Kara Spraggins
Steger,IL
Summary
Dedicated registered nurse with over a decade of experience delivering personalized patient care. Committed to providing top-notch care by educating and counseling patients effectively. Demonstrated leadership in improving patient care and satisfaction levels. Skilled in implementing safety protocols to ensure comprehensive patient care.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Home Health Nurse
Victorious Nursing Agency
08.2022 - Current
- Developed strong rapport with patients and families, fostering trust and open communication during challenging times.
- Educated patients and families on disease management, medication safety, and at-home healthcare strategies to promote selfcare.
- Documented patient vitals, behaviors, and conditions to communicate concerns to supervising nurse.
- Contributed to the overall success of the home health agency by maintaining high levels of patient satisfaction and positive outcomes.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Identified early warning signs of patient deterioration or complications, promptly notifying physicians to adjust treatment plans accordingly.
- Streamlined communication between healthcare providers, patients, and families by acting as a liaison for all parties involved in the care process.
- Provided compassionate care for patients with chronic illnesses, alleviating stress and promoting optimal wellness.
Utilization Review Nurse/Registered Nurse Case Manager
United Health Group
01.2022 - Current
- Ensure quality reviews according to agency standards.
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Mitigated potential legal issues related to improper admission or discharge decisions by consulting with physicians regarding complex cases that required further clarification.
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices in utilization review nursing.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Served as a vital liaison between patients, healthcare providers, and insurance companies, fostering effective communication and coordination among all parties involved in the care process.
- Increased referral rates by providing excellent service and building meaningful relationships with patients and caregivers.
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Applied critical thinking skills during case reviews to identify potential risks or challenges before they escalated into larger issues.
- Discharge Planning and Patient Education
Prior Authorization Nurse
Centene
04.2021 - 01.2022
- Obtain clinical records for clinical review for Behavioral Health.
- Approve initial short term hospital stays.
- Complete concurrent reviews.
- Present and discuss cases regarding DCFS clients while working closely with the medical director.
QI Nurse
Aunt Martha's Healthworks
02.2018 - 04.2021
- Abstract medical records to determine individual needs and develop Health summary in coordination with multidisciplinary healthcare professionals, including physicians, case managers and social workers.
- Establish and refer complex medical patients for nurse referrals following policy and procedures.
- Educated family members and caregivers on patient care instructions.
- Performed audits for medical records and files for increased accuracy.
- Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
Psychiatric Registered Nurse
Silver Oaks Behavioral Hospital
08.2019 - 04.2021
- Administered medication and treatments to patients to observe and record responses.
- Coordinated with medical and paramedical professionals to provide appropriate input and effectively formulate and implement treatment plans for patients.
- Explained useful coping methods to relieve depression and anxiety, including meditation and yoga.
- Performed patient assessments to monitor expected response to medications, altering treatment plans as needed.
- Utilized multi-modal diagnostic tools to diagnose and treat patients with memory difficulties and dementia.
RN
ICC
02.2014 - 02.2018
- Cultivated rapport with patients and caseworkers utilizing effective communication with parents and children of all age groups.
- Analyzed and interpreted patients' histories, symptoms, physical findings and diagnostic information to develop appropriate diagnosis.
- Identified common pediatric and adolescent illnesses to plan and implement interventions and management.
- Helped young patients feel comfortable with procedures and immunizations.
- Devised individualized care plans tailored to each patient''s unique situation, optimizing clinical outcomes.
RN Case Manager
Aunt Martha's
01.2012 - 02.2014
- Consulted with clinicians to devise and manage effective ongoing care plans for at-risk patients.
- Verified legibility of all patient clinical notes and updates prior to review by primary physicians.
- Responded promptly and professionally to patient questions and concerns.
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
Clinic Manager
Aunt Martha's Health And Wellness
04.2010 - 01.2012
- Performed patient assessments and contributed to development of interdisciplinary care plans.
- Oversaw day-to-day business and clinical activities by establishing goals, objectives, standards of performance and policies and procedures when managing annual budget and supervising 10 employees.
- Built relationships with physicians to create steady referral pipeline.
- Recruited, hired and educated staff on state and federal statutes on sleep service and independent diagnostic testing facility (IDTF) guidelines.
Triage Charge Nurse
Aunt Martha's Youth Service Center
12.2008 - 04.2010
- Implemented quality patient care techniques to align with safety, health and organizational regulations.
- Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Counseled patients via telephone according to established guidelines and protocols, advising on provider-established plans of care.
Education
High School Diploma -
Rich Central High School
Olympia Fields, ILLPN - Nursing
South Suburban College
South Holland, IL05-2008
ADN -
South Suburban College
South Holland, IL05-2011
BSN -
Chamberlain College Of Nursing
Addison, IL05-2018
Skills
- Progress Evaluation
- Mental Disability Management
- Therapeutic Care Plans
- Patient Relationships
- Family Education
- Crisis Management
- Medication administration
- Medication and IV administration
- Patient care
- Disease management expertise
- Utilization review
- Documentation and reporting
- InterQual criteria
- Case management
- Discharge Planning
- Patient Education
- Telephonic Nursing
- HIPAA compliance
- Care plan adherence
- Regulatory compliance
Certification
- Licensed Real Estate Agent
- CPR Certification
Timeline
Home Health Nurse
Victorious Nursing Agency
08.2022 - Current
Utilization Review Nurse/Registered Nurse Case Manager
United Health Group
01.2022 - Current
Prior Authorization Nurse
Centene
04.2021 - 01.2022
Psychiatric Registered Nurse
Silver Oaks Behavioral Hospital
08.2019 - 04.2021
QI Nurse
Aunt Martha's Healthworks
02.2018 - 04.2021
RN
ICC
02.2014 - 02.2018
RN Case Manager
Aunt Martha's
01.2012 - 02.2014
Clinic Manager
Aunt Martha's Health And Wellness
04.2010 - 01.2012
Triage Charge Nurse
Aunt Martha's Youth Service Center
12.2008 - 04.2010
High School Diploma -
Rich Central High School
LPN - Nursing
South Suburban College
ADN -
South Suburban College
BSN -
Chamberlain College Of Nursing
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