Jessica Taylor
Sorrento,FL
Summary
Patient-oriented Nurse with 14 years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with case management, utilization review specialty. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Overview
14
14
years of professional experience
Work History
Pre-Authorization Nurse/Utilization Review Registered Nurse
Humana Military
05.2017 - Current
- Communicated with provider's offices to obtain pre-authorizations for treatment.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Managed patients recovering from medical or surgical procedures.
- Recorded details regarding therapies to keep patient charts updated.
- Participated in evidence-based practice project implementation, nursing competency development and nursing simulation activities.
- Evaluated patient histories, complaints, and current symptoms.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated family members and caregivers on patient care instructions.
Care Coordinator for Inpatient and Denials
Meridian
06.2015 - 05.2017
- Used company software and databases to maintain records of services performed and patient conditions.
- Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Built strong relationships with clients to deliver emotional support and companionship.
- Supported patient care excellence via planning and interpretation of programs.
- Updated policies and procedures, leading continuous improvement of resident assessments and care.
Case Manager
HSHS St. Elizabeth's Hospital
11.2013 - 06.2015
- Developed and implemented comprehensive case management plans to address client needs and goals.
- Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients.
- Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources.
- Monitored clients' progress and tracked client services to provide crisis interventions.
- Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations, and procedural costs.
- Collaborated with an interdisciplinary team to determine timely delivery of services.
- Evaluated treatment plans against individual goals and healthcare standards.
- Assessed community needs and identified resources for social and community service programs.
- Analyzed trends and data to inform decision-making and program development.
Hospice Nurse Case Manager
Heartland Hospice
09.2011 - 10.2013
- Offered listening ear to both patients and loved ones to meet emotional and mental, as well as physical needs.
- Recognized and understood specific stages of dying process, providing comfort-based care during vulnerable times.
- Developed and implemented individualized care plan for each hospice patient while following physician instructions.
- Provided high level of quality, compassionate care to patients and caregivers during each nursing shift.
- Established and maintained successful relationships with patients, families and physicians by utilizing exemplary communication and active listening skills.
- Taught family members and caregivers various ways to manage patients' pain, how to check for vital signs and proper methods for dressing changes.
- Evaluated patient histories, complaints, and current symptoms.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Educated family members and caregivers on patient care instructions.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Observed and documented patient factors such as diets, physical activity levels and behaviors to understand conditions and effectively modify treatment plans.
Home Health Nurse Case Manager
VNA Tip
05.2009 - 09.2011
- Educated patients and families on disease processes, medications and treatments.
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Monitored vital signs, developed and implemented care plans, and documented patient progress.
- Coordinated with other healthcare team members to support patient needs.
- Provided emotional support and kind companionship to patients and families to increase overall wellness.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
- Documented patient vitals, behaviors and conditions to communicate concerns to supervising nurse.
- Assessed patients' health status and developed individualized care plans to suit needs.
- Administered medications and treatments as prescribed by physicians.
- Administered different therapies and medications in line with physician orders and treatment plan.
- Delivered after-hours care to patients based on strict role-call rotations.
- Developed and implemented discharge plans to promote continued care after discharge.
- Evaluated patient histories, complaints, and current symptoms.
- Educated family members and caregivers on patient care instructions.
- Managed patients recovering from medical or surgical procedures.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
Education
Bachelor of Science - Nursing
Saint Louis University
St Louis, MO05.2008
Skills
- Resource Management
- Rehabilitative Nursing
- Delegation and Motivation
- Specialized Healthcare Referrals
- Patient Data Management Systems
- Accurate Documentation
- Microsoft Office
- InterQual Criteria
- Manage Cases
- Insurance Eligibility
- Diagnostic Software
- Patient Care Assessment
Timeline
Pre-Authorization Nurse/Utilization Review Registered Nurse
Humana Military
05.2017 - Current
Care Coordinator for Inpatient and Denials
Meridian
06.2015 - 05.2017
Case Manager
HSHS St. Elizabeth's Hospital
11.2013 - 06.2015
Hospice Nurse Case Manager
Heartland Hospice
09.2011 - 10.2013
Home Health Nurse Case Manager
VNA Tip
05.2009 - 09.2011
Bachelor of Science - Nursing
Saint Louis University
Similar Profiles
Faith FarrerFaith Farrer
Claims Representative at Humana MilitaryClaims Representative at Humana Military
Trevor RawleighTrevor Rawleigh
Software Engineer at Humana MilitarySoftware Engineer at Humana Military
Jennifer Bruner, BSN, RNJennifer Bruner, BSN, RN
Manager, Utilization Management at Humana MilitaryManager, Utilization Management at Humana Military