Jessica Richards
13650 N Harmony Ln Opdyke
Summary
Dedicated and detail-oriented Registered Nurse with extensive experience in acute care and a strong background in Case Management. Skilled in coordinating patient care, conducting assessments, developing care plans, and advocating for patient needs. Proficient in interdisciplinary collaboration, utilization review, chronic disease management, and discharge planning. Recognized for adaptability, reliability, and a results-focused approach in dynamic healthcare settings.
Overview
13
13
years of professional experience
1
1
Certification
Work History
REGISTERED NURSE- Case Manager/Utilization Review
SSM Health St. Mary's/ Good Samaritan Hospital
08.2020 - Current
- Manage caseloads of up to 35 patients, coordinating individualized care plans based on clinical and psychosocial needs.
- Perform initial assessments, ongoing evaluations and discharge planning with patients and families to determine and address individual care needs post acute hospitalization.
- Collaborates and communicates effectively with physicians, social workers, and insurance providers to ensure timely and cost-effective care.
- Identifies optimal outcomes for the patient in collaboration with the patient, family and inter-professional team.
- Develops a plan that prescribes strategies and alternatives to attain outcomes, using clinical judgement in collaboration with patient, family and inter-professional care team.
- Reduced hospital readmission rates with proactive follow-up care and patient education on self-management techniques for CHF, COPD and AMI diseases processes.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Applied critical thinking skills to assess complex medical cases and determine appropriate levels of care in accordance with industry benchmarks.
- Expedited claim resolution by effectively communicating clinical rationale for treatment recommendations to insurance reviewers.
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
- Performed admission reviews based for medical necessity based upon MCG/InterQual specification.
REGISTERED NURSE- CSU and CCU
SSM Health Good Samaritan Hospital - IL
02.2016 - 08.2020
- Responsible for assessing, prioritizing, monitoring, and implementing of physician ordered treatments and interventions for patients.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
- Assisted in the training and mentorship of new nursing staff members, contributing to a positive work environment and high-quality patient care.
- Document information related to patient care including, assessment results, interventions, medications, and patient responses to interventions and treatments.
- Educated patient and support person on current illness or medical issue, answer questions appropriately within my scope of practice.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Crossed trained into the Critical Care Unit, covered on average 1-2 shifts per week.
REGISTERED NURSE- ICU/IMCU
Southern Illinois Healthcare- Herrin Hospital - Herrin, IL
04.2014 - 01.2020
- Prioritized nursing care for assigned critically ill patients based on assessment data and identified needs.
- Set up and/or manage medical equipment and devices such as cardiac monitors, mechanical ventilators, and central lines including transducers, pressure lines.
- Assisted physicians with bedside procedures such as bronchoscopy, thoracentesis, central line insertion, endotracheal intubation, chest tube placement.
- Administration of titratable pharmacological and sedation medications per hospital policy.
- Collaborate with members of multidisciplinary health care teams to plan and manage current and future needs of the patient.
- Supervised and assisted unit nursing staff as a relief charge nurse.
- Continually improved knowledge, skills, and performance based on feedback and self-identified professional developmental needs.
REGISTERED NURSE
Baptist Health Paducah - Paducah, KY
07.2012 - 12.2013
- Assessed and cared for patients on the Transitional Care Unit.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Developed initial plan of treatment based on physician's orders, initial assessment and patient needs.
- Accurately documented all elements of nursing assessment, treatments, medication, admissions, discharge instructions and follow-up care.
- Educated patients and families on health care needs, conditions and options.
Education
Associate of Applied Science - Registered Nurse
Kaskaskia College
Centralia, IL01.2012
Bachelor of Science - BSN
Central Methodist University
Fayette, MOSkills
- Case Management & Care Coordination
- Discharge planning
- Interdisciplinary Team Collaboration
- Insurance Authorization & Appeals
- CMS Guidelines / HIPAA compliance
- Chronic Disease and Post Acute Care
- Utilization Review
Certification
- Registered Nurse in Illinois 2014-2026
- Registered Nurse in Kentucky 2012-2014
Timeline
REGISTERED NURSE- Case Manager/Utilization Review
SSM Health St. Mary's/ Good Samaritan Hospital
08.2020 - Current
REGISTERED NURSE- CSU and CCU
SSM Health Good Samaritan Hospital - IL
02.2016 - 08.2020
REGISTERED NURSE- ICU/IMCU
Southern Illinois Healthcare- Herrin Hospital - Herrin, IL
04.2014 - 01.2020
REGISTERED NURSE
Baptist Health Paducah - Paducah, KY
07.2012 - 12.2013
Associate of Applied Science - Registered Nurse
Kaskaskia College
Bachelor of Science - BSN
Central Methodist University
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