ARTISHA FIELDS
Kepro
1
Certification
16
years of professional experience
Advanced practice registered nurse with strong background in problem-solving and collaboration skills. Delivers effective solutions through adaptability and a proactive approach. Committed to enhancing team success and advancing organizational objectives.
Work History
Supervisor / Clinical Reviewer – Hospice Utilization Review (Remote)
5 Years 1 Month- Perform comprehensive concurrent and retrospective utilization reviews for hospice services under Alabama Medicaid.
- Evaluate medical records against CMS hospice eligibility criteria and LCD guidelines to determine medical necessity and appropriateness of care.
- Review physician certifications, recertification, face-to-face encounters, interdisciplinary documentation, and evidence of terminal decline.
- Assess appropriateness of General Inpatient (GIP), Continuous Care, Routine Home Care, and Respite levels of service.
- Maintain production goals while achieving high internal QA audit scores.
- Provide education to providers regarding documentation requirements and regulatory compliance.
- Ensure compliance with NCQA, URAC, and Alabama Medicaid Agency standards.
Nurse Practitioner Student
2 Months- Conducted patient assessments to gather medical history and evaluate health status.
- Improved patient outcomes by providing thorough assessments and implementing appropriate care plans.
- Coordinated specialty referrals for further evaluation or treatment options.
- Established effective relationships with patients and families by respecting patient rights and involving patients and families in decision making.
- Referred patients to medical specialists and coordinated patient care with social workers, case managers and mental health professionals.
- Facilitated the coordination of specialty referrals when necessary for further evaluation or treatment options.
- Engaged in peer discussions to share insights and best practices for improved patient outcomes.
- Managed acute illnesses by collaborating with provider to prescribe medications or recommend non-pharmacological interventions as appropriate based on individualized patient needs.
- Completed 160 clinical preceptorship hours.
Nurse Practitioner Student
3 Months- Monitored vital signs and recognized changes in patient conditions for timely interventions.
- Collaborated with healthcare teams to ensure comprehensive patient care and treatment continuity.
- Assisted in developing individualized care plans based on patient needs and goals.
- Educated patients on disease management, preventive care, and health promotion strategies.
- Promoted preventive healthcare measures through patient counseling on lifestyle modifications and risk factor management.
- Documented patient interactions and treatment plans in electronic health record systems efficiently.
- Participated in clinical rotations across various specialties to enhance practical nursing skills.
- Completed 160 clinical preceptorship hours.
Practicum Student
3 Months- Improved patient outcomes by conducting thorough assessments and developing individualized care plans.
- Educated patients on disease prevention, management, and healthy lifestyle choices.
- Collaborated with healthcare teams to coordinate patient care and referrals effectively.
- Assisted in performing diagnostic tests and interpreting results for treatment planning.
- Documented patient histories and clinical findings accurately in electronic health records.
- Contributed to the development of clinic policies and procedures, ensuring compliance with regulatory requirements and promoting best practices in patient care.
- Completed 160 clinical preceptorship hours.
Practicum Student
4 Months- Managed appointment scheduling to optimize patient flow and reduce wait times.
- Implemented electronic health record updates to enhance data accuracy and accessibility.
- Assisted healthcare providers with patient intake and documentation processes.
- Educated patients on disease management, preventive care, and health promotion strategies.
- Documented patient interactions and treatment plans in electronic health record systems efficiently.
- Monitored vital signs and recognized changes in patient conditions for timely interventions.
- Improved patient outcomes by providing thorough assessments and implementing appropriate care plans.
- Completed 160 clinical preceptorship hours.
Clinical Coordinator
1 Year 3 Months- Managed accreditation, compliance, and standards to meet criteria for Bariatric Surgery Program for clinic and hospital facility, set forth by Federal and State regulations; MBS-AQIP standards; and American College of Surgeons Regulatory standards.
- Collaboration with Bariatric Surgeon Medical Director, clinic staff and physicians, promoting positive communication techniques and the ability to multitask and problem-solve.
- Utilized evidence-based practice to improve bariatric clinic operations and report development to the Metabolic and Bariatric Surgery Accreditation and Quality improvement program.
- Developed corrective action plans and enhanced teamwork for more effective processes.
- Integrated evidence-based practice into bariatric clinic improvements develop reports for areas of improvement with quality measures and present to leadership and medical director.
