My name is Donna Habick. I am Registered Nurse for 32 years and a Nurse Case Manager for 19 years. I have a son who is 19 years old. I taught religion for 12 years. I love animals. I have a BSN... show more
My name is Donna Habick. I am Registered Nurse for 32 years and a Nurse Case Manager for 19 years. I have a son who is 19 years old. I taught religion for 12 years. I love animals. I have a BSN and 6 credits towards my Master's. I would like to get my Master's in Nursing within the next 3 years. I continuously educate myself in nursing as well as case management. I find that Medicare, Medicaid, and the Insurance industry is constantly changing and we need to keep up with it.
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Case manager for a telemetry/ventilator unit. I did utilization review and discharge planning. Oriented new staff as case managers. Obtained authorization for procedures for patients going to other hospitals such as, heart cath. Ordered DME and Cardiac infusion drips for home.
I was the Director of Case Management for an LTAC- Long term acute care hospital. I ran the department and worked closely with the CEO. I did weekly reports, attended daily meetings, scheduling, payroll, hiring, orienting, and maintained a 10 patient case load. The patients were all ICU patients. I was in charge of decreasing length of stay and making sure utilization review was done on all patients. I attended all family meetings.
Brought onboard to assist with implementing this newly opened hospital's case management department.
*Helped troubleshoot 'Go-Live' issues related to the data input system; made recommendations to revise protocols.
*Role incorporates case management, utilization review and discharge planning for a 9-bed ICU, 9-bed CCU and 11-bed Telemetry Unit. Perform concurrent and retrospective reviews from day of admission to day of discharge.
*Respond to insurance denials; high level of success in obtaining favorable outcomes on appeals.
*Utilize InterQual evidence-based guidelines to qualify diagnoses for admission versus observation status.
*Evaluate level and intensity of services required; insure cost-effective treatment within acceptable time constraints.
*Promptly initiate discharge plans and identify any barriers impeding care delivery.
*Complete Medicaid pre-screening for patients being discharged to extended care and rehabilitation facilities.
*Liaison to insurance companies to provide status updates and substantiate need for continuance of stay.
Received concurrent and retrospective reviews from case managers at 7-9 hospitals; typical caseload 50-75.
*Entered data to determine if they met Milliman criteria for approval of services; forwarded potential denials to the Medical Director for review. Met 24-hour turn-around time in making final determinations.
*Initiated process for extended care with physician; approved DME supplies, home care and other services.
Role incorporated case management, utilization review and discharge planning for telemetry, ventilator unit and hemodialysis, totaling 40-beds. In charge of interdisciplinary rounds with daily review of each patient.
Responsible for medicine-surgery, telemetry, ICU and renal unit; utilized InterQual guidelines.
Similar to role at Hackensack/Pascack Valley; included psychiatry, telemetry and ICU; additional responsibilities for Quality Improvement (QI) and Risk Management (RM).
*Responsible for thorough investigation of occurrences to identify triggers involved in incidents and accidents.
*Active involvement in the appeals process; submitted required documentation to insurers to reverse denials.
On-site at Passaic General Hospital; reviewed suitability of referrals for home cared to determine for the program.
*Identified frequency and intensity of care required, approved or denied skilled nursing, home health aides, home infusion therapy, durable medical equipment, pharmacy services, transportation, etc.
Visited hospitals in Bergen and Passaic counties; established contact with case managers and social workers to receive referrals for extended care. Met with patients and family to familiarize them with Bristol and arranged tours.
*Rotated to Administrator on Duty of this 180-bed facility; responsible for oversight of all departments.
Liaison to insurance providers to furnish medical justification for a wide variety of therapies and services in order to capture maximum reimbursement and substantiate need for continuance of care.
*Followed a caseload of over 100; insured timely transmission of updated data on patient status.
On-site at hospital; processed patients for home services. Visited Kessler Institute weekly to obtain referrals.
*Reviewed charts and applied ICD and DRG coding; assigned home therapists (PT, OT and ST) to cases.
Classroom, clinical and skills lab instruction; included A, medical terminology, vital signs, medications, etc.
Managed 10-RN staff; reviewed documentation, delegated assignments, conducted home visits, evaluated job performance and provided educational support. Conducted chart Utilization Reviews prior to billing.
New Jersey Professional Registered Professional Nurse. Went to paralegal school form September 1987 to May 1988.
- Can operate a computer printer cell phone. I can also fix and trouble shoot problems with this equipment.
Taught religious education (Catholic) to 2nd, 4th, 6th, and 7th graders. From Sept. 1999 to May 2010