Summary
Overview
Work History
Education
Skills
Timeline
Generic

Andrea L. Johnson

Hahira,GA

Summary

  • Registered Nurse – 239403; Multistate License
  • Air Force Reserves Veteran – Mental Health Technician
  • Knowledge of TRICARE policies and procedures, Utilization Management principles, Managed Care and CMS guidelines; Ability to work independently
  • Effective computer skills including navigating multiple systems proficiently with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint
  • Maintain knowledge of regulations, accreditation standards, and industry best practices
  • Experience in hospital, skilled and rehabilitation clinical settings
  • Ability to work independently under general instructions and with a team continuously improving consumer experiences
  • Experienced healthcare professional with strong background in telehealth services and patient care.
  • Expertise in remote patient monitoring, digital health platforms, and clinical assessments
  • Known for team collaboration, flexibility with changing needs, and achieving results
  • Reliable, adaptable, and skilled in effective communication and problem-solving.

Overview

16
16
years of professional experience

Work History

Various Positions - Special Needs, Casualty Rep

Department of the Air Force
06.2020 - 06.2024

Special Needs Coordinator and Casualty Assistance Representative

Special Needs Coordinator – Exceptional Family Member Program

RAF Lakenheath and Mildenhall
06.2020 - 08.2024
  • Establish and maintain procedures to identify sponsors whose family members have special medical and/or educational needs in a timely manner

Casualty Assistance Representative

Department of the Air Force
06.2020 - 08.2024


  • Enhanced company reputation by providing exceptional customer service and support to family members and survivors by processing insurance benefits
  • Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.

Volunteer

Red Cross – RAF Lakenheath Chapter
09.2019 - 08.2024
  • Case management training
  • Fire safety presentations at Lakenheath Elementary School
  • Volunteer at Lakenheath Elementary School for vision and hearing screenings
  • Supported engaging, fun, and smooth-running events by helping with organization and planning.

BAND 3 HEALTHCARE ASSISTANT

Tri-base Partnership with West Suffolk Hospital
01.2020 - 04.2020
  • Wash and dress patients
  • Monitor vital signs every two hours for critical patients and every four hours for stable patients
  • Report critical vital signs to Registered Nurse
  • Complete training as required
  • Complete other duties as assigned by Charge Nurse
  • Assist charge nurse with procedures and dressing changes as directed

Manager - BH UM TRICARE/Senior Telehealth Nurse

TRICARE Contract United Health Care/Optum
01.2013 - 01.2019
  • Deliver induction/onboarding training and ensure evaluation of training completion
  • Manage a team of 20 clinicians remotely across all time zones effectively; voted Best Manager
  • Acts as primary contact for escalated calls/issues that require research or special handling
  • Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment
  • Coordinate and communicate with providers, members, or other parties to facilitate appropriate discharge planning including to assist with social determinants and closing gaps
  • Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
  • Make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
  • Follows established guidelines/procedures
  • Present information and respond to questions from peers, leaders and internal/external customers
  • Assess medical necessity by screening available information against established criteria
  • Provide best care recommendations via approved guidelines to direct client to the appropriate level of care on 24/7 telephonic nurse line via inbound calls from clients/consumers
  • Listen to symptoms and questions from client and provide appropriate advice/education as needed using contract specified managed care guidelines and protocols to determine level of care
  • Conduct prior authorization, continued stay and referral management activities; interpret information and make decision to ensure it aligns with the benefit program
  • Ensure timely reviews and clarify information with beneficiary and/or provider as needed
  • Managed and motivated employees to be productive and engaged in work.
  • Accomplished multiple tasks within established timeframes.
  • Maintained professional, organized, and safe environment for employees and patrons.
  • Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.

Medical Assistant Program Supervisor/Instructor

Intellitec Medical Institute
01.2011 - 01.2013
  • Perform classroom observations and give training to instructors; Strong facilitation and classroom management skills for adult learners
  • Hire and evaluate faculty to ensure that syllabi and order of curriculum was followed per accrediting educational agency
  • Prepare for and maintain accreditation standards for audits; resolve issues identified in audits

Charge Nurse and Registered Nurse Renal Floor

Namaste Alzheimer’s Care Center/Penrose Hospital/Memorial Health System/Colorado Department of Corrections
01.2009 - 01.2013
  • Administer medication via po and parenteral routes
  • Educate patients and families on disease process and progression of stages and behaviors
  • Note and execute physician orders

Education

Associate Degree - Nursing

Concorde Career College
Denver, CO
06.2008

MBA - Healthcare Management Emphasis

Keller Graduate School of Management
Colorado Springs, CO
03.2007

Bachelor of Arts - Communication

University of Colorado at Boulder
Boulder, CO
08.2001

Skills

    Over eight years' remote utilization and case management experience

    Proficient in EHR systems and medical terminology

    Strong listening, communication and organizational skills

    Strong empathy and ability to establish rapport over phone

Timeline

Various Positions - Special Needs, Casualty Rep

Department of the Air Force
06.2020 - 06.2024

Casualty Assistance Representative

Department of the Air Force
06.2020 - 08.2024

Special Needs Coordinator – Exceptional Family Member Program

RAF Lakenheath and Mildenhall
06.2020 - 08.2024

BAND 3 HEALTHCARE ASSISTANT

Tri-base Partnership with West Suffolk Hospital
01.2020 - 04.2020

Volunteer

Red Cross – RAF Lakenheath Chapter
09.2019 - 08.2024

Manager - BH UM TRICARE/Senior Telehealth Nurse

TRICARE Contract United Health Care/Optum
01.2013 - 01.2019

Medical Assistant Program Supervisor/Instructor

Intellitec Medical Institute
01.2011 - 01.2013

Charge Nurse and Registered Nurse Renal Floor

Namaste Alzheimer’s Care Center/Penrose Hospital/Memorial Health System/Colorado Department of Corrections
01.2009 - 01.2013

MBA - Healthcare Management Emphasis

Keller Graduate School of Management

Bachelor of Arts - Communication

University of Colorado at Boulder

Associate Degree - Nursing

Concorde Career College
Andrea L. Johnson