Adrienne Evans
Banks,OR
Summary
Insightful UM Nurse with 25 healthcare years of experience. Reviews and updates production processes to increase consistency, minimize waste and capitalize on latest technological developments. Systematic problem solver in pursuit of boundless progress.
Overview
16
16
years of professional experience
Work History
Hospice UM Quality Coordinator RN
Kaiser Permanente
07.2022 - Current
- Tracked quality issues with external customers, suppliers, and internal operations.
- Ensures standardization of benefits and services across the region
- Strategic collection and analysis of quality and utilization data for outsourced patients.
- Analyzed data trends to identify opportunities for process improvements, leading to more efficient workflow and higher quality output.
- Maintained open communication channels between departments so that any issues could be quickly addressed before affecting overall product quality.
Hospice Referral Nurse
Kaiser Permanente
02.2018 - 07.2022
- Chart review along with bedside assessment for hospice eligibility
- Provided compassionate support to patients and families during the referral process, addressing concerns and answering questions.
- Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
- Admissions with benefit period assessments
- Phone triage, hospice phone advice, and team lead duties
- Care coordination, discharge planning
- Educating families, nurses, and other partners of hospice benefits.
Registered Nurse
Kaiser Permanente
09.2015 - 02.2018
- Medical/Surgical Telemetry Unit
- Managed care from admission to discharge.
- Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
Registration Representative
Kaiser Permanente
09.2013 - 09.2015
- Urgent Care triage and registration
- Ensuring patient safety, confidentiality, verification of medical benefits, and proper handoff to medical staff
- Catalogued patient data in clinical databases and registries according to regulatory practices.
- Assisted other clerks with front desk duties, answering questions and accurately using reservation system.
Pre-Registration Representative
Kaiser Permanente
12.2010 - 09.2013
- Verify insurance coverage and eligibility
- Medical record review to confirm eligibility and gather clinical information for pre authorization
- Creating estimates based on current benefits, CPT, ICD-9, and DRG coding
- Medicare part A and B, Medicaid pre authorizations
Patient Support Representative
Kaiser Permanente
09.2007 - 12.2010
- Patient support with disability claims, private insurance, FMLA forms, releasing of PHI to patients and med-legal release
- Scanning of medical records for appropriate information to release and preparing records for copying or printing
- Including ICD-9 coding and procedural coding
- Doctor notes and supporting facts for ICD-9 coding.
Education
RN to BSN -
Western Governors University
Salt Lake City, UT03.2016
Associate of Applied Science in Nursing -
Mt. Hood Community College
Portland, OR06.2015
Skills
- Documentation Auditing
- Training and Development
- Microsoft Office
- Self-Directed
- Supervision and leadership
- Problem-Solving
- Epic
Certifications Awards
- BLS with AED AHA
- Epic Proficient
Timeline
Hospice UM Quality Coordinator RN
Kaiser Permanente
07.2022 - Current
Hospice Referral Nurse
Kaiser Permanente
02.2018 - 07.2022
Registered Nurse
Kaiser Permanente
09.2015 - 02.2018
Registration Representative
Kaiser Permanente
09.2013 - 09.2015
Pre-Registration Representative
Kaiser Permanente
12.2010 - 09.2013
Patient Support Representative
Kaiser Permanente
09.2007 - 12.2010
RN to BSN -
Western Governors University
Associate of Applied Science in Nursing -
Mt. Hood Community College