Summary
Overview
Work History
Education
Skills
Timeline
Generic

LaKeisha Brown

Round Rock,TX

Summary

Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, case management, utilization review and guidelines writing.

Overview

26
26
years of professional experience

Work History

Utilization Review Nurse

BC Forward Staffing
12.2024 - Current
  • Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Performed prior authorization review of services requiring notification.

Quality Improvement Specialist

Health Services Advisory Group
05.2023 - 10.2024
  • Analyze patient Covid-19 data related to clinical care and outcomes, to evaluate performance, reveal trends, identify opportunities, and leverage health information
    technology to improve patient engagement and outcomes
  • Coordinate quality assurance and improvement activities through a collaborative approach with long-term care facilities enrolled in a QII
  • Utilize the results of audit/quality improvement and/or research activities to help facilities improve patient care

Senior Nurse Analyst

HealthHelp, LLC
01.2022 - 06.2024
  • Research clinical topics using an evidence-based approach
  • Correlate clinical research to create or update clinical guidelines
  • Maintain clinical guidelines research and development database for the radiation therapy program
  • Monthly review of guideline suggestions from clinical and physician reviewers regarding indications/criteria and updates

Telephonic Case Manager /Utilization Review Nurse

Conduent, LLC
08.2018 - 08.2021
  • Maintained accurate documentation of all case management activities, ensuring compliance with regulatory guidelines and company policies
  • Identified potential barriers to treatment adherence and devised strategies to overcome them, ultimately enhancing patient wellbeing
  • Reviewed complex worker's compensation medical treatment requests to ensure accordance with evidence-based medical treatment guidelines
  • Performed quality assurance of file reviews submitted by physician reviewers

Registered Nurse Field Case Manager

Genex
06.2016 - 01.2018
  • Evaluated patient progress regularly, adjusting care plans as needed to optimize results
  • Developed strong working relationships with community resources and organizations to support patients' needs more effectively
  • Enhanced patient outcomes by developing and implementing individualized care plans for each case
  • Served as a liaison between patients, insurance carriers, and medical professionals to manage complex cases effectively

Registered Nurse

Various Employers
02.1999 - 04.2016
  • Worked as a Registered Nurse in a variety of clinical settings which included: ICU, PACU, psychiatric, pediatric, medical/surgical, cardiopulmonary, clinical education and long-term administration

Education

Bachelor of Science - Nursing

Hampton University
Hampton, VA
12.1998

Skills

  • Documentation And Reporting
  • Utilization review
  • Records analysis
  • Clinical assessment
  • Interpersonal and written communication
  • Prior Authorization
  • Medicare knowledge

Timeline

Utilization Review Nurse

BC Forward Staffing
12.2024 - Current

Quality Improvement Specialist

Health Services Advisory Group
05.2023 - 10.2024

Senior Nurse Analyst

HealthHelp, LLC
01.2022 - 06.2024

Telephonic Case Manager /Utilization Review Nurse

Conduent, LLC
08.2018 - 08.2021

Registered Nurse Field Case Manager

Genex
06.2016 - 01.2018

Registered Nurse

Various Employers
02.1999 - 04.2016

Bachelor of Science - Nursing

Hampton University

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