Ashley Dobie
Franklin,VA
Summary
Patient-focused Physician specializing in Corrections and Insurance , providing high quality, personal levels of healthcare to patients in clinical environments. Savvy business mind coupled with recognized medical skills resulting in 6 years of successful practice. Warm, caring approach to patients and persistent in finding best treatment options available. Proficient and caring nursing team member offering outstanding patient-facing experience. Adept at addressing patient needs with compassionate care and attention to detail. Diligent about maximizing satisfaction, safety and wellness while serving patients of all backgrounds. Skilled Licensed Practical Nurse offering 5+ years of experience in the field. Knowledgeable about assisting with non-invasive procedures and performing respiratory treatments. Strong documentation skills and a firm grasp of compliance requirements.
Overview
5
5
years of professional experience
Work History
Medical Doctor Orders Nurse, Licensed Practical Nurse
Deerfield Correctional Center, Vital, Strategies
2018.08 - Current
- Ensuring the provider’s orders are fulfilled and entering medication orders into Sapphire EMAR
- Assisted in the delivery of healthcare through patient assessments, interventions and monitoring
- Administered medications to the patients and monitored and documented the effectiveness of all medications
- Assured the safety and comfort of residents and supervised caregivers
- Performed skin assessments and implemented standing orders as needed to treat skin breakdown/wounds
- Assisting with telemedicine visits.
Licensed Utilization Review II
Anthem
2021.03 - 2022.08
- Responsible for working primarily with healthcare providers to help ensure appropriate and consistent administration of plan benefits through collecting clinical information required to preauthorize services, assess medical necessity, out of network services, and appropriateness of treatment setting and applying appropriate medical policies, clinical guidelines, plan benefits, and/or scripted algorithms within scope of licensure Such functions may include: review of claim edits, pre-noted inpatient admissions or, episodic outpatient therapy such as physical therapy that is not associated with a continuum of care, radiology review, or other such review processes that require an understanding of terminology and disease processes and the application of clinical guidelines but do not require nursing judgment
- Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines in compliance with department guidelines and consistent with the members eligibility, benefits and contract
- Working with systems such as MCG and Interqual
- Develops relationships with physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Supervised and maintained all utilization review documentation through Mcg, InterQual and Medical Policies.
- Obtained authorizations from multiple insurance carriers for various levels of care.
Licensed Practical Nurse
Children’s Hospital of
2020.09 - 2021.03
- Check in child patients, evaluating their symptoms and checking their vital signs
- Administer Vaccinations to the patients per the Doctors orders
- Assure the safely of the patients while in the office
Licensed Practical Nurse
Southampton Memorial Hospital
2019.05 - 2019.09
- Reviewed medical records for accuracy
- Wrote prescriptions at a physician's request
- Assisted with the scheduling of medical appointments
- Assessed, plan implemented, and evaluated care for residents
- Provided personal care to patients including personal hygiene maintenance
- Gathered patients' health information to ensure best care
Education
Practical Nursing -
Paul D. Camp Community College
05.2018
Skills
- Patient Data Management Systems
- Medical Supply Management
- Patient Record Reviews
- Admissions and Discharge Processes
- Update Electronic Charts
- Medication Side Effect Knowledge
- Health Care System
- Care Planning
- ADLs Assistance
- Medication Administration
- Monitoring Vital Signs
- Documenting Vitals
Accomplishments
Licensed Practical Nurse
Class of 2018
Class Secretary
Certification
- Licensed Practical Nurse - August 2018
Timeline
Licensed Utilization Review II
Anthem
2021.03 - 2022.08
Licensed Practical Nurse
Children’s Hospital of
2020.09 - 2021.03
Licensed Practical Nurse
Southampton Memorial Hospital
2019.05 - 2019.09
Medical Doctor Orders Nurse, Licensed Practical Nurse
Deerfield Correctional Center, Vital, Strategies
2018.08 - Current
Practical Nursing -
Paul D. Camp Community College
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