Dewana Philpot
Baton Rouge,LA
Summary
Skilled Licensed Practical Nurse with significant experience in case management, skilled in developing and implementing client care plans that address individual needs and circumstances. Known for fostering team collaboration and driving results, adaptable to changing environments, and capable of managing multiple priorities. Proficient in needs assessment, resource coordination, and client advocacy, consistently maintaining high standards and results-oriented approach. Demonstrated strong communication and problem-solving skills in fast-paced healthcare environments.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Care Coordination Nurse
Blue Cross Blue Shield Louisiana
02.2022 - 10.2024
- Ensure effective communication with policy managers and support team
- Provide support to clinical and non-clinical staff
- Complete all assigned tasks in accordance with performance standards
- Assess medical necessity of proposed treatments
- Responsible for presenting, preparing, and submitting all recommendations for denial to the medical director and plan
- Liaison, including arranging any peer-to-peer reviews, if requested by hospitalist, attending, or primary care physician
- Responsible for requesting clinical information for concurrent review with strict adherence to URAQ guidelines
- Analyze appropriate medical benefits are applied to services reviewed for medical necessity
- Responsible for ensuring accurate documentation when applying policy benefits for requested service
- Effectively utilizing clinical systems including InterQual, MCG, MMS, and EPIC, handling over 30 reviews per day and enhancing interdisciplinary communication for improved patient outcomes
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
Admission Nurse
Carpenter Health Network
01.2019 - 01.2022
- Collaborate with physicians and nursing staff to schedule admissions/discharges
- Confirm that patients completed required test prior to scheduled procedures
- Ensure that medical orders were properly entered into database
- Maintain inventory of medical equipment and available medications
- Coordinate with appropriate staff to ensure optimal patient care
- Update patient information and verify insurance
LPN Wound Care Nurse
Carpenter Health Network
08.2017 - 12.2018
- Educated staff on skin breakdown prevention, facility policy and procedure when new skin issues observed and proper treatment and dressing change technique
- Collaborated with dietary department, PT/OT, Unit managers, DON and Wound Care Physician to provide patient centered and individualized care
- Analyzed monthly and quarterly wounds and healing times and organized data collected for Quality Assurance meetings
- Utilized clean & sterile techniques to perform various treatments including negative pressure therapy for wound management
- Managed wound care for a patient roster of over 50 individuals weekly, achieving a 95% healing rate by meticulously assessing wound stages and applying appropriate treatments in collaboration with interdisciplinary healthcare teams
Case Manager
Med Pass Staffing
05.2013 - 07.2017
- Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care
- Managed support services and fostered communication among social workers, therapists, facility staff and patients
- Admit new patients by reviewing records and applications
- Determine patient's requirements by completing intake interviews
- Managed and streamlined referral queues by efficiently prioritizing patients and clearing insurance obstacles
- Effectively communicated with physicians regarding patient needs, performance, medications and changes
- Authored initial assessments of patients and family to develop plans for individual home care needs
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Fostered open lines of communication with clients'' families and support networks, involving them in the case management process as appropriate.
- Trained new case managers, raising team's overall competency and service delivery standards.
Education
Diploma - Practical Nursing
Delta College of Arts & Tech
Baton Rouge, LA01.2013
High School Diploma -
Baker High School
Baker, LA05-2001
Skills
- Problem-Solving
- Organization and Multitasking
- Case Management
- Relationship Building
- Decision-Making
- Positive Attitude
- Resource Management
- Compassionate Care
- Strong Communication Skills
- Microsoft Office expertise
- Spreadsheet Management
- Word Processing
- Microsoft Office proficiency
- Excel expertise
- Dependable and reliable
- Superior organizational skills
- Work independently
Personal Information
Title: LPN
Certification
CMCN Certification
S.W.O.C (Wound Care) Certification
CPR Certification
Timeline
Senior Care Coordination Nurse
Blue Cross Blue Shield Louisiana
02.2022 - 10.2024
Admission Nurse
Carpenter Health Network
01.2019 - 01.2022
LPN Wound Care Nurse
Carpenter Health Network
08.2017 - 12.2018
Case Manager
Med Pass Staffing
05.2013 - 07.2017
CMCN Certification
S.W.O.C (Wound Care) Certification
CPR Certification
Diploma - Practical Nursing
Delta College of Arts & Tech
High School Diploma -
Baker High School
Similar Profiles
Teoshi DaschTeoshi Dasch
Tier 1 IT Help Desk Technician at Vantage Health Plan/Blue Cross and Blue Shield of Louisiana/AffinityTier 1 IT Help Desk Technician at Vantage Health Plan/Blue Cross and Blue Shield of Louisiana/Affinity
Aadarsha KandelAadarsha Kandel
Software Engineer at Blue Cross and Blue Shield of LouisianaSoftware Engineer at Blue Cross and Blue Shield of Louisiana
Derrick JudsonDerrick Judson
Intake Coordinator I at Blue Cross and Blue Shield of LouisianaIntake Coordinator I at Blue Cross and Blue Shield of Louisiana