Deborah Unger, RN, 154 Lake Chateau Drive Hermitage, TN.

37076-3007 Home Phone #615-871-4985 - Cell: #424-3985 du13bbdb2@westpost.net _____________________________________________________________________________ QUALIFICATIONS Recognition through "The National Association of Healthcare Quality "(NAHQ) As a Certified Professional in Healthcare Quality (CPHQ) - 1995 - 2004 Certified as a Long Term Care Surveyor through Centers for Medicare and Medicaid (CMS) in 2002. * Upper management and consulting levels in homecare environments. Experience w ith JCAHO, Federal Conditions of Participation (COP's), State, and Centers for M edicare and Medicaid Services (CMS) guidelines. * Experience with Medicare denials, case management, audit skills, utilization review, telephonic concurrent review. * Proficient in Microsoft Word, Excel and PowerPoint computer skills WORK HISTORY HealthSpring ( 11/10 - present) Case Manager for HealthSpring at Home. Case manage members, make home visits, develop a care plan for high utilization of health care. Telephonic and on-site case management . Guardian Hospice - Quality Improvement Director (10/08 to 9-09) . Implement ation of new Hospice Federal Conditions of Participation, staff development,. Be nchmarking against national Hospice guidelines Zero deficiencies on State Surve y. NHC Homecare - Regional Administrator / Director of Performance Improvement (1 1/03 - 10/08) Regional Operations manager of 7 homecare agencies. Internal audi ts in Performance Improvement, OASIS and ICD-9 CM Coding in preparation of Pay 4 Performance. Zero State Survey deficiencies. State Travel. Blue Cross Blue Shield (4/03 - 11/03) TennCare Case Manager - Perform tel ephonic case management with adult and pediatric patients. Utilization review , care planning, Authorization of referrals to hospitals, home care, private dut y. Review records in accordance with company policies. Process denials, refer t o Medical Director. NCQA Accreditation Tennessee Department of Health /Division of Health Care Facilities - (6/02 - 11 /03) State Surveyor - Long Term Care - Investigation of consumer complaints against healthcare facilities. Inspection and interpretation of State and Feder al guidelines r/t healthcare facilities. Healthcare Consultants, Inc (5/00 - 6/02). Clinical Consultant / Medicare Appea ls Analyst Worked under Melinda Gaboury for analysis and preparation of appeal process for Medicare denials via contract with a national rehabilitation company. HIPPA, Cor porate Compliance HomeCare Solutions, Inc. (7/99 - 5/00) Director of Clinical Services - Ope rations, Performance Improvement and clinical oversight of three merged companie s, (Home Health. Hospice and DME) consisting of 7 offices, covering 30 counties. Successful State and JCAHO accreditation. America Service Group, Prison Health Services - (4/99 - 6/99) Interim Risk Manag er - Review/analysis of multi-state prison site incident reports. Identification and analysis of loss exposures for company. Interact with regulat ory agencies, insurance and law firms. Friendship Healthcare Services - Consultant - (2/99 - 4/99) Planning and impl ementation of Corporate Compliance Plan, QI, Advisory Board, and annual program evaluation.

Quality Healthcare Management - Columbia Homecare (1996 - 1998) Assistant Admi nistrator. Michael Minch, MD owner. Management company contract for overall administration and operation of hospital based home health agency. JCAHO accre ditation in 1997. Columbia Home Health sold 7/98. Currently HCA/Tristar ResCare Management Services -(1994 - 1996) QI Specialist. Multi-state Operation al audits/analysis, QI compliance and regulatory training. JCAHO and Medicare providers. l. Company sold '96. ABC Home Health - (1991 - 1993) Staff Development Coordinator: Direct client c are and management. Development and facilitation of regional orientation of fie ld employees. Company dissolved 1993. Vanderbilt University Medical Center _ (1986 - 1991) Staff RN, Quality Perform ance/Utilization Management. Concurrent and retrospective reviews for insurance providers. EDUCATION * State of Tennessee Dept. of Health and Environment - Board of Nursing * #RN0000071945, exp. 10/31/2011 * Tulsa Junior College, School of Nursing, RN - AAS Degree 1980 * Tulsa Vocational School of Practical Nursing, 1974 - LPN * .Certified Surveyor in Long Term Care - 10/2002 REFERENCES * Cathy Nash, RN - Cell: 615- 289-3051 . * Madeline Coleman, JD, RN - Quality Manager State of TN. Work: 615-741-7524, Cell: 615-668-0937 * Michelle Bobo, RN - Director of homecare Regulatory and Compliance - Tn Assoc. Home Care * Cell: 615-604-6656