Annie Warren-Fleming

• Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings. Collaborate with various staff within provider networks and discharge planning team. Electronically, telephonically, or onsite to coordinate member care. Educate providers on utilization and medical management processes. Enter and maintain pertinent clinical information in various medical management systems.
• Contacted providers, state agency offices and applicants to obtain information and records needed to conduct comprehensive clinical review of case and final determination.
• Reviewed and documented relevant information into data system applications.
• Determined and authorized services for patients in accordance with guidelines and regulations.

• Administered medications and dialysis treatment to patients and monitored responses.
• Advocated for and strived to protect health, safety, and rights of patient.
• Worked with healthcare team to develop new dialysis treatment flow sheet and other log forms, improving clinical documentation and accountability.
• delegate tasks to techs and LPN's accordingly
• Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.

• Communicated with healthcare team members to plan, implement and enhance treatment strategies.
• Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
• Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
• Responsible for patient’s safety, admissions and assessments.

Here my responsibilities included nursing care for children, adolescents, and adult mental health issues, admission, discharge and assessment, administration of medicines and report changes as needed to the physician.