper agency (CRS). *Direct intervention with prior auth, claims, QM, case management, pharmacy, member services to ensure communication /understanding of the CRS process. *Maintain knowledge of CRS policies, guidelines, related state regulations to assist with compliance within the health plan.

*Facilitate care for members within the AHCCCS (AZ medicaid) population. *Assisting members with chronic/catastrophic conditions into appropriate eduction classes, as well as telephonic education to guide them in receiving the necessary care/treatment available through the health plan to prevent ER visits and hospitalizations. *Interaction with providers as well as UR nurses, hospital social workers/case managers/home health agencies/DME companies/hospice services to assure members have access to all resources available to them.*Verification and authorization for wound clinics/home health/hospice services/education classes.

*Chart reviews of eligible patients for a preventative cardiovascular health program. Enter required information into database and submit to corporate site via laptop. *Apply 24 hour heart monitor on patients and provide education of program/preventative health issues. Upload the monitor readings to the corporate site via company provided equipment. *Interaction between providers, staff and patients.

*Telephonic population disease management and education for members with diabetes and/or cardiac disease. *Proficient in use of 'Population Works' database. *Active in call center Newsletter Committee as editor and submission/recruitment of articles. *Participated in creation of education tools to assist members with smoking cessation and weight management. Also participated in presentations related to 'Goal Setting' for co-workers.

*Telephonic interventions to educate and council those members (with diabetes), regarding their disease process enabling them to prevent complications. *Deploy community and/or other resources based on needs for living with their chronic disease. *Produce better health outcomes for members * Input ideas towards changing existing survey scripts and creating new scripts.* Create educational materials for members specific to health and wellness. *Produce letters of correspondence related to the health surveys. *Edit letters and educational materials as requested by supervisor. *Share educational information I've researched with co-workers. *Assist fellow staff with computer related issues and educate them on basic computer applications as needed. *Departmental team leader on occasions as requested by supervisor. *Problem solves system issues as necessary.

*Managed the Physician Profiling (grading tool) in conjunction with the Medical Director. *In-house education of staff. *Presented to provider reps the initiatives for mams/paps, diabetes clinical practice guidelines, and other preventative care measures, as well as the physician profiling. *Development of functional educational tools for myself as well as other staff members to utilize. * Education of providers related to wellness/preventative care programs as well as QIA initiatives (i.e., mams/paps, diabetes clinical practice guidelines, etc). *Create professional correspondence for providers and members. * Compose health-related articles for the provider and member newsletters. * Managed the CRS (Children's Rehabilitative Services) project, as 'CRS Liaison'. *Identified costly procedures/hospital admissions that should be covered by CRS, rather than HCA. *Telephonic intervention with providers and members.

Phoenix, Arizona Area

*Staff nurse on an inpatient pediatric floor for 6 years.*Children's Rehabilitative Services (outpatient clinic for children with special needs)- 8 years. *Organized orthopedic clinics (i.e., general, Cerebral Palsy, Scoliosis, Hand, Amputee). *Organized and managed Pediatric Screening Clinic. *Coordination of care for special needs children. *Team player on acute care pediatric ward- 6 years. I’ve also worked some part-time home health jobs in the Phoenix area and pediatrics, OB, Labor and Delivery, medical surgical wards at different hospitals in Philadelphia, PA..

Diploma, Practical Nursing

School of Practical Nursing

Diploma, Commercial-Academic