Carrie Rayburn
Summary
Registered Nurse with 29 years of diverse nursing experience in NICU, hospice, home health, school health, and case management. Demonstrated ability to provide high-quality patient care, assess medical guidelines, and collaborate on care plans with multidisciplinary teams. Skilled in utilization management, medical coding (ICD-9, ICD-10, CPT), and EMR systems. Experienced in finding solutions to complex healthcare challenges, following clinical protocols, and promoting patient well-being. Currently licensed RN with compact privileges in Tennessee. Proficient in Microsoft Office Suite, clinical platforms, and telehealth operations.
Overview
25
25
years of professional experience
Work History
Home Health Nurse
Tennessee Home Health
04.2024 - Current
- Conduct comprehensive assessments of patient needs, identifying appropriate levels of care and coordinating interventions to align with medical guidelines
- Deliver high-quality patient care in a home health setting, including medication administration, wound care, and patient education
- Collaborate with interdisciplinary teams to review and adjust care plans based on patient progress and changes in condition
- Utilize EMR systems to document patient visits, maintain compliance with clinical guidelines, and ensure seamless communication across healthcare providers
RN Case Manager
Adoration Home Health
10.2023 - 04.2024
- Managed patient care plans, evaluating medical necessity and aligning treatments with evidence-based guidelines, including InterQual Criteria
- Performed OASIS assessments to establish individualized care plans and achieve measurable health outcomes
- Facilitated communication with physicians, families, and other healthcare providers to address complex patient needs, ensuring continuity of care
- Oversaw scheduling and case prioritization to streamline service delivery while meeting organizational goals and regulatory compliance requirements
Registered Nurse – Hospice
Hospice of Chattanooga, Inc.
11.2022 - 09.2023
- Delivered end-of-life care with a focus on symptom management, emotional support, and patient dignity
- Evaluated patient conditions to determine the appropriateness of hospice services and implemented care plans accordingly
- Utilized expertise in clinical decision-making to resolve non-standard care challenges, adapting quickly to patient and family needs
- Acted as a resource for less experienced team members, providing guidance on challenging cases and ensuring adherence to hospice standards
NICU Nurse
HCA Healthcare
09.2021 - 08.2022
- Provided advanced care for neonates with complex medical conditions, including ventilator management, tracheostomy care, and nutritional support
- Performed thorough assessments to determine the appropriateness of interventions, ensuring alignment with neonatal care protocols and best practices
- Collaborated with interdisciplinary teams to create individualized care plans and achieve optimal patient outcomes
- Educated families on neonatal care techniques and supported them during critical decision-making processes
School Health Nurse
Department of Education
01.2011 - 12.2020
- Delivered health services to a diverse pediatric population, ensuring compliance with immunization mandates and state health regulations
- Played a key role in the multidisciplinary team to support students with Individualized Education Plans (IEPs) and504 plans, addressing medical needs and accommodations
- Assessed and managed acute health incidents, maintaining a safe school environment for students and faculty
- Developed and implemented health promotion initiatives, providing education on hygiene, nutrition, and disease prevention
Neonatal Intensive Care Unit Nurse
Erlanger Health System
01.2002 - 01.2007
- Specialized in the care of critically ill neonates, managing conditions such as respiratory distress, cardiac anomalies, and sepsis
- Applied InterQual Criteria and evidence-based practices to evaluate medical necessity for NICU services
- Coordinated with attending physicians and ancillary staff to ensure the highest standard of care for vulnerable patients
- Trained new staff members on NICU protocols, fostering a collaborative and efficient team environment
Cardiology Office Nurse/Supervisor
Dr. Leonard Hays, Diagnostic Center
01.2000 - 01.2002
- Supervised daily clinical operations, ensuring adherence to protocols for cardiology patient care
- Conducted insurance verifications and managed ICD-9 and CPT coding for billing and claims processing
- Provided patient education on cardiac conditions, treatment plans, and medication management
- Supported physicians with diagnostic procedures, including stress tests, EKGs, and Holter monitoring
Education
Associate of Science - Registered Nurse
Southern Adventist University
Collegedale12-2020
Skills
- NICU Clinical Expertise
- Case Management & Utilization Management
- Knowledge of InterQual Criteria
- Proficiency in EMR Systems & Clinical Platforms
- ICD-9, ICD-10, and CPT Coding
- Strong Interpersonal & Communication Skills
- Telehealth & Remote Healthcare Operations
- Team Leadership & Staff Development
- Regulatory compliance
- Privacy and confidentiality
- Physician collaboration
- Pediatric care
- Recording vital signs
- Patient monitoring
- Patient assessments
- Treatment implementation
Accomplishments
- Successfully integrated knowledge of InterQual Criteria and evidence-based guidelines into care delivery and case management.
- Developed expertise in utilization management, ensuring appropriate resource allocation and compliance with organizational standards.
- Served as a resource for team members, mentoring new staff and providing clear direction on complex cases.
- Proficiently utilized multiple EMR platforms (EPIC, Cerner, Meditech) and Microsoft Office Suite to streamline documentation and reporting.
Timeline
Home Health Nurse
Tennessee Home Health
04.2024 - Current
RN Case Manager
Adoration Home Health
10.2023 - 04.2024
Registered Nurse – Hospice
Hospice of Chattanooga, Inc.
11.2022 - 09.2023
NICU Nurse
HCA Healthcare
09.2021 - 08.2022
School Health Nurse
Department of Education
01.2011 - 12.2020
Neonatal Intensive Care Unit Nurse
Erlanger Health System
01.2002 - 01.2007
Cardiology Office Nurse/Supervisor
Dr. Leonard Hays, Diagnostic Center
01.2000 - 01.2002
Associate of Science - Registered Nurse
Southern Adventist University
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