Jennifer Buchtan
Greensboro,PA
Summary
Accomplished Registered Nurse with 30 years of diverse nursing experience. Successful at working with all levels of healthcare providers and physicians. Most recent experience includes working remotely to successfully ensure medical standards of care are followed.
Overview
35
35
years of professional experience
Work History
Clinical Nurse Reviewer
Pain Specialists Of Charleston
05.2020 - Current
- Exhibited strong analytical skills when interpreting complex medical records to evaluate patient care outcomes against established benchmarks.
- Enhanced interdisciplinary communication by collaborating with healthcare providers to discuss case findings and develop optimal care plans.
- Conducted in-depth research on emerging medical trends and best practices, sharing findings with colleagues to inform clinical decision-making processes.
- Improved patient care quality by conducting thorough clinical reviews and providing evidence-based recommendations.
- Adhered to strict timelines for case completion while maintaining a high level of accuracy and attention to detail during the review process.
- Contacted providers, state agency offices and applicants to obtain information and records needed to conduct comprehensive clinical review of case and final determination.
- Remote nurse responsible for obtaining authorization for medications and medical procedures for Medicare, Medicaid and commercial insurance. Performed detailed chart reviews to gather specific information to support need. Knowledgeable of ICD 10 codes, CPT and J codes. Submited authorization requests online and via telephone after chart review to collect appropriate codes. Communicated with physicians, healthcare providers and patients to disclose outcomes and submit appeals requests if indicated. Performs and arranges for peer to peer reviews with insurance companies to demonstrate treatment plan is medically necessary.
Registered Nurse Case Manager
Amedisys Homecare
08.2008 - 05.2020
- Determined and coordinated appropriate level of care to meet individual patient needs.
- Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
- Optimized program resource utilization to prevent unnecessary hospital admissions.
- Conducted 30 day evaluations to address changes in patient needs, conditions and medications and communicate finding to physicians.
- Trained, guided and mentored home healthcare providers.
- Collaborated with physicians and other healthcare providers to ensure appropriate resource utilization for complex cases.
- Nurse preceptor responsible for training new nurses. Trained new RN hires and ancillary staff members to meet patient service goals and standards of care.
- Promoted to RN Case Manager and developed and initiated care plans to provide best patient out comes.
- Performed detailed chart reviews to ensure standards of practice and Medicare guidelines were being adhered to.
Registered Nurse
Oliverio ENT
05.2003 - 08.2008
- Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
- Collaborated with doctors to plan post-treatment home care and prevent return hospitalization due to complications.
- Delivered direct patient care, including stabilizing patients and identifying treatment options.
- Conducted patient assessments and diagnostic tests to provide physician with important patient health information.
- Updated physicians on patient test results and assisted in developing care plans.
- Obtained insurance authorization for surgical procedures.
- Worked closely with physicians assisting with office procedures and coded procedures for billing purposes.
Registered Nurse, Medical-Surgical Unit
Uniontown Hospital
03.1990 - 08.2003
- Administered medications, tracked dosages and documented patient conditions.
- Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
- Cared for patients in recovery from medical procedures by caring for wounds, monitoring vitals and managing pain.
- Assessed and prepared patients for procedures, performing initial and ongoing patient assessments.
- Collaborated with doctors to plan post-treatment home care and prevent return hospitalization due to complications.
- Delivered direct patient care, including stabilizing patients and identifying treatment options.
- Planned and spearheaded in-service educational programs focusing on fall safety, skin care and adherence to core measures.
- Assisted patients with healing and recovery after surgery by closely monitoring and caring for wounds, answering questions and educating about continued care strategies.
- Participated in bedside reporting and handoff at change of shift and for patient transfers.
- Administered medications and treatments as directed and as appropriate for patient's medical care in collaboration with multi-disciplinary team.
- Implemented pre, intra- and post-care, evaluating response to clinical interventions with progression toward discharge.
- Communicated with primary care physicians or emergency care providers to relay patient needs.
- Documented nursing intervention and patient and family responses accurately and in compliance with hospital policies.
- Imparted medical, operational and patient care knowledge to junior nurses to maximize performance and quality of team operations.
- Delivered high-quality nursing care to patients on 25 bed medical-surgical unit with emphasis on orthopedics, urology and gastro-intestinal post-operative patients.
Education
Diploma in Nursing - Nursing
Uniontown Hospital School of Nursing
2 1990
High School Diploma -
Mapletown High School
Greensboro, PA5 1986
Skills
- Patient care planning
- Physical assessment
- Acute home health specialized care
- Nursing staff leadership
- Nursing Plan Development and Modification
- Staff Development and Precepting
- Team supervision
- Nursing Documentation
- HIPAA knowledge
- Medical record review
- Utilization review
- Teamwork and Collaboration
- Time Management
- Problem-solving abilities
- Multitasking Abilities
- Home care
- Preventive health
- Acute care expertise
- Nursing Performance Assessment
- Case Management
Additional Information
Valid Registered Nursing License in Pennsylvania and West Virginia.
Timeline
Clinical Nurse Reviewer
Pain Specialists Of Charleston
05.2020 - Current
Registered Nurse Case Manager
Amedisys Homecare
08.2008 - 05.2020
Registered Nurse
Oliverio ENT
05.2003 - 08.2008
Registered Nurse, Medical-Surgical Unit
Uniontown Hospital
03.1990 - 08.2003
Diploma in Nursing - Nursing
Uniontown Hospital School of Nursing
High School Diploma -
Mapletown High School
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