Cardiovascular Critical Care Expert Witness

Expert Witness No.1590

Alabama

Education

2005 Canyon College Obtained certification from Canyon College as Legal Nurse Consultant – Certified Specialist (LNC-CSp)

1983- 1987 University of Alabama Birmingham, Birmingham, AL
Bachelor of Science in Nursing (RN BSN)

Experience

2006- 2008 Healthspring of Alabama, Birmingham, AL

Responsible for the day to day operations of the Chronic Care Improvement department.  Including, but not limited to:
Identifying high-risk/high-cost patients for possible case management intervention. Early identification of discharge planning needs. Interfaces with providers of medical services and equipment to facilitate effective communication, referrals, development of discharge planning and alternative treatment plan development. Provides case management service for assigned patients in addition to responsibilities as manager.  Serves as an internal and external resource person (department personnel, members of additional departments, insurance and stop-loss carriers, vendors, providers and members). Assists with assignment of patients to case managers. Assists case managers in decision making for appropriateness of treatment plan in the absence of the director. Represents department director at designated meetings in her absence. Provides assistance to department manager in the orientation and education of department members. Involved in development and implementation of department’s policies and procedures. Reviews written communication (such as correspondence and case management reports) for content and grammar prior to mailing. Monitors and analyzes department’s reports regarding case management monthly summary report. Monitors and audits case managers’ cases quarterly, weekly and daily. Conducts inter-rater reliability testing according to department policy. Conducts any and all necessary department meetings in the absence of the director. Attends any and all conference calls in the absence of the director.

2006 Oasis Healthcare / A Medicare Hospice Provider-Leeds, AL      

Clinical Director / Administrator
Recruited by the owner of Oasis Healthcare to open a hospice in Leeds, Alabama and to become the corporate hub for the company. Responsible for all aspects of the hospice, I was also performing utilization reviews for this company in their Alexandria, Louisiana office.

2005- 2006 Healthspring of Alabama Birmingham, AL

Life Enhancement Case Manager
I coordinated the completion of the development and implementation of the life enhancement program at Healthspring of Alabama. This included promotion to local hospitals and healthspring employees as needed. I performed intensive case management of and for health plan members with life limiting illnesses. This included utilization management skills, advanced care planning and other facets to assist the member as they progressed through their disease process. This helped the member and saved costs over time.

2005- Present Legal Nurse Consultant - Owner of Private Company

I perform legal consulting on cases to assist attorneys in find the facts and evidence in legal cases that involves medical information in a legal context.                
These include policies and procedures, missing or tampered records, witness deposition, identification of deviations from standards of care to name a few.

2005 Utilization Review Nurse Birmingham, AL

Utilization Review Nurse
Chart review for National Insurance companies to ensure proper utilization of health care system including utilization reviews, PIR audits, etc. (project work)

2002- 2005 SouthernCare Hospice Inc. Birmingham, AL

Clinical Director Birmingham Office
Supervised, oriented, trained and assigned all employees giving direct patient care and also functioned as Care Team Leader. The Clinical Director is responsible for management of the hospice program in matters of overall operation at the local office level. Conducted focused medical review audits on a daily basis.

I began work with this company on August 19, 2002. My average caseload of 16-18 patients. I was also responsible for supervising the home health aids for these patients as well as taking call for all the patients on the team. The average census at this time for my team was approximately 50-75 patients.

In August of 2003 I was promoted to the position of Lead Case Manager. In this position I was responsible for scheduling of home health aides, assisting the Clinical Director, chart auditing, and various other duties.