Cayla Flynn
Bend
Summary
Knowledgeable, caring, hardworking, and service-oriented Registered Nurse with over 15 years of experience in delivering comprehensive, evidence-based patient care, and strong experience with assessment, coordination, case management and utilization management. Advanced skills working with diverse patient populations. Demonstrated ability to foster relationships and coordinate with healthcare professionals to advance patient care.
Main working experience includes acute care, Hospice Case Management, and Utilization Review
Overview
11
11
years of professional experience
Work History
Utilization Management Nurse
PacificSource
02.2020 - Current
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
- Contributed to team success by consistently meeting productivity goals while maintaining high-quality standards in job performance.
- Applied critical thinking skills to assess complex medical cases and determine appropriate levels of care in accordance with industry benchmarks.
- Promoted a positive work environment by mentoring new nurses and serving as a resource for clinical questions and concerns.
- Performed review of acute inpatient stays and post-acute admissions,
Registered Nurse
Life Care Centers Of America
06.2018 - 12.2019
- Addressed unit staff concerns, including staffing ratios, resource management, allocation of responsibilities and optimized workload management.
- Immunized patients against diseases such as influenza and pneumonia to protect vulnerable populations from serious illnesses.
- Treated patients using pharmacological and non-pharmacological treatment modalities to address various disorders, diseases and injuries.
- Developed and adapted individualized treatment plans according to patient recovery goals.
- Administered medications, tracked dosages and documented patient conditions.
- Administered scheduled medications and therapies intravenously, rectally, orally, subcutaneously and via intramuscular injections while overseeing pain management plans.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
- Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Conducted patient assessments and diagnostic tests to provide physician with important patient health information used to create focused treatment plans and manage ongoing care.
RN Hospice Case Manager
Hospice Visions
07.2013 - 06.2017
- Reviewed effectiveness of treatment for individual and family situations.
- Collaborated with different disciplines to provide cohesive care to patients.
- Informed patients and families of treatment options and at-home care strategies to reduce unnecessary burden on hospital resources.
- Coordinated resources from diverse providers for intervention plans.
- Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
- Administered oral, IV and intra-muscular medications and monitored patient reactions.
- Delivered information regarding care and medications to patients and caregivers in comprehensible terminology.
- Participated in continuing education programs to enhance training and nursing knowledge.
- Answered patient questions and provided take-home materials for further information.
- Counseled caregivers and families on end-of-life planning and educated on patient care options.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Delivered quality care and comfort to patients with heart failure, pulmonary hypertension, pulmonary embolisms and end-stage renal disease.
- Observed strict safety measures, including checking medication dosages before administration to patients.
Education
Associate of Science - Nursing
College of Southern Idaho
Twin Falls, ID11 2009
Skills
- Wound cleaning/dressing changes
- Broad medical terminology knowledge
- Intake and discharge
- Staff Development and Precepting
- Care planning
- Geriatric treatment knowledge
- Acute and rehabilitative care
- Colostomy care familiarity
- Body mechanics knowledge
- IV drug therapy management
- Progress reporting
- Schedule coordination
- Computerized charting/records
- Comforting/calming upset or distraught patients/families
- De-escalating stressful situations
- Customer service
- Care coordination
- Clinical assessment
- Patient confidentiality
- Continuing education
- Policy adherence
- Utilization review
- Interdisciplinary collaboration
- Medical necessity evaluation
- HIPAA compliance
- Utilization management
- Strong clinical judgment
- Team collaboration
- Active listening
- Patient and family advocacy
- Patient care assessment
- Patient education
- Clear patient communication
- Pain management
Education and Training
Twin Falls, ID,other
Timeline
Utilization Management Nurse
PacificSource
02.2020 - Current
Registered Nurse
Life Care Centers Of America
06.2018 - 12.2019
RN Hospice Case Manager
Hospice Visions
07.2013 - 06.2017
Associate of Science - Nursing
College of Southern Idaho
Similar Profiles
Tamra SappingtonTamra Sappington
Utilization Management Clinician at PacificSourceUtilization Management Clinician at PacificSource
Khristin JonesKhristin Jones
Government Operations Team Lead at PacificSourceGovernment Operations Team Lead at PacificSource
Emily Groshong-CoxEmily Groshong-Cox
Manager, Commercial Individual Operations at PacificSourceManager, Commercial Individual Operations at PacificSource