Laura Pryor
Arcadia
Summary
Dynamic Clinical Care Manager at Aetna with expertise in claims monitoring and workflow documentation. Proven track record as a liaison in quality improvement and communication, enhancing patient care protocols. Adept at critical thinking and problem-solving, I consistently optimize program performance and ensure compliance with regulations, driving significant improvements in clinical outcomes.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Clinical Care Manager
Aetna
05.2024 - Current
- Monitored claims, appeals, denials, and clinical documentation of members consistently.
- Documented workflows accurately while reviewing transcribed documentation daily.
- Utilized Workflows, Quickbase, Case Prep Tool, and HOME Tool for effective documentation.
- Accurately document per workflows, and review and evaluate the accuracy of documentation transcribed by Nabla daily.
- Consistently document using Workflows, Quickbase, Case Prep Tool, and HOME Tool.
- Participated in the development of the Nabla template for DNSP CM.
- Provide feedback and recommendations on quality improvement for the Nabla AI program and systems used.
- Advised on policy and program development, and assisted in community program implementation.
- Introduced new departmental policies and oriented staff to facilitate adoption of changes.
- Improve policies and procedures through development, implementation, revision and evaluation of new protocols.
- Managed patient caseloads according to established guidelines while ensuring timely completion of paperwork.
- Participated in performance improvement activities within the department by providing feedback on processes and procedures.
- Acted as a liaison between various departments within the organization when resolving issues related to patient care.
- Assisted with developing innovative strategies for improving overall quality of care across all departments.
- Ensured compliance with applicable laws, regulations, accreditation standards, policies and procedures related to clinical care management activities.
- Performed chart audits on a periodic basis in order to evaluate accuracy of documentation completed by clinicians.
- Conducted regular meetings with multidisciplinary teams to ensure quality of patient care.
Restaurant Owner
Matt & Laura’s Treats and Eats, LLC
Arma
06.2022 - Current
- Regularly complete audits, performance reviews, and feedback on workflow.
- Developed and implemented operational procedures.
- Analyzed reports to identify areas for improvement.
- Complete audits to ensure compliance with regulations and policies.
- Negotiated contracts with vendors for food, equipment, and supplies.
- Updated website content regularly to promote upcoming events and specials being offered at the restaurant.
- Developed and implemented effective marketing strategies to increase restaurant sales.
- Established standards for quality control, customer service, health and safety regulations.
Hemodialysis Registered Nurse
Fresenius Medical Care
01.2023 - 05.2024
- Function efficiently and effectively in a fast-paced environment.
- Manage and adjust the patient treatment schedule.
- Liaison for communication between family members regarding their loved one's condition.
- Conducted weekly quality assurance audits of all dialysis machines used at the facility.
- Developed a comprehensive understanding of applicable legal regulations.
- Participated in interdisciplinary team meetings to discuss patient care plans.
- Maintained accurate records of all patient activities, treatments, and progress notes according to workflow.
- Mentor individuals, sharing positive life experiences to encourage improved self-esteem.
Registered Nurse, Float Pool
Travel Contracts
12.2021 - 06.2022
- Executed travel contracts as a registered nurse across Med Surg, ICU, Neuro ICU, MICU, SICU, and Float Pool units.
- Completed contracts for HCA hospitals and Research Medical Center.
- Contributed to unit-based quality improvement initiatives focused on safety and patient outcomes.
- Instituted new processes and standards that achieved departmental goals for inpatient care.
Case Manager/Hemodialysis Nurse/ Registered Respiratory Therapist Manager/Registered Nurse/Vascular Access Nurse
Landmark Hospitals Joplin
11.2020 - 11.2021
- Submit paperwork for insurance recertification for continuation if stay.
- Evaluate Medicare criteria for admission and continuation of need to be hospitalized.
- Working Respiratory Therapy Manager - Intubate, Extubate, Run codes, Trach changes, Bronchoscopy.
- Clinical Liaison - Facilitate and follow through pt admissions.
- Hemodialysis Registered Nurse - Learned HD/Tablo to run Dialysis treatments.
- Vascular Access Nurse - Insert and manage PICC and Midlines.
Registered Nurse ICU/ Vascular Access
Freeman Health System
12.2017 - 05.2020
- Assist with pt assignments for the shift.
- Manage Balloon Pumps, Impella devices, CRRT.
- Assist with bedside procedures, including Intubations/Extubations, Line Placement, Bedside Peg placement, Bronchoscopy.
- Place Ultrasound IV’s, Monitor hemodynamic stability and maintain/remove, A-lines, Central Lines, Chest tubes, Foley catheters, Rectal Tubes.
- Place NG/OG tubes.
- Manage Trauma patients.
- Manage Organ donor patients.
- Manage patients on multiple drips.
- Insert and manage PICC lines, Midlines, Ultrasound guided IV’s and assist with Difficult lab draws.
Registered Nurse ICU - Temporary
Nevada Regional Medical Center
04.2017 - 05.2018
- Hired as internal temporary staff d/t my variety of knowledge and experience rather than the hospital hiring agency.
Registered Nurse ICU/Float Pool
Ascension Via Christi Pittsburg
02.2016 - 01.2017
- Float pool from Feb 2016 to June 2016 then Full time ICU days.
Registered Respiratory Therapist
Ascension Via Christi Pittsburg
05.2008 - 02.2016
- Started as a student RT in May 2008, Graduate RT May 2009, Licensed RT June 2009.
Education
AAS - Registered Nurse
Fort Scott Community College
Ft Scott, Kansas12.2015
AAS - Respiratory Therapy
Labette Community College
Parsons, Kansas05.2009
Skills
- Claims monitoring and review
- Workflow documentation
- Documentation accuracy evaluation
- Quality improvement feedback
- System performance analysis
- Case management
- Critical thinking
- Problem solving
- Time management
- Communication skills
- Team collaboration
- Dependability
- Vital signs monitoring
- Patient education
- Patient safety practices
- Medical device management
- Bedside procedure assistance
- Medical tube placement
- Trauma patient management
- Data analytics expertise
- Workflow design strategies
- Program performance optimization
- Stakeholder communication skills
- Data integrity maintenance
- Educational workflow streamlining
- Critical patient care management
- Educational program development strategies
- Preceptorship experience
Certification
- KS RT, 16-03802, 03/31/26
- MO RT, 2010005160, 07/31/26
- KS RN NLC, 09/30/25
Affiliations
- Bookkeeping
- payroll
- Menu management - microsoft 365
Timeline
Clinical Care Manager
Aetna
05.2024 - Current
Hemodialysis Registered Nurse
Fresenius Medical Care
01.2023 - 05.2024
Restaurant Owner
Matt & Laura’s Treats and Eats, LLC
06.2022 - Current
Registered Nurse, Float Pool
Travel Contracts
12.2021 - 06.2022
Case Manager/Hemodialysis Nurse/ Registered Respiratory Therapist Manager/Registered Nurse/Vascular Access Nurse
Landmark Hospitals Joplin
11.2020 - 11.2021
Registered Nurse ICU/ Vascular Access
Freeman Health System
12.2017 - 05.2020
Registered Nurse ICU - Temporary
Nevada Regional Medical Center
04.2017 - 05.2018
Registered Nurse ICU/Float Pool
Ascension Via Christi Pittsburg
02.2016 - 01.2017
Registered Respiratory Therapist
Ascension Via Christi Pittsburg
05.2008 - 02.2016
AAS - Registered Nurse
Fort Scott Community College
AAS - Respiratory Therapy
Labette Community College
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