Dedicated LPN specializing in Case Management and Utilization Review, with a comprehensive understanding of patient care and medical procedures. Proven track record of effectively managing diverse patient needs across multiple healthcare settings, consistently ensuring high-quality care and exceptional patient satisfaction. Strong communication and problem-solving skills demonstrated through successful collaboration with multidisciplinary healthcare teams, enhancing overall service delivery and patient outcomes. Committed to continuous improvement in patient care practices while adapting to the evolving healthcare landscape.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Triage LPN
Providence Health Services
11.2019 - Current
Collaborated with interdisciplinary teams to enhance patient outcomes and ensure continuity of care.
Administered medications and treatments according to established protocols and patient care plans.
Assisted with admissions, appointments, transfers, and discharges.
Collaborated with interdisciplinary healthcare teams to ensure continuous quality improvement in patient care delivery.
Documented accurate and complete patient information to address patient problems and expected outcomes.
Educated patients and families on health promotion, disease prevention, and self-care management strategies.
Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
LPN (Licensed Practical Nurse)
DSHS Washington
02.2017 - Current
Administered medication and treatments as prescribed by healthcare providers.
Monitored patient vital signs and reported changes to nursing staff promptly.
Assisted in the development and implementation of individualized care plans.
Educated patients and families on health management and disease prevention strategies.
Collaborated with interdisciplinary teams to enhance patient care quality and safety.
School Nurse
Maxim Health Care, Home Health Care
09.2017 - 10.2019
Administered immunizations and health screenings to students, ensuring compliance with state health regulations.
Developed and implemented individualized health care plans for students with chronic conditions.
Educated students, parents, and staff on health issues, promoting wellness and preventive care practices.
Collaborated with multidisciplinary teams to address student health needs and enhance school safety protocols.
LPN Charge Nurse
Bridgeport Place Assisted Living
09.2015 - 11.2017
Supervised nursing staff to ensure high-quality patient care and compliance with health regulations.
Developed and implemented individualized care plans based on resident assessments and preferences.
Coordinated medication administration and monitored residents for adverse reactions or changes in condition.
Trained and mentored new LPNs, fostering a collaborative team environment focused on patient outcomes.
Collaborated with interdisciplinary teams to optimize resident care through effective communication and problem-solving.
Achieved successful unit leadership by providing quality nursing care to 80 to 100 patients per day in Medicaid-bed unit.
Hematology/Oncology Triage Nurse
North West Medical Specialties
06.2014 - 09.2015
Conducted patient assessments to prioritize care based on clinical needs.
Collaborated with multidisciplinary teams to develop effective treatment plans.
Utilized electronic health record systems to document patient interactions accurately.
Streamlined communication processes between departments to improve patient outcomes.
Evaluated and updated triage guidelines based on emerging best practices and patient feedback.
Utilization Management, Concurrent Review LPN
Sound Path Health Plan
08.2013 - 06.2014
Conducted comprehensive Medicare concurrent reviews to ensure compliance with clinical guidelines.
Collaborated with healthcare teams to optimize patient care plans and treatment protocols via CMS guidelines.
Analyzed patient data for quality assurance, identifying areas for improvement in care delivery.
Mentored junior nurses on best practices in concurrent review processes and documentation standards.
Implemented process enhancements that streamlined review workflows, increasing efficiency across departments.
Evaluated clinical information to support decision-making regarding patient admissions and continued stay criteria.
Facilitated training sessions on regulatory requirements and documentation practices for nursing staff.
Managed complex cases effectively, coordinating with multidisciplinary teams to ensure seamless delivery of care across the continuum.
Streamlined the utilization review process for more efficient case management and improved resource allocation.
Served as a liaison between healthcare providers, insurers, patients, and families to facilitate communication and resolve issues related to care coordination or coverage determinations.
Care Transitions Nurse, First Touch Program Coordinator
Signature Home Health
04.2013 - 08.2013
.
Developed and implemented individualized care plans in collaboration with healthcare providers.
Educated patients and families on health management and disease prevention strategies.
Led nursing staff in best practices for patient safety and infection control measures.
Streamlined patient intake process, improving efficiency of admissions by coordinating with interdisciplinary teams.
Mentored new nurses, fostering skill development and adherence to clinical standards.
Advocated for patient needs during multidisciplinary team meetings to enhance care quality.
Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
Administered medications via oral, IV, and intramuscular injections and monitored responses.
Performed routine wound care and dressing changes on schedule.
Promoted a safe and comfortable healing environment by addressing patient concerns promptly and professionally.
Collaborated with interdisciplinary teams for optimized patient treatment plans and outcomes.
Mentored new nursing staff members, fostering teamwork and improving unit efficiency.
Utilized strong clinical judgment in prioritizing patient needs during high-stress situations, ensuring optimal outcomes.
Concurrent Review Nurse, Nurse Case Manager
Centene Corporation, Coordinated Care Health Plan
05.2012 - 04.2013
Conducted Medicaid concurrent reviews to assess medical necessity and appropriateness of patient care.
Collaborated with healthcare teams to ensure compliance with regulatory standards and policies.
Utilized clinical judgment to evaluate treatment plans and recommend adjustments as needed followed CMS guidlines and recommendations working closely with the Medical Director.
Mentored junior nurses on best practices for concurrent review processes and documentation techniques.
Implemented quality improvement initiatives that enhanced review accuracy and reduced turnaround times.
Analyzed case data to identify trends in patient care outcomes and inform clinical decision-making.
Developed training materials for staff on concurrent review methodologies and criteria application.
Led interdisciplinary meetings to discuss complex cases, fostering collaboration among healthcare providers.
Provided ongoing education to nursing staff regarding best practices in concurrent review processes, enhancing overall team performance.
Developed strong rapport with patients and families by demonstrating empathy, active listening skills, and a genuine commitment to their wellbeing.
Achieved timely authorizations for services by maintaining strong relationships with insurance company representatives and advocating for patients'' needs.
Contributed to the development of evidence-based policies and procedures for the case management department, ensuring alignment with industry best practices and regulatory requirements.
Supported effective care transitions by collaborating with healthcare providers, patients, and families to develop individualized discharge plans.
Enhanced interdisciplinary collaboration by participating in daily rounds, discussing patient cases, and providing clinical input.
Expedited patient throughput within the hospital setting by identifying barriers to timely discharges or transfers and working collaboratively with stakeholders to address them.
Billing Specialist 1 Medicare for Medical and Hosp at Providence Health ServicesBilling Specialist 1 Medicare for Medical and Hosp at Providence Health Services