Elizabeth Mack

• Managed Potential Quality of Care cases that were determined to require Quality Investigations.
• Participated in Auditing of providers for EPSDT, AMRR, and CPG as needed. Assisted in medical record retrieval for HEDIS season.
• Managed data/reports pertaining to quality of care related matters. Findings presented to internal organizational stakeholders.
• Served as the key contact with external stakeholders.

Facilitated and performed Annual Medical Record Review in accordance with CMS guidelines for Behavioral Health providers.

• Facilitated healthcare telephonically for clients ranging from neonate to geriatric.
• Utilize nursing experience and organizational tools to address and effectively resolve the needs of the client.
• Communicate with providers in all disciplines as warranted to resolve client issues.
• Committee work to design and implement processes that enabled telephonic nursing units maintains Level 5 status for best practice.

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• Performs case audits and participates in accreditation reviews.
• Led a team comprised of clinical and non-clinical members with the delivery of clinical programs.
• Provides clinical guidance, serves as content expert, and manages escalated member calls.
• Performs the work of the clinical team as needed to maintain department performance metrics, and to retain clinical practice proficiency, and operations expertise:
• Serves as a clinical advocate for the frontline clinical associates using clinical skills, experience and training.
• Collaborates with medical directors, health professionals, providers and members to promote quality member outcomes.
• Acts as preceptor resource and clinical subject matter expert for the team.

• Led Quality teams by setting Quality Initiatives and following through
• Assess and direct processes that meet educational needs of all Critical Care staff members. Responsible for the transition of new employee's ranging from novice to expert, into the critical care environment.
• Minimize staff frustration and attrition through early recognition and resolution of challenges, which are inherent in the critical care environment.
• Designed and conducted annual recertification for staff of the ICU, IICU, and CCU.
• Designed programs to address No Lift Initiative, Patient Fall prevention, Pressure Ulcer Prevention, and Pain Prevention in the continuously ventilated patient.
• Served as auditor for quality initiatives as well as auditor for state wide programs related to clinical and research purposes. JCAHO representative for auditing.

• Clinical Informatics Instructor- Instructed and supported clinical staff education facility wide as it related to implementation of new clinical software and associated applications.
• Served as instructor to all staff facility wide, throughout employment.
• Created baseline structure for use in the implementation of Electronic Medical Record, Electronic Pharmacy Records, and applications that supported Electronic Charting of care rendered.
• Provided the implementation of computerized charting in two additional facilities.

• Staff/Charge RN on Intermediate Intensive Care unit.
• Directed and provided primary care to acutely ill patients, adolescent through geriatric.
• Provided comprehensive nursing care as part of an interdisciplinary team, whose goal was to restore each patient to his or her optimal level of health.
• Supervised and coordinated care for all patients.

Supervised and directed all operational and clinical functions of a 527-bed acute care facility and all of its ancillary departments and staff.

Directed nursing care of patients on a 32-bed unit, comprised of high-risk obstetrical and complicated gynecological surgeries.

Directed nursing care of patients on a 27-bed cardiopulmonary unit requiring telemetry.

• Directed nursing care and daily operations of a 7-bed progressive ICU step-down.
• Acted as primary nurse care provider to patients in ICU and PICU.