Julie Anne Arvizu
LPN
Sun City West,Arizona
Summary
Skilled LPN excelling in Remote Nursing, Pre Auth Clinical Review, Utilization Management, Retro Auth Review, Care Coordination, recognizing gaps in Medical Care, with the outcome being to prevent patient Hospital re-admissions. My goal while working remotely is to implement a caring team approach both to efficiently address patient needs and to communicate with Healthcare Providers Medically necessary criteria allowing MD’s to make Pre-Auth determinations
Overview
12
12
years of professional experience
Work History
Home Health Aide
Total Care Connections
09.2022 - 03.2023
- Administered medication on time using schedules and reminders
- Coordinated care with nursing and clinical staff
- Collected vital signs, recording blood pressure, pulse and temperature
- Boosted client wellbeing through social, mental and physical support
- Washed, sanitized and changed dressings for wound care patients.
Home Health Aide
Home Instead Senior Care
09.2021 - 04.2022
- Assisted home-bound individuals with personal hygiene and care needs to maintain health and dignity
- Minimized safety hazards, arranging living spaces to meet patient needs
- Coordinated care with nursing and clinical staff
- Collected vital signs, recording blood pressure, pulse and temperature
- Administered medication on time using schedules and reminders.
Utilization Management LPN
TriWest Healthcare Alliance
04.2017 - 01.2021
- Communicated with Veteran's Administration Providers to obtain clinical information supporting prior authorizations
- Applied medical criteria and clinical judgement to claims to evaluate coverage determinations
- Managed care products and steered members to appropriate providers
- Provided insurance company with detailed clinical information when completing authorization and pre-certification processes.
Retro Review Nurse
Aerotek Recruiting and Staffing
12.2016 - 04.2017
- Contracted with the Veteran's Administration as a Retro Review LPN
- Created specialty consults associated with active retro claims so that consults could be approved
- Collaborated with the Nursing Teams for claims resolution
- Worked with the Veteran population to resolve questions regarding retro claims in order to complete claims processing
- Communicated with VA providers to obtain clinical information supporting prior authorizations.
Care Coordinator LPN
Dependable Staffing
07.2013 - 09.2016
- Educated clients and family members on medical diagnosis and Chronic Disease Self-Management with the goal being to prevent ER visits &/or hospitalizations
- Identified gaps in care and assisted in scheduling Provider appointments to ensure continuity of care between Providers throughout the year
- Assisted in care plan implementations, verification and improvement.
Veteran's Administration LPN
Valor Healthcare/Veteran's Administration
04.2011 - 02.2013
- Worked in a Veteran's Community Based Outpatient Clinic as an LPN
- Managed Veteran Demographic intakes
- Documented vitals, assisted with surgical procedures, Gyn exams and Internal Medicine appointments and administered Vaccinations
- Documented Health Concerns in EMR utilizing CPRS software
- Assessed Veteran's experiencing PTSD issues to facilitate seeing a Provider &/or contacting Emergency Services as needed.
Education
Certification of Completion in Practical Nursing - Nursing -
North Seattle Community College
Seattle, Washington08.1994
Skills
- Utilization Management
- Clinical Review
- Work with Medically Unlikely Edits
- Orthopedics
- Oncology
- Remote Nursing
- Medical Terminology
- Medical Code Application
- Patient Care
Languages
Spanish
Professional Working
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Home Health Aide
Total Care Connections
09.2022 - 03.2023
Home Health Aide
Home Instead Senior Care
09.2021 - 04.2022
Utilization Management LPN
TriWest Healthcare Alliance
04.2017 - 01.2021
Retro Review Nurse
Aerotek Recruiting and Staffing
12.2016 - 04.2017
Care Coordinator LPN
Dependable Staffing
07.2013 - 09.2016
Veteran's Administration LPN
Valor Healthcare/Veteran's Administration
04.2011 - 02.2013
Certification of Completion in Practical Nursing - Nursing -
North Seattle Community College
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