Professional nurse with extensive experience in utilization review. Skilled in analyzing patient care and ensuring compliance with healthcare regulations. Strong focus on team collaboration and achieving optimal patient outcomes. Adaptable and reliable, excelling in dynamic environments requiring precise decision-making and effective communication.
Overview
12
12
years of professional experience
Work History
Home Health Care Coordinator
Navihealth/Optum
12.2022 - Current
Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
Developed strong relationships with community partners, facilitating referrals and collaboration on behalf of patients.
Maintained accurate and up-to-date documentation of patient records in accordance with HIPAA regulations.
Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Assisted discharge planning efforts through prompt identification of medically stable patients who were ready for transition to alternate levels of care.
Improved patient outcomes by meticulously reviewing patient records to ensure appropriate care levels.
Contact: Brigitte Hallum, 615-585-0523
On Call Coordinator/Field RN
Amedisys Home Health and Hospice
11.2018 - Current
Scheduling, entering referrals, and triaging after-hours calls for 10 care centers
Improved client satisfaction by efficiently addressing concerns or grievances in a timely manner.
Boosted caregiver retention by providing ongoing support, promptly responding to concerns, and maintaining open lines of communication.
Ensured compliance with company policies and industry regulations through meticulous recordkeeping and documentation practices.
Provided crisis intervention support for clients experiencing emergencies, using appropriate techniques to de-escalate situations safely.
Developed strong rapport with patients through active listening skills, empathetic communication, and genuine concern for their wellbeing.
Provided compassionate care for patients experiencing acute symptoms, offering emotional support and comfort during stressful situations.
Improved communication among healthcare team members by serving as a liaison between patients, physicians, and nursing staff.
Contact: Courtney Casey, 251-593-1094
Case Manager/Field RN
Springhill Home Health and Hospice
09.2017 - 08.2018
Instruction & supervision of patient/family/caregivers in procedures & providing appropriate care in the home
Report patient changes, reactions, and s/s of patient's status to appropriate physicians
Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
Conducted thorough assessments of clients' situations, identifying issues, goals, and necessary interventions.
Enhanced communication between clients and providers through consistent follow-ups and progress updates.
Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
Increased client satisfaction through diligent follow-up and personalized support.
Developed strong rapport with patients and families, fostering trust and open communication during challenging times.
Educated patients and families on disease management, medication safety, and at-home healthcare strategies to promote selfcare.