Ann Jefferson - Sims
Registered Nurse
Pearl,MS
Summary
Smart Utilization Review Nurse considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Overview
18
18
years of professional experience
Work History
Utilization Review Nurse
Telligen Inc
12.2023 - Current
- Collaborated with insurance companies to verify coverage, clarify benefits, and facilitate authorization for medical services, reducing delays in patient care delivery.
- Demonstrated commitment to ethical practice by upholding patient confidentiality and advocating for individual rights in all interactions with stakeholders.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Assisted with the implementation of a UM/QIO contract
Registered Nurse (Utilization Review)
Alliant Health Solutions
12.2021 - 12.2023
- Assisted in the training and mentorship of new nursing staff members, contributing to a positive work environment and high-quality patient care.
- Participated in ongoing professional development opportunities to stay current on best practices in nursing care and emerging trends in healthcare delivery.
- Assisted with the completion of a UM/QIO contract
Registered Nurse (Utilization Review)
St Dominic Hospital
07.2021 - 12.2021
Registered Nurse (ICU contract)
Loyal Source Travel Agency
01.2021 - 03.2021
Registered Nurse (Case Manager)
Sta-home Healthcare
02.2020 - 01.2021
Registered Nurse (ICU)
Baptist Medical Center
06.2019 - 01.2021
Registered Nurse (ICU)
Sonny Montgomery VA Medical Center
07.2017 - 05.2019
Register Nurse (Hemodialysis)
Fresenius Medical Care
02.2016 - 07.2017
Registered Nurse (Burn ICU/ Burn Step Down)
Central MS Medical Center
11.2013 - 01.2016
Registered Nurse (LTAC)
Regency Hospital Company
12.2011 - 11.2013
Registered Respiratory Therapist (ER/med surg)
St Dominic Hospital
08.2006 - 11.2012
Registered Nurse (Telemetry)
Baptist Medical Center
10.2010 - 12.2011
Education
Associate of Applied Sciences -
Hinds Community College - RRT
Jackson, MSAssociate of Science in Nursing - undefined
Hinds Community College -ADN
Jackson, MSBachelor of Science in Nursing -
South University - BSN
Savanna, GASkills
Healthcare regulations
Documentation And Reporting
HIPAA Compliance
Medicaid knowledge
Utilization review
References
Available upon request
Timeline
Utilization Review Nurse
Telligen Inc
12.2023 - Current
Registered Nurse (Utilization Review)
Alliant Health Solutions
12.2021 - 12.2023
Registered Nurse (Utilization Review)
St Dominic Hospital
07.2021 - 12.2021
Registered Nurse (ICU contract)
Loyal Source Travel Agency
01.2021 - 03.2021
Registered Nurse (Case Manager)
Sta-home Healthcare
02.2020 - 01.2021
Registered Nurse (ICU)
Baptist Medical Center
06.2019 - 01.2021
Registered Nurse (ICU)
Sonny Montgomery VA Medical Center
07.2017 - 05.2019
Register Nurse (Hemodialysis)
Fresenius Medical Care
02.2016 - 07.2017
Registered Nurse (Burn ICU/ Burn Step Down)
Central MS Medical Center
11.2013 - 01.2016
Registered Nurse (LTAC)
Regency Hospital Company
12.2011 - 11.2013
Registered Nurse (Telemetry)
Baptist Medical Center
10.2010 - 12.2011
Registered Respiratory Therapist (ER/med surg)
St Dominic Hospital
08.2006 - 11.2012
Associate of Applied Sciences -
Hinds Community College - RRT
Associate of Science in Nursing - undefined
Hinds Community College -ADN
Bachelor of Science in Nursing -
South University - BSN