Charlotte Carver
Grand Junction,CO
Summary
Searching for a position that offers professional challenges where critical thinking, collaboration, and problem-solving skills can be utilized. Skilled in working under pressure and adapting to new situations and challenges.
Overview
17
17
years of professional experience
Work History
Prior Authorization Nurse
Cohere Health
01.2022 - Current
- Using clinical knowledge and critical thinking, review prospective and retrospective requests using evidence-based criteria utilizing MCG, NCD, LCD, and Humana guidelines.
- Refer cases to company physician for higher level review that do not meet criteria or have questionable findings.
- Perform timely communication with requesting providers to obtain missing information to process reviews efficiently
- Collaborate with SME's, clinical reviewers, and physicians to ensure high quality, timely, and cost-effective care.
Registered Nurse/Operating Room Circulator
Grand Valley Surgery Center
07.2020 - 11.2021
- Monitored surgical patients and delivered quality level care before, during and after operations to promote positive outcomes.
- Collaborated with members of patients' healthcare team to deliver appropriate level of care.
- Performed preoperative assessments on patients and evaluated overall health.
R.N. Orthopedic
St. Mary's Hospital
07.2019 - 07.2020
- Delivered nursing care for orthopedic, surgical, and medical patients with a focus on controlling pain through oral medications, IV push, PCA pumps, On-Q, and Sapphire blocks
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Provided ongoing patient care including monitoring wounds for signs of infection, dressing changes, care and monitoring drains.
HEDIS R.N (contractor)
Rocky Mountain Health Plans/Express Employment
01.2019 - 05.2019
- Performed on-site and remote audit visits to physician offices, analyzing electronic and paper medical records for information pertinent to Healthcare Effectiveness Data and Information Sets (HEDIS) measures
- Abstracted relevant clinical information and ensured accurate and complete clinical data entry into Inovalon Platform and Hybrid Reporter
- Achieved 95% chart review accuracy.
R.N. Cardiac Cath Lab
St. Mary's Hospital
04.2014 - 09.2018
- Assisted Physicians during scheduled and emergent cardiac catheterizations, TAVR procedures, balloon pump insertions, Pacemakers, and cardiac ablations
- Administered conscious sedation, monitored heart rhythm and vital signs, responsible for administering Propofol and ACLS medications/ IV drips
- Collaborated as part of a team that set up a new TAVR program.
RN - Labor and Delivery (casual)
St. Mary's Hospital
08.2013 - 03.2014
- Responded to emergency situations such as pre-eclampsia, early labor and fetal distress.
- Leveraged computerized documentation systems to monitor, record and communicate patient condition.
- Assisted obstetricians and midwives with deliveries and cared for newborns directly after birth.
Travel Nurse LDRP
Numerous Hospitals
01.2006 - 01.2014
- Prioritized nursing care for high and low risk patients based on assessment data and identified needs on 23 different contracts (the majority of these were in Labor and Delivery, as well as Postpartum and GYN)
- Accurately documented patient interactions, interventions, medications, and treatments in various EMR's such as EPIC, Cerner, Meditech, OBIX, OB Tracevue.
Education
Associate of Applied Science - Nursing Science
University of Alaska Anchorage
Anchorage, AKSkills
- Care Management
- Utilization Review
- Remote Nursing
- Collaboration
- Clinical Documentation
- Critical Thinking
- Healthcare and HIPPA Regulations
- MCG/NCD/LCD
- Medicare
- Determine Medical Necessity
- Chart Review
- Data abstraction
Timeline
Prior Authorization Nurse
Cohere Health
01.2022 - Current
Registered Nurse/Operating Room Circulator
Grand Valley Surgery Center
07.2020 - 11.2021
R.N. Orthopedic
St. Mary's Hospital
07.2019 - 07.2020
HEDIS R.N (contractor)
Rocky Mountain Health Plans/Express Employment
01.2019 - 05.2019
R.N. Cardiac Cath Lab
St. Mary's Hospital
04.2014 - 09.2018
RN - Labor and Delivery (casual)
St. Mary's Hospital
08.2013 - 03.2014
Travel Nurse LDRP
Numerous Hospitals
01.2006 - 01.2014
Associate of Applied Science - Nursing Science
University of Alaska Anchorage
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