Andrea Newbold

• Collaborated and communicated issues/concerns with the treatment team on clinical and non-clinical issues.
• Supported admission and medical staff in screenings for potential admissions for medical appropriateness.
• Reviewed newly admitted client's medical histories and obtains additional medical information as necessary.
• Completed comprehensive nursing assessment, including: obtaining & monitoring vital signs, drawing blood, urinalysis, performing CIWA-AR & COWS scales, and performing other physical and social assessments as appropriate and necessary.
• Screened ongoing client's medical symptoms or concerns to determine level of medical intervention needed.
• Provided nursing interventions as appropriate with available facilities, following medical policies, procedure & protocols safely & accurately.
• Reviewed medication and orders and enter prescription orders safely and accurately.

• Complied with all security regulations within prison system and administered care in safest possible environment.
• Performed mental health evaluations when warranted and recommended patients to therapists.
• Stabilized prisoners suffering from falls, stab wounds or other injuries prior to hospital transfer.
• Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.

• Completed assignments within company operations with an emphasis on internal controls, operating efficiencies and compliance with corporate policies
• HIPPA Compliance
• Developed, supported and evaluated audit findings and communicated with management team
• Performed periodic quality Review Audits' in line with the agreed approach and quality audit schedule
  Created Training Modules on PowerPoint for new hires and team
  Utilization Management/Interqual
• Coordinated care for members with chronic illnesses, co-morbidities and/or disabilities and in conjunction with the member and the health care team, to ensure cost effective and efficient utilization of health benefits
• HEDIS
• Verified and interpreted the information, conducted additional assessments, as necessary, and developed, monitored, evaluated, and revised the member's care plan to meet the member's needs
• Reviewed Medical records to assess with provider compliance for State/Corporate Reported issues on absence of documentation, incorrect decision making, noncompliance with accrediting body's standards
• Investigated findings on grievances and incident reports QOC according to ACHA stratification levels
  Credentialed and reviewed provider licenses for renewals
  Trained new hires and team on new NCQA Performance Measures

• Understood qualifications of Medicaid and Disability
• Assessed and analyzed outcomes, identified complex problems in patient care, and provided interventions to assist to achieve optimal patient outcomes.
• Created Training Modules on PowerPoint for new hires and team.
• Supervised, trained Nurse Techs/ LPN's and participated in evaluations along with hiring process
• Conducted regular department rounds to promote and establish compliance to evidence based quality measures and educational opportunities
• Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
• Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.

• Leadership/Management

Sterling Lean Six Sigma-FL