Kimberly Braxton
Summary
Reliable individual bringing multiple years of experience in healthcare environments. Maintains positive relationships with case managers and providers. Remains polished and calm under extreme stress.
Overview
13
13
years of professional experience
Work History
Utilization Review Manager
Florida Blue - Blue Cross Blue Shield Of Florida
12.2018 - Current
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Supervised and maintained all utilization review documentation through JIVA.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Established team priorities, maintained schedules and monitored performance.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
Nurse Case Manager
Humana Behavioral Health
07.2016 - 12.2018
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Developed and modified patient care plans and assisted interdisciplinary team in identifying client needs and goals to determine priorities of care.
- Educated patients and caregivers on healthcare protocols and processes.
- Analyzed patient responses to medications, therapies and variances in plans of care.
Registered Nurse, Medical-Surgical Unit
Orange Park Medical Center
04.2014 - 07.2016
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
Program Director
Florida Career College
09.2010 - 04.2014
- Supervised program staff, managing and evaluating performance provide high-quality services to program participants.
- Provided ongoing direction and leadership for program operations.
- Developed and implemented program goals and objectives, establishing specific and measurable outcomes aligned with organization's overall mission.
- Scheduled and supervised staff meetings to discuss new ideas and update participants on program details and milestones.
- Monitored program performance to identify areas for improvement.
- Coordinated budgeting, scheduling and resource allocation to facilitate smooth flow of operations.
Education
Master of Science - Psychiatric Mental Health Nurse Practitioner
Walden University
Minneapolis, MN08.2025
Bachelor of Science - Nursing
Kaplan University
Davenport, IA05.2016
Associate of Science - Nursing
Kaplan College - Columbus
Columbus, OH03.2014
Master of Science - Education
Keiser University
Fort Lauderdale, FL03.2011
Bachelor of Science - Health Administration
Keiser University
Fort Lauderdale, FL05.2009
Skills
- Patient Care Plans
- Patient Admission
- Emotional Support
- Treatment Options
- Utilization Management
Timeline
Utilization Review Manager
Florida Blue - Blue Cross Blue Shield Of Florida
12.2018 - Current
Nurse Case Manager
Humana Behavioral Health
07.2016 - 12.2018
Registered Nurse, Medical-Surgical Unit
Orange Park Medical Center
04.2014 - 07.2016
Program Director
Florida Career College
09.2010 - 04.2014
Master of Science - Psychiatric Mental Health Nurse Practitioner
Walden University
Bachelor of Science - Nursing
Kaplan University
Associate of Science - Nursing
Kaplan College - Columbus
Master of Science - Education
Keiser University
Bachelor of Science - Health Administration
Keiser University
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