Janet Stokes
Jackson,MS
Summary
Dedicated Utilization Review RN specializing in clinical assessment and case management. Achieved optimal patient care outcomes through effective communication and collaboration with interdisciplinary teams while ensuring compliance with clinical guidelines. Enhanced resource utilization and streamlined care processes to support patient satisfaction and confidentiality.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Utilization Review RN
Merit Health Central
Jackson, MS
05.2022 - Current
- Conducted comprehensive utilization reviews to ensure compliance with clinical guidelines and regulatory standards.
- Collaborated with interdisciplinary teams to develop patient care plans that optimize resource utilization.
- Analyzed medical records and treatment plans to determine appropriateness of services rendered.
- Facilitated communication between healthcare providers and insurance companies regarding authorization requests.
- Established strong working relationships with insurance representatives, fostering open communication channels for efficient resolution of coverage issues or disputes related to medical necessity determinations.
RN Case Manager
Merit Health Central
Jackson, MS
05.2020 - 05.2022
- Coordinated patient care plans to optimize health outcomes and resource utilization.
- Monitored patient progress and adjusted interventions based on clinical assessments.
- Collaborated with multidisciplinary teams to ensure comprehensive patient support services.
- Educated patients and families on disease management and treatment options effectively.
- Conducted regular case reviews to identify barriers to care and implement solutions.
- Developed and maintained accurate documentation in electronic health record systems.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
- Implemented evidence-based practices to improve overall clinical performance and patient outcomes.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
Quality Clinical Analyst RN
Merit Health Central/Central MS Medical Center
Jackson, MS
05.2009 - 05.2022
- Led initiatives to optimize electronic health record (EHR) utilization across departments.
- Developed and maintained dashboards for real-time data monitoring and reporting.
- Collaborated with healthcare teams to enhance patient care processes and outcomes.
- Analyzed clinical data to identify trends, supporting evidence-based decision-making.
- Conducted thorough audits of clinical workflows, recommending process improvements for efficiency.
- Evaluated system performance, identifying areas for enhancement and implementing solutions effectively.
- Conducted regular audits of clinical documentation to ensure accuracy, completeness, and compliance with regulatory requirements.
- Developed comprehensive reports for healthcare providers, highlighting key insights from clinical data to inform decisionmaking.
- Collaborated with multidisciplinary teams to design and implement improvements in clinical processes, leading to better patient outcomes.
- Supported quality improvement initiatives by gathering and analyzing performance metrics related to patient care delivery processes.
RN Case Manager
Central MS Medical Center
Jackson, MS
05.2004 - 05.2009
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Advocated for patient needs within the healthcare system, enhancing access to services.
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Trained and mentored new staff on case management protocols and best practices.
- Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Educated patients and caregivers on healthcare protocols and processes.
- Facilitated multidisciplinary team meetings to discuss patient care, fostering a collaborative approach to healthcare.
- Developed strong relationships with patients and their families, providing support and education on health management.
- Used firsthand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
Telemetry Registered Nurse
Central MS Medical Center/Methodist Healthcare
Jackson, MS
05.2001 - 05.2009
- Monitored patients' vital signs and telemetry data to identify abnormalities and initiate timely interventions.
- Collaborated with interdisciplinary teams to develop and implement individualized care plans for optimal patient outcomes.
- Educated patients and families on health management, medication administration, and post-discharge care strategies.
- Assisted in training new nursing staff on telemetry monitoring protocols and emergency response procedures.
- Conducted comprehensive assessments to determine patient needs, ensuring timely and effective care delivery.
- Led team meetings to discuss patient progress, share best practices, and address workflow challenges within the unit.
- Enhanced patient care by accurately interpreting cardiac monitor readings and promptly reporting critical findings to healthcare the team.
- Prevented life-threatening complications by quickly recognizing early warning signs of deterioration in critically ill patients under close observation.
- Administered prescribed medications safely and effectively while closely monitoring potential side effects or adverse reactions.
- Enhanced teamwork within the telemetry unit through active participation in daily huddles, shift handoffs, and collaborative problem-solving sessions.
- Provided patients with information on such subjects as side effects from medications and benefits of proper nutrition to help promote better outcomes.
- Maintained accurate and comprehensive electronic health records for all patients under care, facilitating seamless communication among healthcare team members and continuity of care across shifts.
Education
Bachelor of Science - Nursing
University of Mississippi Medical Center
Jackson12-1993
Bachelor of Science - Biology
Jackson State University
Jackson, MS08-1987
Associate of Arts - Biology
Hinds Community College Utica Campus
Utica, MS05-1985
Skills
- Resource utilization
- Discharge planning coordination
- Medical documentation
- Utilization review
- Clinical assessment
- Quality improvement
- Patient confidentiality
Certification
- Nursing License - [01/01/2024 to12/31/2026]
Timeline
Utilization Review RN
Merit Health Central
05.2022 - Current
RN Case Manager
Merit Health Central
05.2020 - 05.2022
Quality Clinical Analyst RN
Merit Health Central/Central MS Medical Center
05.2009 - 05.2022
RN Case Manager
Central MS Medical Center
05.2004 - 05.2009
Telemetry Registered Nurse
Central MS Medical Center/Methodist Healthcare
05.2001 - 05.2009
Bachelor of Science - Nursing
University of Mississippi Medical Center
Bachelor of Science - Biology
Jackson State University
Associate of Arts - Biology
Hinds Community College Utica Campus