Latoya Hemphill
Greenville,MS
Summary
Experienced Licensed Practical Nurse with 7 1/2 years of diverse clinical experience in long-term care, pediatrics, and medical-surgical settings. Strong nursing skills and a proven track record of delivering exceptional care and performing assigned duties effectively. Currently serving as a Provider Engagement Administrator with comprehensive knowledge of insurance-related matters, including claims, credentialing, prior authorizations, and various processes. Expertise in quality aspects such as HEDIS and medical record retrievals. Collaborative approach to engaging providers and fostering positive relationships to achieve high-quality member outcomes. Authorized to work in the US for any employer.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Provider Quality Liaison/Provider Engagement Administrator
Centene
Greenville, MS
04.2022 - Current
- Serve as primary contact for providers and act a liaison between the providers and the health plan
- Triages provider issues as needed for resolution to internal partners
- Investigate, resolve, and communicate provider claim issues and changes
- Initiate data entry of provider-related demographic information changes
- Educate providers regarding policies and procedures related to referrals and claims submission, website usage, EDI solicitation and related topics
- Perform provider orientations and ongoing provider education, including writing and updating orientation materials
- Manages network performance for assigned territory through a consultative/account management approach
- Evaluated provider performance and develops strategic plan to improve performance
- Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc
- Completes special projects as assigned.
LPN (Licensed Practical Nurse)
Favorite Healthcare Staffing
Belleville, IL
01.2021 - 02.2022
- Triaged patients
- Obtained and documented patient information
- Administered COVID-19 vaccines to a variety of residents of all ages (12-older) of the city along with surrounding areas
- Monitored patients for possible adverse reactions during given waiting period.
LPN (Licensed Practical Nurse)
Cleveland Nursing & Rehabilitation
Cleveland, MS
08.2020 - 01.2021
- Triaged patients which included monitoring the respiration, blood pressure, temperature, oxygen levels and heart rates
- Inserted catheters, administered injections and medications as ordered by the medical director
- Performed wound care under the scope and guidelines as mandated
- Utilized nursing knowledge and skills in the safe implementation of basic preventative therapeutic and rehabilitative nursing care of assigned patient/family as evidenced by documentation and observation of positive patient care outcomes
- Performed delegated independent nursing functions using established procedures, policies, guidelines and standards as observed by the registered nurse
- Administered medication accurately, observing patient response, as evidenced by documentation in the medical record and lack of negative outcomes
- Maintain and coordinate communication among patient/significant other, staff and physician as evidenced within medical record, client and health care team feedback
- Developed care plans for patients and implemented the clinical plan of care to impact quality outcomes.
LPN (Licensed Practical Nurse)
Angel Staffing
Cleveland, TX
11.2020 - 12.2020
- Triaged patients which included monitoring the respiration, blood pressure, temperature, oxygen levels and heart rates
- Inserted catheters, administered injections and medications as ordered by the medical director
- Performed wound care under the scope and guidelines as mandated
- Utilized nursing knowledge and skills in the safe implementation of basic preventative therapeutic and rehabilitative nursing care of assigned patient/family as evidenced by documentation and observation of positive patient care outcomes
- Performed delegated independent nursing functions using established procedures, policies, guidelines and standards as observed by the registered nurse
- Administered medication accurately, observing patient response, as evidenced by documentation in the medical record and lack of negative outcomes
- Maintain and coordinate communication among patient/significant other, staff and physician as evidenced within medical record, client and health care team feedback
- Developed care plans for patients and implemented the clinical plan of care to impact quality outcomes.
LPN
Arbor Walk Healthcare Center
Greenville, MS
09.2016 - 08.2020
- Triaged patients which included monitoring the respiration, blood pressure, temperature, oxygen levels and heart rates
- Inserted catheters, administered injections and medications as ordered by the medical director
- Performed wound care under the scope and guidelines as mandated
- Utilized nursing knowledge and skills in the safe implementation of basic preventative therapeutic and rehabilitative nursing care of assigned patient/family as evidenced by documentation and observation of positive patient care outcomes
- Performed delegated independent nursing functions using established procedures, policies, guidelines and standards as observed by the registered nurse
- Administered medication accurately, observing patient response, as evidenced by documentation in the medical record and lack of negative outcomes
- Maintain and coordinate communication among patient/significant other, staff and physician as evidenced within medical record, client and health care team feedback
- Developed care plans for patients and implemented the clinical plan of care to impact quality outcomes.
LPN (Licensed Practical Nurse)
Broadway Manor
Greenville, MS
09.2019 - 12.2019
- Triaged patients which included monitoring the respiration, blood pressure, temperature, oxygen levels and heart rates
- Inserted catheters, administered injections and medications as ordered by the medical director
- Performed wound care under the scope and guidelines as mandated
- Utilized nursing knowledge and skills in the safe implementation of basic preventative therapeutic and rehabilitative nursing care of assigned patient/family as evidenced by documentation and observation of positive patient care outcomes
- Performed delegated independent nursing functions using established procedures, policies, guidelines and standards as observed by the registered nurse
- Administered medication accurately, observing patient response, as evidenced by documentation in the medical record and lack of negative outcomes
- Maintain and coordinate communication among patient/significant other, staff and physician as evidenced within medical record, client and health care team feedback
- Developed care plans for patients and implemented the clinical plan of care to impact quality outcomes.
Cashier/Customer Service
Walmart
Greenville, MS
01.2013 - 09.2016
- Scanned goods and ensured prices were accurate
- Collected payments and issued receipts, refunds, change, or tickets
- Redeemed stamps and coupons
- Greeted customers
- Maintained clean and tidy checkout areas
- Tracked transactions and reported discrepancies
- Bagged, boxed, or gift-wrapped packages
- Handled merchandise returns and exchanges
- Resolve customer complaints.
Education
Associate in Art -
Mississippi Delta Community College
Moorhead, MS07.2016
Skills
- Medication Administration
- Nursing
- Tube Feeding
- Experience Administering Injections
- Transcription
- Triage
- Laboratory Experience
- Vital Signs
- Hospice Care
- Home Care
- Medical Office Experience
- Critical Care Experience
- Supervising Experience
- Patient Care
- Caregiving
- Data entry
- Customer service
- Outbound sales
- Call center
- EMR systems
- Vital signs
- Medical terminology
- Documentation review
- Typing
- Epic
Certification
- Licensed Practical Nurse, EXP:12/01/25, MS
Timeline
Provider Quality Liaison/Provider Engagement Administrator
Centene
04.2022 - Current
LPN (Licensed Practical Nurse)
Favorite Healthcare Staffing
01.2021 - 02.2022
LPN (Licensed Practical Nurse)
Angel Staffing
11.2020 - 12.2020
LPN (Licensed Practical Nurse)
Cleveland Nursing & Rehabilitation
08.2020 - 01.2021
LPN (Licensed Practical Nurse)
Broadway Manor
09.2019 - 12.2019
LPN
Arbor Walk Healthcare Center
09.2016 - 08.2020
Cashier/Customer Service
Walmart
01.2013 - 09.2016
Associate in Art -
Mississippi Delta Community College