LaTunya Ohimai
1447 Stone Road L94,FL
Summary
To obtain a position as a Registered Nurse with your company that will allow me to apply the skills and abilities I have acquired as an opportunity for grow and advancement.
Overview
6
6
years of professional experience
Work History
Care Coordinator/Utilization Manager
Signature Healthcare
11.2023 - Current
- Determining whether requested services are medically necessary based on established criteria and guidelines.
- Communicating with insurance companies to obtain pre-authorizations, ensure coverage, and manage claims.
- Ensuring all interventions and authorizations are accurately documented in the appropriate system.
- Participating in the implementation and modification of UR processes and policies.
- Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
- Conducted regular evaluations of care plan effectiveness, making necessary adjustments based on feedback from patients and providers.
- Advocated for patients during care team discussions, ensuring their preferences and needs were prioritized.
Case Manager Coordinator
Georgia Regional Hospital
05.2022 - 11.2023
- Conducted thorough assessments of client needs, strengths, and risks to inform appropriate interventions and support services.
- Managed high caseloads effectively while maintaining close attention to detail and accuracy in documentation.
- Assisted clients in crisis situations by providing immediate intervention and connecting them with relevant resources.
- Improved client outcomes by developing and implementing individualized case management plans.
- Reviewed caseworkers' client cases and made recommendations for additional actions and improvements.
Utilization Manager
Aspire health partners
11.2021 - 06.2022
- Assessing clients' needs and developing individualized treatment plans
- Ensuring accurate documentation and billing.
- Documenting client treatment details in the Electronic Health Record.
- Served as a liaison between clinical staff, administrative personnel, and external stakeholders for all matters related to utilization management, facilitating clear communication across all parties involved.
- Enhanced patient care by conducting thorough utilization reviews and coordinating with healthcare providers.
- Identified gaps in service delivery and recommended improvements to optimize resource utilization and quality of care.
RN Supervisor/Case Manager
Centurion Health Wakulla
02.2019 - 10.2021
- Connecting individuals with appropriate clinical services, placements, and community resources.
- Partnering with correctional facility staff, community providers, and other stakeholders to ensure a smooth and successful transition.
- Championing the rights and needs of clients within the system and advocating for their well-being.
- Maintaining accurate records of services provided and progress made.
- Served as an approachable leader who consistently addressed concerns raised by both nursing staff and families regarding patient care issues or operational challenges within the unit effectively resolving them promptly whenever possible.
- Successfully managed resources within budget constraints while maintaining high-quality care standards for all patients served in the unit.
Education
Master of Science - Nursing
Chamberlain University
08-2026
No Degree - Practical Nursing
Lively Technical College
12-2008
Associate of Science - Nursing
ITT Technical College
09-2016
Skills
- Discharge Planning
- Prior Authorization
- Cerner EMR
- Epic EMR
- Meditech EMR
- InterQual
- Syntranet
- Correctek EMR
- Travel Nurse
Timeline
Care Coordinator/Utilization Manager
Signature Healthcare
11.2023 - Current
Case Manager Coordinator
Georgia Regional Hospital
05.2022 - 11.2023
Utilization Manager
Aspire health partners
11.2021 - 06.2022
RN Supervisor/Case Manager
Centurion Health Wakulla
02.2019 - 10.2021
Master of Science - Nursing
Chamberlain University
No Degree - Practical Nursing
Lively Technical College
Associate of Science - Nursing
ITT Technical College
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