Lori Burch
KENTWOOD,LA
Summary
Experienced nursing professional with 20 years of experience, bringing demonstrated clinical expertise, leadership skills, and technical knowledge. Proficient in updating charts, monitoring medications and working with multidisciplinary teams to optimize patient care. Quality-driven, and efficient, with strong interpersonal abilities.
Hardworking nursing professional well-versed in primary care. Work well with people of all ages. Proficient in monitoring vitals, documenting changes and a wide range of clinical procedures. Proficient in doing Medicare/Medicaid MDS assessments and working with IDT team members to coordinate patient care
I am looking to find employment in the state in which i now reside in.
Overview
20
20
years of professional experience
Work History
UTLIZATION MANAGEMENT
Oceans Behavioral Hospital
KENTWOOD, LA
03.2021 - Current
- Utilized advanced technical skills and expertise to troubleshoot complex problems and implement solutions.
- Achieved cost-savings by developing functional solutions to problems.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Worked effectively in team environments to make the workplace more productive.
- Identified needs of customers promptly and efficiently.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Provided support and guidance to colleagues to maintain a collaborative work environment.
- Assisted in developing and implementing training programs for new utilization review staff.
- Coordinated with healthcare teams to develop care plans that meet patient needs and insurance coverage.
- Assessed the appropriateness of medical services and procedures based on clinical documentation and criteria.
- Maintained up-to-date knowledge of changes in healthcare regulations, policies, and evidence-based practices.
- Remained up-to-date on various benefit plans, medical policies and state-specific clinical guidelines or criteria.
- Utilized evidence-based guidelines to support utilization review decisions and recommendations.
- Performed pre-certification, concurrent, and retrospective reviews of inpatient and outpatient services.
- Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
- Contacted insurance carriers to obtain authorizations for services delivered to patients.
- Collaborated with case managers to facilitate timely discharge planning and transition of care.
- Managed appeals for denied services, providing additional information to support medical necessity.
MDS CoordinatorLPN
McComb Nursing And Rehabilitation Center
McComb, MS
01.2008 - 02.2021
- Managed and provided leadership to help staff with direct and indirect patient care
- Imparted medical, operational and patient care knowledge to junior nurses to maximize performance and quality of team operations
- Used facility EMR system to update patient records, transmit prescriptions and transfer files
- Developed and adapted individualized treatment plans according to patient recovery goals
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans
- Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services
- Ensured quality patient care from admission to discharge through direct supervision of all nursing and ancillary staff
LPN-Triage Nurse
Gastroenterology Associates, McComb MS
McComb, MS
02.2010 - 10.2013
- Created comprehensive medical histories to facility continuity of care
- Ordered lab tests and interpreted test results and maintained patient records
- Served as liaison between management, clinical staff and the community
- Maintained patient records and ensured patient privacy and clinical compliance
- Evaluated patient care needs, prioritized treatment and maintained patient flow
Education
LPN - Nursing
SMCC
Summit MS12.2007
Skills
- Diagnostic tools experience
- Geriatric treatment knowledge
- Unit administration
- Computerized charting specialist
- Body mechanics knowledge
- Wound cleaning/care expertise
- Diabetes management
- Triaging patient concerns
- Medication administration expert
- Colostomy care familiarity
- Broad medical terminology knowledge
- Care planning
- CPR and BLS certified
- Basic Life Support Certification
- Gastrostomy tube care
- Team leader
- Organization and planning
Timeline
UTLIZATION MANAGEMENT
Oceans Behavioral Hospital
03.2021 - Current
LPN-Triage Nurse
Gastroenterology Associates, McComb MS
02.2010 - 10.2013
MDS CoordinatorLPN
McComb Nursing And Rehabilitation Center
01.2008 - 02.2021
LPN - Nursing
SMCC
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