CURRICULUM VITAE KRISTEN JONES, RN, CLNC, CNLCP
SPECIAL CERTIFICATES AND LICENSES PROFESSIONAL EXPERIENCE (Detail)
Certified Nurse Life Care Planner Reviewed and entered all Acute Myocardial Infarction (AMI) Data into National Core Studies Program,Joint Commission on Accreditation of Healthcare Organizations, and National Medicare Program for Major Medical Center Participated in Congestive Heart Failure (CHF), Pneumonia, Surgical Infection, and Cesarean Section data collection for National Core Studies Program, Joint Commission on Accreditation of Healthcare Organizations, and National Medicare Program for Major Medical Center Performed Physician Peer Review and Quality Assurance duties for Obstetrics and Gynecology, Pediatric, Surgery, Psychiatric, Emergency, Radiology, and Medicine Departments of Major Medical Center Established and Implemented Physician Peer Review Program to interface with Physician Credentialing for all departments of a Major Medical Center Developed Medical Appropriateness Guidelines Manual and Policy and Procedure Manual for HMO/IPA Responsible for Single Source Contract for Home Health Care, Home IV Therapy, and Durable Medical Equipment for HMO/IPA Case Management of Catastrophic, High Cost, and Long Term Care situations for National Insurance Company and HMO/IPA Interpretation of Benefits/Claims Adjudication for National Insurance Company and HMO/IPA Developed and Implemented Policy and Procedure Manual for Level ll Nursery of new Home Birthing Unit Participated in development and implementation of Policy and Procedure Manual for Labor and Delivery, Ante-partum and Post-partum units of new Home Birthing Unit Patient Care in all areas of Labor and Delivery, Ante-partum, Post-partum, Well-Baby Nursery and Neonatal Intensive Care Units
SPECIAL CERTIFICATES AND LICENSES Registered Nurse – California - License #905454 – Active American Association of Nurse Life Care Planners PROFESSIONAL SUBSCRIPTIONS Journal of Nurse Life Care Planning NURSE LIFE CARE PLANNING Certification Kelynco Salt Lake City, Utah 2007 LEGAL NURSE CONSULTING Certification Vickie Milazzo Institute Houston, Texas 2007 REGISTERED NURSE Diploma Degree Merritt Hospital School of Nursing Oakland, California 1979 MAJOR : HEALTH SCIENCES San Diego State University San Diego, California 1976 2007 CEO
KRISTEN JONES CONSULTING, LLC
ALAMO, CALIFORNIA
Certified Nurse Life Care Planning and Certified Legal Nurse Consulting
Life Care Planning and Legal Nurse Consulting Services, including Medical Case
Screening for Merit, Comprehensive Medical Case Review, IME Attendance, Expert
Witnessing, Life Care Planning and Life Care Plan Critique and Rebuttal.
1998 – 2007 COORDINATOR
CLINICAL RESOURCE MANAGEMENT
ALTA BATES SUMMIT MEDICAL CENTER,
BERKELEY, CALIFORNIA
Reviewed the charts of all the patients with a diagnosis of Acute Myocardial
Infarction (AMI) averaging 125 to 150 charts per month, 1500-2000 chart reviews
per year. Also reviewed the charts of patients diagnosed with Congestive Heart Failure
(CHF), Pneumonia, Surgical Infections, and Caesarian Sections. This data base,
specific to the hospital, was then sent to the National Core Studies Program, the
Joint Commission of Healthcare Organizations, and the National Medicare Program.
The data is used to compare outcomes, rate hospital compliance, and set standards
at national levels. On the hospital level, it indicates areas and systems needing
performance improvement.
1995 – 1997 MANAGER
PHYSICIAN PEER REVIEW
ALTA BATES MEDICAL CENTER
BERKELEY, CALIFORNIA
Developed a Peer Review system for all departments of Alta Bates Medical Center
that provided the physicians with statistical feedback regarding performance.
It identified specific individual, departmental, and hospital indicators and then
provided individual and departmental feedback, which was presented monthly to the
Medical Director and CEO. This system also interfaced with the Credentialing
Department to provide data for Physician Recredentialing every 2 years. The
Peer Review System also investigated and documented situations with serious or
egregious outcomes. These situations happened in every department and needed
thorough investigation. Due to a very large Obstetrics department and large
volume of maternity patients, Fetal Heart Tracing interpretation and knowledge of
Labor and Delivery systems was essential to the investigation of “bad baby” cases.
