Amber Jackson
Heartland,TX
Summary
Dedicated Licensed Vocational Nurse with 14 years' expertise in the healthcare field managing clinically complex patients, quality assurance, and clinical coordination.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Lead Clinical Specialist
Abbott Laboratories
08.2020 - Current
- Facilitated and assisted providers and their patients with the pre-certification process by working with respective carrier's utilization departments.
- Led efforts to develop programs that assisted with multiple levels of appeals in the event of coverage denial.
- Led provider in-servicing surrounding the pre-authorization process.
- Acted as conduit for policy and coverage training/updates to the PTA Specialist while working in tandem with leadership and Healthcare Economics & Reimbursement representatives.
- Lead for a team of 8 while simultaneously managing multiple cases within the central region.
- Audited clinical documents for completeness, accuracy, and medical necessity.
- Facilitated a team environment by providing training to appeal specialist and territory managers on the authorization process, defining common goals, encouraging communication, and promoting collaboration.
Clinical Coordinator/Quality Assurance
Ally Home Health
07.2016 - 03.2021
- Auditing of nursing notes, oasis, and other documentation to ensure compliance with federal and state guidelines.
- Prepared and submitted Home Health authorization request and DME request,
- Reviewed pre-service denials and prepared and submitted appeals.
- Reviewed and monitored the following reports for accuracy and compliance: infection reports, hospitalizations, and incident reports.
- Telemonitoring of high-risk patients.
- Developing and implementing SOP's for remote patient monitoring programs.
- Communication with doctors, infusion pharmacies, and other community entities.
- PRN field infusion visits.
Care Manager
C & S Staffing/Humana
12.2018 - 07.2020
- Acted as an advocate for members by coordinating care between the member, physician, and family members ensuring coordination of care.
- Evaluated the need for interventions during patient assessments and, when appropriate, evaluated, and implemented available resources/options for a successful patient outcome.
- Completed member assessments to assist with the creation and implementation of care plans based on each member's specific needs.
- Provided disease-specific education and researched available resources to assist with the prevention of recurrent hospital admissions.
- Educated the member/family on aging issues, health, and life choices.
- Conducted orientation with all new members to fully explain the member's program benefits, reviewed the assessment and completed an individualized plan of care.
- Performed member medical record audits to prepare for regulatory audits and to maintain a set standard of care.
- Assisted with the development and implementation of SOP's to improve company standards and general operational functions.
- Provided training and education to field staff.
- Completed QA on nursing notes to assist with state and Medicate regulations.
LVN Field Nurse
Stonegate Home Health
06.2015 - 07.2016
- Chronic illness management and education in the home setting.
- Complex and general wound care management
- Provided health care education to patients and family members to assist the patient with becoming self-sufficient.
- Coordinated care within a multidisciplinary care team to provide optimal care for patients.
- Started, maintained, and discontinued IV for IV therapy such as antibiotics and IVIG..
Clinical Coordinator
Humana at Home
04.2013 - 06.2015
- Developed relationships with physicians, hospitals, and other disciplines to coordinate care for 100+ patients
- Effectively communicated with multiple disciplines to assist in the development of patient care plans
- Provided home telemonitoring for chronically ill patients
- Analyzed, monitored, and maintained supply budgets to maximize profit and reduce cost
- Formulated ordering protocols which resulted in the reduction of supply cost by 40% in three months
- Developed and implemented protocols for intake, care coordination, and Q&A process
- Developed and maintained a patient infection database resulting in the reduction of infections by 30%, and streamlined the reporting process to health care professionals resulting in reduced hospitalizations
- Completed chart audits to ensure agency notes and orders are within Medicare guidelines
- Performed independent health assessments of individuals by evaluating their physical, mental, social, and environmental health status; and provided nursing interventions based on need.
Licensed Vocational Nurse
NurseCore Staffing
10.2010 - 05.2013
- Performed independent health assessments of individuals by evaluating their physical, mental, social, and environmental health status; and provided nursing interventions based on need.
- Provided personal care, wound care, collection of lab specimens, and performed laboratory tests.
- Administered vaccines and oral/IV medications.
- Provided medical care in various settings according to PRN staffing needs (TACT, Home Health, Medical office, etc).
- Educated and counseled patients and their families on medical procedures, treatments, and medications.
Charge Nurse LVN
Remington Medical Resort
07.2011 - 04.2013
- Assessed, monitored, and provided total care for 7 medical/surgical patients.
- Monitored patients and coordinated care with various disciplines to reduce length of stay and aided in the development of patient's POC.
- Educated patients/families on health care needs, conditions, options, etc.
- Provided intravenous therapy, wound care, PICC care, foley care, and other various skills routinely.
- Provided training for new hires.
Education
LVN - Nursing
North Central Texas College
Corinth, TX05.2010
Skills
- Quality assurance
- Case management
- Training
- Nursing care (injections, vital signs, medication administration, basic IV, etc)
- Home care
- Triage
- EMR systems
- Microsoft Office
- Care plans
- Decision making
- Adaptability
- Team leadership
- Interpersonal skills
- Organizational skills
- Critical thinking
Certification
- IV Certification
- LVN
- LPN
Timeline
Lead Clinical Specialist
Abbott Laboratories
08.2020 - Current
Care Manager
C & S Staffing/Humana
12.2018 - 07.2020
Clinical Coordinator/Quality Assurance
Ally Home Health
07.2016 - 03.2021
LVN Field Nurse
Stonegate Home Health
06.2015 - 07.2016
Clinical Coordinator
Humana at Home
04.2013 - 06.2015
Charge Nurse LVN
Remington Medical Resort
07.2011 - 04.2013
Licensed Vocational Nurse
NurseCore Staffing
10.2010 - 05.2013
LVN - Nursing
North Central Texas College