Lanelle Britton
Palm Harbor,Fl
Summary
Accomplished Team Lead Pre-cert Nurse at First Stop Health, adept in coaching and HIPAA compliance, significantly enhanced team productivity and patient satisfaction. Leveraged critical thinking and performance improvement skills to streamline processes, ensuring high-quality care and efficient patient database maintenance. Demonstrated exceptional leadership and organizational abilities, fostering a positive and collaborative work environment.
Overview
32
32
years of professional experience
Work History
Team Lead Precert Nurse
First Stop Health
01.2024 - Current
- Medical Necessity review of inpatient & outpatient services using approved clinical criteria guidelines.
- Communicates with Medical Director when there is a threat to patient safety.
- Advocates on behalf of the member to secure access to quality, cost-effective care & attainment of treatment goals.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Engages Medical director for consultations when appropriate.
- Managed schedules, accepted time off requests and found coverage for short shifts.
- Worked with team to identify areas of improvement and devised solutions based on findings.
- Directed and supervised team of five engaged in processing authorizations in a timely manner.
Team Lead Precert Nurse
Sentry Health
07.2021 - 12.2023
- Reduced patient wait times for approval by diligently reviewing medical records and obtaining necessary documentation.
- Mentored new hires within the department, sharing best practices for navigating complex insurance requirements and fostering a supportive team environment.
- Improved team productivity with regular training sessions on new software programs and tools utilized in the precertification process.
- Ensured smooth communication between healthcare providers, patients, and insurance companies, resulting in timely approvals and positive experiences.
- Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
- Maintained strict adherence to HIPAA regulations by safeguarding confidential patient information during all aspects of the precertification process.
- Facilitated successful appeals for denied services by providing detailed documentation supporting medical necessity as required by insurers.
- Boosted efficiency within the team by regularly updating coworkers on changes in insurance policies or procedural requirements affecting precertification.
- Directed and supervised team of 5 engaged in authorization approvals in a timely manner.
Advocacy/Precertification RN
Delphi MAP Health
01.2012 - 07.2021
- Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
- Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
- Streamlined documentation processes to ensure accurate record-keeping and compliance with regulatory standards.
- Championed quality improvement initiatives within the unit by identifying areas for improvement and implementing evidence-based strategies.
- Evaluated patient histories, complaints, and current symptoms.
Registered Nurse, PACU
Bayfront Ambulatory Surgery Center
05.1995 - 11.2011
- Provided timely interventions to address airway management complications such as respiratory depression or obstruction in post-operative patients.
- Reduced complications by promptly identifying and addressing post-operative issues in PACU patients.
- Enhanced patient recovery by providing comprehensive post-anesthesia care and monitoring vital signs.
- Decreased medication errors by meticulously administering medications following proper protocols and verifying dosages.
- Provided individualized care and dedicated oversight to 2 patients on average in post-operative recovery room.
Staff Registered Nurse, PACU
Bayfront Medical Center
02.1992 - 05.1995
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Implemented appropriate interventions based on assessment findings which resulted in improved symptoms management.
- Facilitated smooth transitions of care for patients by effectively communicating with other healthcare providers.
Education
Associate of Science - Nursing Practice
Santa Fe College
Gainesville, FL05.1992
Skills
- Coaching and Mentoring
- Performance monitoring
- Performance Improvement
- Schedule Management
- Complex Problem-Solving
- Documentation And Reporting
- Patient Database Maintenance
- Patient Health Information Access
- Critical Thinking
- HIPAA Compliance
- Organization and Time Management
Timeline
Team Lead Precert Nurse
First Stop Health
01.2024 - Current
Team Lead Precert Nurse
Sentry Health
07.2021 - 12.2023
Advocacy/Precertification RN
Delphi MAP Health
01.2012 - 07.2021
Registered Nurse, PACU
Bayfront Ambulatory Surgery Center
05.1995 - 11.2011
Staff Registered Nurse, PACU
Bayfront Medical Center
02.1992 - 05.1995
Associate of Science - Nursing Practice
Santa Fe College
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