Andrine Toussaint

•Prior authorizations for Rx request

•Prior authorizations for specific radiology/procedure requests

•Review criteria-based prior authorizations following policy and procedure

•Reviews Drafting Rx refills Communication with pharmacy

•Provide on-call after hours nurse availability for urgent PA requests

•Handling any acute communications from facilities or patients that come through during the shift

•Completing any tasks that come through during the shift Working with on-call NP and MD to address any patient concerns

•Data entry to EMR Resolving patient needs via tickets within EMR

•Triage calls Laboratory and Radiology Report

•Home Health/Therapy Certs/485's for the providers

•Data Entry & Clinical Documentation

•Chronic Care Management (CCM) Chart Reviews & Documentation reviews

•Hired onto the Elevance (Anthem) HEDIS team to continue the abstraction project season.

•Adhered to projection assignment as delegated by the Lead Worked with Hybrid measures with primary focus on TRC submeasures

•Production metrics 25-35 a day or more

•Production with 95-99% accuracy

•Data entry

•Processed both outgoing and incoming requests for medical records from multiple sources.

• Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
• Documented all elements of care and updated patient charts and confidential files to reflect changes in care plans, interventions applied, and observations.
• Collaborated with interdisciplinary teams to develop impactful treatment plans.
• Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.

•Prior authorizations for Rx request

•Prior authorizations for specific radiology/procedure requests

•Review criteria-based prior authorizations following policy and procedure

•Reviews Drafting Rx refills Communication with pharmacy

•Provide on-call after hours nurse availability for urgent PA requests

•Cared for wounds, provided treatments, and assisted with procedures.

•Documented accurate and complete patient information to address patient problems and expected outcomes.

•Assisted with admissions, appointments, transfers, and discharges.

•Assisted with feeding and monitored intake to help patients achieve nutritional objectives.

•School nurse for students ranging from nursery to high school

•Member of the school's Health and Safety Team

•Phone calls/triage/back office duties/EMR data entry •Medication Administration

•Health Education for staff, employees, and students

•Prior authorizations for RX as ordered by physician/NP/PA

•Prior authorizations for Assist MD with outpatient surgical procedures

•Utilized systems such as Cover My Meds

•Office nursing duties such as phone calls, calling patient's with test results, scheduling surgical procedures, and educating post op patient's

•Surgical assist during minor surgical procedures •Documentation using various EMRs

•Communication with healthcare providers and various 3rd party providers

•Insurance Verifications/back office duties/triage

•Director of nursing for 2 years

•Charge Nurse responsible for a 72-bed memory care skilled nursing unit

•Recruited, hired, and coached employees to ensure that all residents received high-quality care.

•Supervised a team of 25 Certified Nursing Assistants & Medication Technicians

•Medication Administration & Ordered Treatments •Documentation using various EMRs

•Communication with healthcare providers and various 3rd party providers

•Data entry Discharge planning with a care team