Laura Johnson
Farmington,NM
Summary
A healthcare professional with extensive experience at San Juan Regional, excelling in patient assessment and clinical documentation. Proven ability to enhance care coordination through interdisciplinary collaboration and effective utilization review. Recognized for advocating for patient needs and optimizing treatment plans, ensuring high-quality outcomes in complex medical environments.
Overview
38
38
years of professional experience
Work History
Behavioral Health Utilization Review Nurse
San Juan Regional Medical Center - Farmington, NM
Farmington, NM
01.2014 - Current
- Contact insurance carriers to obtain authorizations for services delivered to patients.
- Collaborate with case managers to facilitate timely discharge planning and transition of care.
- Interpret and evaluate diagnostic tests to identify and assess patient's condition.
- Utilize evidence-based guidelines to support utilization review decisions and recommendations.
- Participate in team meetings to discuss cases involving complex conditions or difficult authorization decisions.
- Participate in daily team meetings to discuss patient care issues and utilization review findings.
- Assess patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
- Assess patient medical records to determine the appropriateness of requested services and procedures.
- Advocated for patient needs with treatment team and implement treatment plans.
- Perform pre-certification, concurrent, and retrospective reviews of inpatient services.
- Monitor patient admissions and discharges to optimize care coordination and resource utilization.
- Provide feedback to healthcare providers on clinical documentation improvement to support utilization review.
- Document all utilization review activities, findings, and decisions in patient records and databases.
- Facilitate communication between payers, providers and patients concerning authorization issues or concerns.
- Monitor pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
- Provide education to providers regarding utilization management processes and protocols.
- Manage appeals for denied services and provide additional information to support medical necessity.
Admissions Coordinator
San Juan Regional Medical Center - Farmington, NM
Farmington, NM
01.2014 - Current
- Review the clinical assessment, and ensure the patient meets the admission criteria.
- Review with the psychiatrist all clinical information pertinent to the admission of the patient.
- Coordinate patient admission to the behavioral health unit with staff.
- The ability to find appropriate placement for prospective patients.
RN Floor Nurse
San Juan Regional Medical Center - Farmington, NM
Farmington, NM
01.1988 - Current
- Advocate for patient needs with treatment team and implemente treatment plans.
- Participate in treatment team meetings to individualize, create, implement, evaluate and discuss patient care plans.
- Interpret and evaluate diagnostic tests to identify and assess patient's condition.
- Observe strict safety measures, including checking medication dosages before administration to patients.
- Record patient condition, vital signs, recovery progress and medication side effects.
- Document patient progress notes accurately and efficiently in the electronic medical record system.
- Evaluate effectiveness of interventions through ongoing assessment of patient responses.
- Assess patient conditions, monitor behaviors and update physicians with observations and concerns.
- Maintain thorough, accurate and confidential documentation in electronic medical records.
- Utilize critical thinking skills to assess clinical situations quickly and accurately.
- Administered medications and treatments, monitoring patients for reactions and side effects.
Education
Bachelor of Science - Nursing
University of New Mexico
Albuquerque, NM12-1999
Associate of Science - Nursing
San Juan College
Farmington, NM05-1989
Skills
- Patient assessment
- Clinical documentation
- Utilization review
- Interdisciplinary collaboration
- Care coordination
References
References available upon request.
Timeline
Behavioral Health Utilization Review Nurse
San Juan Regional Medical Center - Farmington, NM
01.2014 - Current
Admissions Coordinator
San Juan Regional Medical Center - Farmington, NM
01.2014 - Current
RN Floor Nurse
San Juan Regional Medical Center - Farmington, NM
01.1988 - Current
Bachelor of Science - Nursing
University of New Mexico
Associate of Science - Nursing
San Juan College