Carlee Heausler
Mandeville,LA
Summary
Experienced nursing professional bringing clinical expertise, leadership skill, and technical knowledge highly motivated to take on new challenges. Collaborative and motivational leader with expertise in training new nursing staff while providing top-notch service to members. Focused on continuously driving innovation and improving member and employee satisfaction and outcomes.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Inpatient Authorization Nurse
Peoples Health Network/United Healthcare
Metairie, LA
04.2019 - Current
- Researched complex cases that require additional information before determining approval and denial status.
- Assessed the appropriateness of requesting provider's treatment plans based on clinical review criteria set forth by the payer or regulatory bodies.
- Ensured that all documentation was accurate and up-to-date according to established guidelines.
- Facilitated communication between members of the healthcare team by attending interdisciplinary meetings.
- Provided guidance to new employees regarding policies and procedures within the organization.
- Managed multiple tasks simultaneously while prioritizing urgent requests from physicians or nurses.
- Prepared detailed reports related to utilization management activities such as pre-authorization reviews, appeals, denials.
- Reviewed patient medical records to determine if requested services are medically necessary and appropriate for the diagnosis.
- Interpreted benefit plans, medical necessity criteria, policy language, and state regulations for proper utilization of services covered under a health plan.
- Provided guidance and support to staff members on prior authorization processes.
- -Communicate with facility case managers, social workers, admissions , physicians and corporate medical directors regarding cases and criteria.
- Coordinated with healthcare team to establish, enact and evaluate patient care plans.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Charge Nurse
Ochsner Medical Center
New Orleans, LA
09.2014 - 09.2021
- Performed triage, prioritizing treatment of incoming patients based on acuity level.
- Collaborated with multidisciplinary teams to ensure optimal patient outcomes.
- Ensured compliance with all hospital policies, procedures, standards, and regulations.
- Monitored vital signs and other indicators of patient health status.
- Provided education to patients regarding disease prevention and home care instructions.
- Reviewed laboratory results promptly for accuracy and followed up on abnormal findings with physicians.
- Assisted in the preparation of trauma victims for transfer or discharge from the hospital.
- Maintained accurate records of patient care services rendered utilizing the electronic medical record system.
- Delivered compassionate end-of-life care when needed according to established hospice guidelines.
- Provided emotional support for patients during stressful times.
- Managed intravenous lines, wound dressings, catheters, and other medical devices.
- Assisted in training new staff members on proper nursing protocols for emergency room operations.
- Facilitated communication between physicians, nurses, technicians, therapists, social workers, family members and other healthcare providers.
- Provided emergency care to critically ill patients in a timely manner.
- Responded quickly to life-threatening situations while maintaining composure under pressure.
- Conducted patient assessments and diagnostic tests to provide physician with important patient health information.
- Conducted daily rounds to assess patient conditions, evaluate progress towards goals, and document changes in status or plan of care as needed.
- Delegated tasks appropriately among staff members according to their qualifications.
- Actively participated in interdisciplinary team meetings to discuss patient progress toward desired outcomes.
- Provided direct patient care, including assessments and treatments, to a variety of patients.
- Served as a preceptor for new nurses by providing orientation to unit policies and procedures, coaching on clinical skills, and mentoring on professional development issues.
- Coordinated, tasked and supervised nurses and ancillary staff based on staffing requirements.
- Coordinated daily staffing assignments for unit ensuring adequate coverage at all times.
Staff Nurse
East Jefferson General Hospital Health
Metairie, LA
06.2013 - 05.2015
- Provided direct patient care including wound dressing, administering medication and IV therapy.
- Conducted patient education on medical treatments and procedures.
- Monitored vital signs and documented changes in a timely manner.
- Provided emotional support to family members during difficult times or end-of-life situations.
- Maintained accurate records of patient progress notes, medications administered and other relevant data.
- Ensured that all equipment was properly maintained according to safety protocols.
- Evaluated the effectiveness of nursing interventions and modified plans as needed.
- Actively participated in departmental meetings, training sessions and educational seminars.
- Managed multiple tasks simultaneously while maintaining quality standards of care.
- Assessed patients to determine their physical condition, health status and needs.
- Coordinated with other healthcare professionals to ensure quality patient care.
- Utilized an electronic medical record system to store patient information securely.
- Demonstrated effective communication skills while interacting with patients, families, physicians and other healthcare staff members.
- Assisted physicians with exams, lab tests or other procedures as requested.
- Addressed rapid response and code situations by strategically organizing and delegating tasks.
- Facilitated transition to home care by providing patients with continued care information and discharge instructions.
- Coordinated care with charge nurse and other staff through daily communication.
Education
Bachelor of Science - Nursing
University of Louisiana At Lafayette
Lafayette, LA05-2021
Associate of Science - Nursing
Charity School of Nursing
New Orleans, LA12-2012
Master of Science - Leadership
Capella University
Minneapolis, MNSkills
- Unit Administration
- Medication Administration
- Direct Patient Care and Patient Education
- Microsoft Office
- Task Prioritization
- Medical chart management
- Clinical Documentation
- Workflow and Patient Management
- Emergency Care
- Electronic Health Records Management
- Policy and procedure compliance
- Nursing staff leadership
- InterQual Criteria
- Insurance Verification
- Utilization Management
- HIPAA Compliance
- Interpersonal and written communication
- Teamwork and Collaboration
- Effective Communication
- Active Listening
- Healthcare regulations
- Training and mentoring
Certification
- M&R Level 1,2,3
Affiliations
- English style horseback riding
Timeline
Inpatient Authorization Nurse
Peoples Health Network/United Healthcare
04.2019 - Current
Charge Nurse
Ochsner Medical Center
09.2014 - 09.2021
Staff Nurse
East Jefferson General Hospital Health
06.2013 - 05.2015
Bachelor of Science - Nursing
University of Louisiana At Lafayette
Associate of Science - Nursing
Charity School of Nursing
Master of Science - Leadership
Capella University
- M&R Level 1,2,3
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