Melissa Lesh

• Collaborated with various members of patient's Interdisciplinary care team, coordinating care, resources and/or services to achieve optimal patient outcomes.
• Performed comprehensive assessments and developed a patient-centered care plan tailored to patients’ needs; identified barriers to meeting goals or plan of care
• Educated patients on disease management and preventive care practices.
• Knowledgeable about reimbursement sources and Medicare regulations.

• Completed medical necessity and level of care reviews for requested services using Clinical Policies, MCG/InterQual and clinical judgment.
• Collaborated with various member of patient's Interdisciplinary care team and community resources electronically or telephonically to coordinate patient care.
• Participated in the development of a State Medicaid pilot program (Healthy Opportunities Pilot Program) addressing social determinants of health for our members including staff education and team lead responsibilities.
• Used professional nursing judgement to individualize plan of care based on assessment of the patient's unique needs and response to care with an interdisciplinary team approach.
• Knowledgeable about reimbursement sources and Medicaid regulations.
• Provided patient education and empowerment to accomplish care plan goals.

Restarted temporarily working with company in 4/2024 till 10/2024 in a Nurse Care Coordinator role.

• Planned, organized and delivered quality direct and indirect care to pediatric patients and their families.
• Collected, labeled and stored lab samples according to laboratory specifications.
• Telephone Triage.
• Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
• Care coordination of complex pediatric patients and assist with reducing high utilization reduction.

• Used professional nursing judgement to individualize the plan of care based on assessment of the patient's unique needs and response to care with an interdisciplinary team approach.
• Educated patients and families on disease processes, medications and treatments.
• Provided training and supervision to nursing assistant staff.
• Collected samples to complete diagnostic and routine assessment tests.
• Wound care management

• Supervisory/charge nurse skills including managing staff scheduling/assignments and payroll.
• Clinical Care CoordinatorWorked solely on an initiative to reduce high utilization ER visits by managing patient follow-ups call and records. Helped reduce barriers to care through patient education and resources management.
• Pediatric assessment and procedure skills.
• Telephone triage and ADHD/Asthma medication management.
• Assisted with practice PCMH certification.

• Worked as part of an interdisciplinary team.
• Wound care management.
• Provided nursing care for patients with neurological and orthopedic injuries.