Carol Willcock
Toledo
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
9
9
years of professional experience
Work History
Registered Nurse
Promedica
Toledo
06.2018 - Current
- Reviewed patient charts for medical necessity and compliance with guidelines.
- Collaborated with healthcare providers to ensure appropriate levels of care.
- Utilized electronic health record systems to document review findings accurately.
- Assessed patient medical records to determine the appropriateness of requested services and procedures.
- Served as a resource for staff members seeking guidance on utilization review matters.
- Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Referred cases to secondary review for failure to meet criteria.
- Collaborated with case managers to facilitate timely discharge planning and transition of care.
- Provided feedback to healthcare providers on clinical documentation improvement to support utilization review.
- Ensured compliance with federal, state, and accreditation requirements related to utilization management.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Registered Nurse
Toledo Hospital
Toledo
12.2016 - 06.2018
- Administered medications and treatments, monitoring patients for reactions and side effects.
- Evaluated effectiveness of interventions through ongoing assessment of patient responses.
- Assessed, planned, implemented and evaluated nursing care for assigned patients.
- Maintained a safe environment for all patients by adhering to infection control policies and procedures.
- Trained and mentored new RNs on best practices, hospital policies and standards of care.
- Advocated for patients by supporting and respecting basic rights, values, and beliefs.
- Evaluated patients, recognized and addressed complications and coordinated treatment with other members of critical care team.
Education
Associate of Science - Nursing
Aultman College of Nursing
Canton, Ohio12-2012
Associate of Science - Accounting
University of Akron
Akron, OH08-1990
Skills
- Utilization review
- Effective communication
- Critical thinking
- Patient advocacy
- Electronic health records
Timeline
Registered Nurse
Promedica
06.2018 - Current
Registered Nurse
Toledo Hospital
12.2016 - 06.2018
Associate of Science - Nursing
Aultman College of Nursing
Associate of Science - Accounting
University of Akron
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