Jeannie Miner
North Little Rock,AR
Summary
Hands-on professional proudly offering more than 29 years of expertise in nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight and performance improvement. Smart Utilization Review Nurse considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
22
22
years of professional experience
Work History
Utilization Review Registered Nurse
Meleeo, Inc
06.2023 - Current
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed admission reviews based for medical necessity based upon Medicare and Medi CAL specification.
- Supervised and maintained all utilization review documentation through Interqual and Epic.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
- Served as subject matter resource, providing information related to level of care and situations.
RN Case Manager
AMN Healthcare
06.2022 - 06.2023
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Responded promptly and professionally to patient questions and concerns.
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Liaised with physicians regarding patient needs, performance and changes.
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
- Authored initial assessments of patients and family to develop plans for individual home care needs.
- Used Cerner secure chat to maintain database of relevant information for practitioners to access and coordinate patient care.
- Educated and supported home healthcare providers with training, guidance, mentoring and resources required to achieve objectives."
- Coordinated rehabilitative and preventive nursing processes and procedures.
- Audited charts and reviewed clinical documents to verify accuracy.
Registered Nurse Case Manager
Arkansas Heart Hospital
05.2001 - 04.2022
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Responded promptly and professionally to patient questions and concerns.
- Liaised with physicians regarding patient needs, performance and changes.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Managed care from admission to discharge.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Updated patient charts with data such as medications to keep records current and support accurate treatments.
- Organized and managed care of patients undergoing various therapies and procedures.
- Collected blood, tissue, and other laboratory specimens and prepared for lab testing.
- Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use, and disease management.
- Maintained quality care and comfort for patients with heart failure, pulmonary hypertension, and other conditions.
- Monitored patient condition by interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
- Participated in nursing simulation activities, evidence-based practice project implementation and competency development to further nursing education.
- Oversaw delivery of care for patients on medical-surgical unit, providing direct care, delegating nursing assignments and supervising team comprised of nurses, LPNs, technicians, and unit clerks.
- Contributed substantially to successful department JCAHO accreditation by consistently operating to highest standards of care.
Education
Associate of Science - Nursing
University of Arkansas At Little Rock
Little Rock, AR05.2001
Diploma - License of Practical Nursing
Pulaski Technical College
North Little Rock, AR05.1994
High School Diploma -
Oak Grove High School
North Little Rock, AR05.1992
Skills
- Discharge Planning Coordination
- Documentation and Reporting
- Physician Consultations
- Utilization Review
- Interpersonal and Written Communication
- Critical Thinking
- Specialized Healthcare Referrals
- Healthcare Personnel Supervision
- Medication Administration
- Preventive Health
- Insulin Medication Assistance
- Intake and Discharge
- Patient and Family Advocacy
- EMR / EHR
- Compassionate and Caring
- Immunizations and Vaccinations
- Accurate Documentation
- Patient Care Assessment
- Medication and IV Administration
- Attention to Detail
- Tracheostomy Care
- Strong Clinical Judgment
- Training Staff
- Oxygen Saturation Standards
- Community Program Referrals
- Cardiac Monitors
- ICD-9 Forms
- ICD-10
- Decision-Making
- Diabetes Management
- Treatment Preparation
- Wound Care
- Direct Patient Care
- Trauma Recovery
- Student Precepting
- Care Coordination
- Patient Condition Monitoring
- Patient Examination
- Case Management
- Chronic Disease Management
Timeline
Utilization Review Registered Nurse
Meleeo, Inc
06.2023 - Current
RN Case Manager
AMN Healthcare
06.2022 - 06.2023
Registered Nurse Case Manager
Arkansas Heart Hospital
05.2001 - 04.2022
Associate of Science - Nursing
University of Arkansas At Little Rock
Diploma - License of Practical Nursing
Pulaski Technical College
High School Diploma -
Oak Grove High School
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