Kimberly Wuebold
Batavia,OH
Summary
Experienced Registered Nurse with strong clinical background and people skills. Ensure high standards of competent care for wide variety of patients with diverse needs. Responsible, excellent communication skills demonstrated by 25+ years of experience in healthcare. Enthusiastic and dedicated work ethic. Demonstrates medical procedure competency with supportive documentation for charging.
Overview
31
31
years of professional experience
Work History
Virtual Utilization Review Nurse
Ensemble Health Partners
05.2021 - Current
- Reduce healthcare costs through efficient utilization of resources.
- Ensure compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintain professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Evaluate medical guidelines and benefit coverage to determine appropriateness of services.
- Improve patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Fostere a culture of continuous learning by actively participating in departmental meetings, trainings, and continuing education opportunities related to utilization review.
- Reduce unnecessary medical costs, ensuring treatments met established medical guidelines and policies.
Registered Nurse
Mercy Health Partners
08.2001 - 05.2021
- COVID Clinic Coordinator - Staffing for M-F vaccine clinic of 2280 vaccines week, assist patients with scheduling, inventory on vaccination vials with coordination of doses vs. patients. Manages everyday activity of clinic with documentation, vaccine reconstitution, schedule changes, registration. Coordinates with Ohio Department of Health regarding high risk vaccination reaction in community population. Coordinates with large local community businesses in setting up clinics for their employees.
- Clinical Coordinator/Pre-admission testing nurse - Daily calling to patients regarding upcoming procedure and requirements, coordinates COVID testing and pre-op labs if applicable, education regarding procedure and prep. Chart review, physician documentation supporting procedures and charges. Audit physician charting for required documentation for procedures. Communicate with physicians regarding missing documentation. Responsible for nurse direction on procedure charges and appropriate documentation to support such charges. Review charges, update procedures and charges based on documentation, post charges, review revenue and usage reports cross referencing submitted charges. Responsible for preference card building/updating. Compile weekly productivity report. Biweekly payroll time keeping/schedules/vacation approvals. Pre-admission testing nurse/Clinical Coordinator/Interim Supervisor - OpTime training, Eastside group/individual education regarding documentation in pre-op, intra-op, post-op areas. Set up new employee status board, work space, build order sets appropriate for Endoscopy.
- Eastside Endoscopy Educator/Interim Endoscopy Manager Mercy Eastside. - Responsible for hiring, payroll, scheduling, quarterly reviews, education, supply ordering, vendor education. Assess employee competency, developed competency assessment programs, assured completion of competency based paperwork and maintained appropriate records. Planned, implements and evaluates unit-based education based on risk management issues and learning needs assessments. Conducted educational activities annually, and identified staff learning needs related to clinical practice. Established individual education competency charts, quick reference guides for individual procedures/duties. Assisted with EBUS /Navigation program set up Mercy Anderson.
- Endoscopy nurse - Clinical Coordinator, Deep dive charting issues, chart auditing, patient procedure charge review and posting. Staffing schedules/on call, Kronos-payroll. Assist unit manager with various reports. Gastroenterology/Pulmonology. EGD, Colonoscopy, Capsule Endoscopy, EUS upper, Celiac Plexus Block, EUS lower, ERCP, Bronchoscopy, EBUS, ENB, pre-op/post-op patient care, procedural sedation, preparation for biopsy/specimen collection, procedural set-up, physician assist with procedures. Established individual education competency charts, expiration dates for certifications, quick reference guides for individual procedures/duties.
- Specialized Services - IV therapy, transfusions, phlebotomy, chemotherapy, among other medication therapies. Monitor infusion charges, update said charges per revenue and usage guidelines with appropriate diagnosis related to treatment.
- Informatics Committee - Review upcoming changes, changes needing to be addressed, introduce changes to unit.
- 7/1994 - 4/1997. Direct Patient Care Medical/Surgical unit, Telemetry unit, Intensive Care Unit.
- Charge Nurse Telemetry unit 2+ years, nursing/CNA productivity, participated as preceptor.
- Strong leader for nursing personnel assigned to the unit/shift.
MDS Plan Coordinator/Director of Nursing
Sunrise Nursing Home
04.1997 - 08.2001
- Planned and assigned workload nursing staff to direct patient care.
- Educated patients and answered questions about health condition, prognosis and treatment.
- Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
- Audited charts and reviewed clinical documents to verify accuracy.
- Performed federally mandated assessments for case mix scores in compliance with state regulations.
- Monitor patient charts and ensure proper coding, transmit electronically timely, coordinate with team in regards to treatment.
- Coordinate patient/family quarterly meetings.
Registered Nurse
Mercy Hospital Clermont
07.1994 - 04.1997
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
Education
BSN - Nursing
The Christ College of Nursing And Health Sciences
Cincinnati, Ohio2017
Diploma - Registered Nurse
Good Samaritan School of Nursing
Cincinnati, Ohio1994
Skills
- Organized
- Approachable
- People oriented
- Problem solver
- Creative
- Dedicated
- Kronos / Dimension Software
- EPIC support/super user
- EPIC OpTime Credentialed Trainer
- Excel Use
Timeline
Virtual Utilization Review Nurse
Ensemble Health Partners
05.2021 - Current
Registered Nurse
Mercy Health Partners
08.2001 - 05.2021
MDS Plan Coordinator/Director of Nursing
Sunrise Nursing Home
04.1997 - 08.2001
Registered Nurse
Mercy Hospital Clermont
07.1994 - 04.1997
BSN - Nursing
The Christ College of Nursing And Health Sciences
Diploma - Registered Nurse
Good Samaritan School of Nursing
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