BRIDGET C JONES
SCOTT,LA
Summary
Dynamic Registered Nurse bringing 30 years of medical experience in various settings. Proven history of leveraging critical thinking, analysis and medical knowledge to deliver superior care in high-pressure environments. Hardworking and energetic. Flexible and adapt easily to change of environment and work schedule. Personable with a positive attitude, consistently developing strong relationships with patients, families, and coworkers through empathetic communication, respectful attitude and excellent customer service.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Preservice Review RN
United Healthcare
01.2022 - 06.2023
- Review 10-14 outpatient Medicaid authorization requests daily for specific treatments, equipment, or surgeries using InterQual software
- Review multi-state requests for prior authorization
- Consider each PA request and collect evidence and patient information to support medical necessity
- Communicate with provider to obtain necessary additional information to complete review in timely manner
- Ensure authorization meets regulations and requirements and contractual obligations of all parties involved
- Collaborating with administrators and MD advisors to gain necessary information and ensure patient receives authorized care
- Resolved problems, improved operations and provided exceptional service
Prior Authorization Nurse II
Louisiana Healthcare Connections
08.2016 - 12.2021
- Review 12-15 outpatient Medicaid authorization requests daily for specific treatments, equipment, or surgeries using InterQual software
- Consider each PA request and collect evidence and patient information to support medical necessity
- Communicate with provider to obtain necessary additional information to complete review in timely manner
- Ensure authorization meets regulations and requirements and contractual obligations of all parties involved
- Collaborating with administrators and MD advisors to gain necessary information and ensure patient receives authorized care
- Resolved problems, improved operations and provided exceptional service
Registered Nurse, Patient Care Manager
Heart of Hospice
10.2015 - 05.2016
- Educated and evaluated team of 12 Hospice clinical and support staff regarding care quality management regulations and standards of care.
- Interpreted regulations to identify patient care requirement criteria to be monitored and establish systems to achieve compliance.
- Evaluated healthcare needs, goals for treatment and available resources of each patient during our weekly IDT meetings to ensure optimal care was being provided
Registered Nurse, Interim Branch Manager
AAA Home Health
02.2015 - 10.2015
- Managed delivery of care for Home Health patients; delegating nursing assignments, and supervising small team comprised of 6 RNs and LPNs
- Managed care from admission to discharge
Director of Nurses
AAA Hospice
09.2013 - 02.2015
- Collaborated with staff, management and external groups to coordinate patient care.
- Monitored infection control programs to provide safe, sanitary environment to prevent transmission of disease and infection.
- Evaluated work performance of 10-12 nursing personnel to determine wage increases and implement discipline.
- Developed positive employee relations, incentives and recognition programs to promote teamwork and mutual respect.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Participated in weekly Interdisciplinary team meetings to discuss patient status, plan of care, and census changes.
Assistant Director of Nurses
AAA Hospice
11.2012 - 09.2013
- Assisted Director of Nurses with daily activities of Hospice Agency
- Developed positive employee relations, incentives and recognition programs to promote teamwork and mutual respect.
- Collaborated with staff, management and external groups to coordinate patient care.
- Established new policies and updated existing policies to improve standard of care for patients.
- Identified department issues to recommend corrective actions.
- Planned and assigned workload to 10 person nursing staff to direct patient care
RN Hospice Case Manager
AAA Hospice
05.2012 - 11.2012
- Developed and implemented individualized care plan for each hospice patient while following physician instructions.
- Taught family members and caregivers various ways to manage patients' pain, how to check for vital signs and proper methods for dressing changes.
- Offered listening ear to both patients and loved ones to meet emotional and mental, as well as physical needs.
- Recognized and understood specific stages of dying process, providing comfort-based care during vulnerable times.
- Administered medications to average of 12 patients and monitored response to medications
Registered Nurse - ER
Total Support Medical Staffing
10.2011 - 05.2012
- Planned, prioritized and provided nursing care by applying advanced specialty clinical nursing knowledge and skills to support comfort and safety of patients and families.
- Adhered to required infection control, isolation procedures and aseptic techniques in delivery of patient care.
- Educated patients and answered questions about health condition, prognosis and treatment.
- Observed and recorded signs, symptoms, behaviors and physiological status of patient.
- Worked in various facilities on per diem schedule
Registered Nurse
University Medical Center Lafayette
12.2011 - 03.2012
- Walk-In Clinic/Non-Acute ER - Managed care from admission to discharge
RN Hospice Case Manager
Heart Of Hospice
02.2011 - 07.2011
- Developed and implemented individualized care plan for each hospice patient while following physician instructions.
- Taught family members and caregivers various ways to manage patients' pain, how to check for vital signs and proper methods for dressing changes.
- Offered listening ear to both patients and loved ones to meet emotional and mental, as well as physical needs.
- Recognized and understood specific stages of dying process, providing comfort-based care during vulnerable times.
- Administered medications to average of 12 patients and monitored response to medications
Registered Nurse - Emergency Room
Regional Medical Center Of Acadiana
07.2004 - 02.2011
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Adhered to required infection control, isolation procedures and aseptic techniques in delivery of patient care.
- Planned, prioritized and provided nursing care by applying advanced specialty clinical nursing knowledge and skills to support comfort and safety of patients and families.
- Educated patients and answered questions about health condition, prognosis and treatment.
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Administered different therapies and medications in line with physician orders and treatment plan.
Education
Associate Degree - Registered Nurse
Louisiana State University At Eunice
Eunice, LA05.2004
Licensed Practical Nurse -
LGMC School of Health Sciences PN Program
Lafayette, La10.1993
Skills
- InterQual
- Decision Making
- Attention to Detail
- Care Coordination
- Critical Thinking
- Accurate Documentation
- Time Management
- Creative Problem Solving
Certification
Registered Nurse
License #109818
Louisiana State Board of Nursing
Active since July 2004
Timeline
Preservice Review RN
United Healthcare
01.2022 - 06.2023
Prior Authorization Nurse II
Louisiana Healthcare Connections
08.2016 - 12.2021
Registered Nurse, Patient Care Manager
Heart of Hospice
10.2015 - 05.2016
Registered Nurse, Interim Branch Manager
AAA Home Health
02.2015 - 10.2015
Director of Nurses
AAA Hospice
09.2013 - 02.2015
Assistant Director of Nurses
AAA Hospice
11.2012 - 09.2013
RN Hospice Case Manager
AAA Hospice
05.2012 - 11.2012
Registered Nurse
University Medical Center Lafayette
12.2011 - 03.2012
Registered Nurse - ER
Total Support Medical Staffing
10.2011 - 05.2012
RN Hospice Case Manager
Heart Of Hospice
02.2011 - 07.2011
Registered Nurse - Emergency Room
Regional Medical Center Of Acadiana
07.2004 - 02.2011
Associate Degree - Registered Nurse
Louisiana State University At Eunice
Licensed Practical Nurse -
LGMC School of Health Sciences PN Program
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