Kimberly Taylor
Oxford,OH
Summary
Professional nurse with experience in utilization review. Strong focus on team collaboration and achieving results. Reliable and adaptable to changing needs. Skilled in medical record analysis, patient care evaluation, and compliance with healthcare regulations. Known for critical thinking, communication, and problem-solving abilities.
Overview
43
43
years of professional experience
Work History
Utilization Review Registered Nurse
UCHealth West Chester Hospital
11.2011 - 10.2023
- Assisted in maintaining regulatory compliance by staying up-to-date on Medicare, Medicaid, and commercial insurance requirements for utilization review activities.
- Provided ongoing education to nursing staff regarding best practices in utilization review and case management strategies.
- Optimized resource allocation within the healthcare facility by accurately reviewing cases for level-of-care determinations according to established criteria sets.
- Strengthened quality improvement initiatives through regular audits of utilization review processes, identifying areas for improvement, and implementing corrective actions.
- Served as a liaison between healthcare providers, insurance companies, and patients for efficient resolution of coverage issues or denials following a utilization review assessment.
Registered Nurse, Medical-Surgical Unit
UCHealth West Chester Hospital
11.2010 - 11.2011
- Collaborated with interdisciplinary teams for optimal patient care, ensuring seamless communication between healthcare providers.
- Consistently maintained accurate documentation of patient assessments, interventions, and outcomes in accordance with regulatory requirements.
- Skillfully performed venipuncture, IV insertion, and catheterizations, ensuring proper technique and adherence to infection control standards.
- Provided health education to patients and families regarding discharge instructions and plans of care.
- Advocated for and strived to protect health, safety, and rights of patient.
- Administered medications and treatment to patients and monitored responses.
- Developed strong rapport with patients and families through active listening, empathy, and clear communication during challenging situations.
- Enhanced patient satisfaction with compassionate, personalized nursing care tailored to each individual''s needs.
- Demonstrated flexibility in managing multiple priorities concurrently during high-stress periods while maintaining a calm demeanor.
Registered Nurse, Medical Surgical Oncology
Middletown Hospital/Atrium Medical Center
05.2003 - 11.2010
- Delivered patient care to improve health and recovery outcomes.
- Coordinated with healthcare teams for seamless patient transitions.
- Enhanced patient safety by adhering to clinical protocols.
- Administered medications and treatments to support patient recovery.
- Collaborated with doctors and staff for comprehensive care delivery.
- Evaluated patient needs to personalize care plans effectively.
- Assisted in emergency situations, ensuring prompt response and care.
- Documented patient information to maintain accurate medical records.
- Reduced patient anxiety by fostering a supportive environment.
Registered Nurse Supervisor/Director of Nursing Services
Hawthorn Glen Nursing Center
05.1993 - 05.2003
- Developed strong rapport with patients and families, providing emotional support during challenging situations.
- Addressed patient concerns promptly by investigating issues thoroughly and collaborating with appropriate personnel to resolve problems efficiently.
- Served as a liaison between administration, medical staff, and nursing team for seamless communication and coordination of care efforts.
- Managed staffing schedules, ensuring adequate coverage for all shifts while minimizing overtime costs.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Mentored junior nurses in clinical decision-making skills, fostering their professional growth and development.
- Led successful team comprised of RNs, LPNs, and ancillary staff.
Senior Administrative Secretary
Miami University Office of Student Housing
06.1980 - 05.1993
- Prepared flawless emails and technical memorandums upon direction of immediate supervisor.
- Acted as backup for other administrative assistants by providing task support and adapting to individual needs.
- Categorized and securely processed sensitive documents with information of deeply personal nature or corporate sensitivity.
- Acquired proper equipment, refreshments and supplies for meetings and supported needs of attendees.
- Drafted documents in company-directed formats and fonts, maintaining exceptional style consistency.
- Wrote and prepared deliberate yet flexible agendas for company meetings.
Education
Associate of Applied Science - Nursing
Miami University School of Applied Science
Oxford, OH05-1993
Skills
- Patient confidentiality
- Medical documentation
- Clinical assessment
- Ethical practice
- HIPAA compliance
- Inpatient care
- Utilization review
- Electronic health records
Timeline
Utilization Review Registered Nurse
UCHealth West Chester Hospital
11.2011 - 10.2023
Registered Nurse, Medical-Surgical Unit
UCHealth West Chester Hospital
11.2010 - 11.2011
Registered Nurse, Medical Surgical Oncology
Middletown Hospital/Atrium Medical Center
05.2003 - 11.2010
Registered Nurse Supervisor/Director of Nursing Services
Hawthorn Glen Nursing Center
05.1993 - 05.2003
Senior Administrative Secretary
Miami University Office of Student Housing
06.1980 - 05.1993
Associate of Applied Science - Nursing
Miami University School of Applied Science
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