- Administers nursing care to patients; includes assessment, planning, implementing, and evaluating the patient's care plan in coordination with the physician.
- Enhanced knowledge of the federal and state regulations/administration regarding bariatric surgery procedures.
- Exemplify problem-solving, decision-making and assertiveness skills.
Executive Director
4 Months- Oversee the general management and day-to-day hospice operations.
- Develop the annual branch budget and monitor daily expenditures.
- Analyze gross profit factors, market conditions, business volume/mix, competition, and operational costs.
- Ensure continued branch growth by expanding new and existing client base.
- Partner with recruiters to attract and hire branch staff and clinicians.
- Partner with clinical resources to oversee patient intake and inquiries and assess patient needs.
Clinical Manager – Hospice Operations & Compliance
2 Years 7 Months- Conducted internal chart audits to ensure compliance with CMS hospice Conditions of Participation.
- Reviewed admission documentation for eligibility criteria and terminal prognosis accuracy.
- Collaborated with billing department to reduce denials and ensure accurate reimbursement.
- Led interdisciplinary team including RNs, hospice aides, social workers, and chaplain.
- Educated staff on documentation standards and regulatory updates.
Account Executive
3 Years 6 Months- Educates health care professionals, patients, and families about end of life and home care services.
- Develops and maintains relationships with key referral sources, such as hospitals, nursing homes and physician offices to generate leads.
- Coordinated with providers to obtain required documentation for hospice admission approval.
- Conducts on-site visits to assess patient needs and identify barriers to care.
- Keeps accurate records of patient interactions and referrals.
- Achieves admissions, product, and payor-mix goals by achieving short and long term goals set.
- Maintains a complete, up-to-date record of targeted referral sources in territory in CRM.
- Attends community events to promote and provide in depth education about end of life care.
Hospice Admissions Nurse / Case Manager
3 Years 1 Month- Evaluated patients for hospice eligibility using CMS guidelines and physician collaboration.
- Conducted skilled assessments and documented decline indicators supporting terminal prognosis.
- Coordinated with providers to obtain required documentation for hospice admission approval.
Education
Master of Science in Nursing (MSN) - Nurse Executive
Certification of Adult Gerontology Nurse Practitioner Primary Care - Adult Gerontology
Bachelor of Science in Nursing (BSN) - Nursing
Associate Degree in Nursing (ASN) - Nursing
Skills
Utilization review
Prior Authorization
Medical necessity
CMS regulations
Processes and procedures
Process monitoring and improvement
Attention to detail
Regulatory training
Interdisciplinary collaboration
Process management
Process improvement
Verbal and written communication
Accomplishments
- Maintained top compliance and quality audit scores within organization.
- Led hospice team with strong retention and positive regulatory survey outcomes.
- Recognized for production efficiency while maintaining quality standards.
Certification
- Registered Nurse – Alabama (Compact License)
- Adult Gerontology Primary Care Nurse Practitioner, AL
- Basic Life Support
Timeline
Nurse Practitioner Student
Renew Health Clinic
11.2024 - 01.2025Read More
Nurse Practitioner Student
Women's Health and Surgery Center
05.2024 - 08.2024Read More
Practicum Student
Southern Lux Health and Metabolic Wellness
05.2024 - 08.2024Read More
Practicum Student
Flowers Medical Group
01.2024 - 05.2024Read More
Supervisor / Clinical Reviewer – Hospice Utilization Review (Remote)
Kepro
07.2021 - CurrentRead More
Clinical Coordinator
Flowers Hospital Bariatric Clinic/Surgical Services
07.2020 - 10.2021Read More
Executive Director
Kindred Hospice
03.2020 - 07.2020Read More
Clinical Manager – Hospice Operations & Compliance
Covenant Care
08.2017 - 03.2020Read More
Account Executive
Covenant Hospice
02.2014 - 08.2017Read More
Hospice Admissions Nurse / Case Manager
Covenant Care
01.2011 - 02.2014Read More
Walden University
Master of Science in Nursing (MSN) from Nurse Executive
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Walden University
Certification of Adult Gerontology Nurse Practitioner Primary Care from Adult Gerontology
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Jacksonville State University
Bachelor of Science in Nursing (BSN) from Nursing
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Wallace Community College
Associate Degree in Nursing (ASN) from Nursing
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