Jesson Don

Administered medications and monitored patient responses to ensure safety and effectiveness. Collaborated with multidisciplinary teams to develop and implement patient care plans. Educated patients and families on treatment options, promoting understanding and compliance. Conducted thorough assessments of patients' conditions, documenting findings accurately in electronic health records.

Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration of relevant clinical information. Function as a member of a self-directed team to meet specific individual and team performance metrics. Ability to communicate in writing and verbally about all types of benefit determinations, including decisions regarding coverage guidelines. Engage in telephonic discussions with health care providers and/or members to explain benefit coverage determinations and to obtain additional clinical information.

The Nurse First Response (NFR) position is responsible for providing a telephonic assessment to the injured worker who has not yet received medical treatment. The Registered Nurse will recommend the appropriate route for treatment based on the answers to specific protocols. A plan of care will be determined for self-care or referral for a medical evaluation.

Concurrent review of the patient’s clinical information for efficiency. Review of pre-certification requests for medical necessity. Coordinates the patient’s discharge planning needs with the healthcare team. Maintains accurate records of all patient-related interactions. Ability to stay organized and interact well with others in any situation, providing daily updates to the Manager of Utilization Management for review.

Provided direct patient care, administering medications and monitoring vital signs to ensure optimal health outcomes. Collaborated with multidisciplinary teams to develop and implement individualized care plans for diverse patient populations. Educated patients and families on health management, promoting effective self-care strategies and medication adherence. Led training sessions for new nursing staff, enhancing team competency in clinical procedures and hospital protocols.