Other specialized areas needing investigation provided intense, and often abrupt,
learning experiences.
1991 – 1995 COORDINATOR
QUALITY ASSURANCE/QUALITY AND RESOURCE MANAGEMENT
ALTA BATES MEDICAL CENTER
BERKELEY, CALIFORNIA
Performed general quality assurance duties, reviewed charts, assisted at monthly
departmental quality assurance meetings, supported department quality assurance
chairmen. The Quality Assurance System was outmoded and needed complete
revision to the more advanced system soon to be required by the Joint Commission.
The QA Department also needed to interface with the Credentialing Department to
decrease duplication of duties and provide data at recredentialing. Indicator
identification, surveillance methods for problem indicators, and all assessment
systems inadequate.
1990 – 1991 COORDINATOR
UTILIZATION REVIEW AND QUALITY ASSURANCE
PACIFIC HEALTHCARE
PLEASANTON, CALIFORNIA
Established and implemented Utilization Review and Quality Assurance Program
for a new Health Maintenance Organization (HMO) and Independent Physician
Association (IPA). Case management of catastrophic, high cost, and long term
care situations. Interpretation of benefits for claims adjudication. Responsible
for single source contract for Home Health Care, Home IV Therapy, and Durable
Medical Equipment. Established Medical Appropriateness Guidelines Manual,
Policy and Procedure Manual, and Standards of Care Manual.
1989 – 1990 COORDINATOR
UTILIZATION REVIEW AND QUALITY ASSURANCE
CIGNA HEALTH PLAN
OAKLAND, CALIFORNIA
Case management for high cost, catastrophic, long-term, and HIV cases. Provided
interpretation of benefits for claims adjudication. Renegotiated contracts for
Home Health Care, Home IV Therapy, Durable Medical Equipment, and
Prosthetics/Orthotics. Subscriber and Provider teaching regarding
HMO procedures.
1988 – 1989 DIRECTOR
PATIENT CARE SERVICES
MARTIN LUTHER KING JR. FAMILY HEALTH CENTER
RICHMOND, CALIFORNIA
State MediCal Program Clinic. Responsible for all LVNs and Aids working in
patient care areas. In charge of Standards of Care, Policy and Procedure guidelines,
and scheduling of LVNs and Aides. Supervised Medical Record Department and
MediCal/Medicare billing. Troubleshooting problem interactions between MDs,
PAs, nurses and patients. Responsible for all Obstetrical Intake and
inpatient hospital utilization.
1986 – 1988 HEAD NURSE - LEVEL II NURSERY
ASSISTANT MANAGER - FBU
FAMILY BIRTHING UNIT
PROVIDENCE HOSPITAL
OAKLAND, CALIFORNIA
Participated in starting a new Home Birthing Unit with Level ll Nursery at major
hospital. Developed and Implemented Policy and Procedure Manual for Level ll
Nursery. Responsible for all special equipment needed in Level ll Nursery and
Birthing Suites. Assisted with development and implementation of Policy and
Procedure Manuals for Labor and Delivery, Ante-partum and Post-partum
areas. Registered Nurse duties in all areas.
1985 – 1986 STAFF NURSE II
MATERNITY UNIT
ALAMEDA HOSPITAL
ALAMEDA, CALIFORNIA
Registered Nurse duties Labor and Delivery, Nursery and Post-partum units.
1982 – 1985 STAFF NURSE ll
BIRTHING UNIT
MARSHALL HOSPITAL
PLACERVILLE, CALIFORNIA
Registered Nurse duties in Labor and Delivery, Nursery and Post-partum units.
1981 – 1982 STAFF NURSE II
MATERNITY UNIT
AMERICAN RIVER HOSPITAL
CARMICHAEL, CALIFORNIA
Registered Nurse duties in Nursery, Post-partum and Labor and Delivery units.
1980 – 1981 STAFF NURSE II
MATERNITY UNIT
JOHN MUIR HOSPITAL
WALNUT CREEK, CALIFORNIA
Registered Nurse duties in Nursery, Post-partum and Labor and Delivery units.
1979 – 1981 STAFF NURSE ll
NEONATAL INTENSIVE CARE UNIT
CHILDREN’S HOSPITAL MEDICAL CENTER
OAKLAND, CALIFORNIA
Registered Nurse duties in Neonatal Intensive Care Unit, working with very
premature infants, compromised newborns, or newborns needing surgery.
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