Lori Mckernan
Winnabow,USA
Summary
Dedicated and Caring Nurse with a wide variety of experience seeking a Nursing position to administer focused and evidence-based nursing care to Veterans.
Able to bring substantial experience in patient care and medical procedures. Highly focused on team collaboration and achieving positive patient outcomes, and adaptable to changing healthcare needs. Expertise in patient assessment, care planning, and medical documentation, coupled with a compassionate approach.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Senior Clinical Admin Telecommuter RN
United Healthcare
08.2025 - Current
- Perform Member assessment of all major domains using evidence-based criteria (behavioral, physical, functional, financial and psychosocial needs.)
- Assess, plan and implement care plan strategies that are individualized by Member and directed toward the most appropriate, least restrictive level of care, to achieve recovery and adaptive functioning and monitor progress toward their goals.
- Utilize both company and community-based resources to establish a safe and effective case management plan for Members.
- Collaborate with Member, family, and health care providers (PCP, BH Providers) to develop an individualized plan of care and supportive services for members.
- Support and coordinate Member behavioral health services and integrated substance use disorder treatment, supporting medication management, symptoms management, rehabilitation, crisis stabilization, and psychosocial education on an outpatient basis.
- Provide advocacy, health education, coaching, referrals and treatment decision support for Members and their caregivers.
- Meet with Members via telephone or video to assess chronic conditions, such as Diabetes, Asthma, Chronic Kidney Disease, CVA, Cardiac conditions, Hypertension, Depression, and other related health conditions. Provide necessary guidance and health coaching to establish positive outcomes.
- Document activities according to established standards and ensure files meet NCQA/Medicaid requirements.
- Accountable to understand role and how it affects utilization management benchmarks and quality outcomes.
- Understand insurance products, benefits, coverage limitations, insurance and governmental regulations as it applies to the health plan.
- Special projects, initiatives, and other job duties as assigned.
Virtual BHIP Nurse Care Manager, BHIP/PACT Care Manager, and Mental Health Care Coordinator GS 02/8
U.S. Department of Veterans Affairs
10.2016 - 05.2017
- Nursing assessment phone calls to newly referred Veterans to determine needs and proper consults and referrals.
- Manage RN phone line: crisis screening and management; management of requests for appointments, referrals, refills, side effects, adverse effects.
- Manage medication clinics for administrations of injections and Patient education.
- Follow up with Vets after hospital discharge with Post Discharge engagement planning and VVC appointments.
- Triage Secure messages for multiple Prescribers. Assist as needed.
- Managing weekly quality improvement and education in regard to medication interactions, current lab values, and VA substance use policies.
- Assist with Telehealth (VCT), room patients, administer AIMS testing and vital signs, measurements. Conduct appointments thru telework, VVC, VCM.
- Formulate Care and Safety Plans to meet Patient Goals, continue evaluation.
- Formulate Interventions and appropriate care so Veteran can meet goals.
- RN Walk in Clinic-BHIP team clinic: provide triage assessment, ability to provide referrals, case management, access to prescriber if warranted.
- Educate Veterans on use of BHI Touch and My HealtheVet.
- Assess for placement of appropriate consults for other disciplines, other programs or services.
- Process incoming consults and approve or forward as appropriate.
- Part of the Care Coordination & Integrated Case management team, outreaching Vets as part of SAIL measures to determine needs.
- Enter consults for Community Care and follow up with Vets to make sure consults are processed in a timely manner.
- Assist in ongoing SAIL Measures for discipline improvement.
- Provide additional point of communication with Ambulatory care, PACT, other healthcare professionals, clinics, and internal or external services and community agencies.
- Provided educational classes regarding menus, nutrition, Diabetes, glucose monitoring, labs etc.
- Worked with other Committee’s to resolve Patient issues and resolve problems.
Registered Nurse/Case Manager/Utilization Review
Jefferson Center for Mental Health
07.2015 - 10.2016
- Provided behavioral health assessments and substance abuse assessments, clinical treatment including medication administration, education, and case management services
- Delegated to/supervised Unlicensed Assistive Personnel (Medical Assistants and LPN’s)
- Performed Office Medication Prior-authorizations and standard of care authorizations with Medicare, Medicaid, and other Insurance companies.
- Worked with outside Pharmacies for appropriate refills, prior authorizations, and called in new prescriptions.
- Managed Suboxone Patients and other alternative pain medications.
- Triage phone calls from outside facilities, labs/diagnostic results
- Entry, Review, Refill and Maintenance of Medications in EMR
- Processed codes for proper billing procedures with Medicaid, Medicare, and other medical insurance companies.
- Conducted medication clinics, medication monitoring, administers injections and STAT medications, as required.
- Taught weekly health classes on health management.
- Worked with the client on discharge planning with an emphasis on follow- up appointments, primary care follow-up.
Charge Nurse/ Utilization Review
Lutheran Medical Center
04.2013 - 07.2015
- Permanent Position reporting to Nurse Manager
- Responsible for Charge Nurse duties on the Medical Surgical, Psychiatric Intensive Care Unit, Pain Management Unit, and Detox unit.
- Implemented and strategized a new admission process for both the Psychiatric ICU and Detox Units resulting in decreased wait time from admissions from the ER from 9 hours down to 4 hours, also improving patient and staff satisfaction.
- Coordinated staffing schedules and implemented PRN Nurses as needed.
- Supervised six Nurses and six CNA’s.
- Mentored Student Nurses and CNA’s.
- Attended and participated in clinical collaboration conferences regarding patient progress, problems and needs.
- Epic Super user and Preceptor of new grads, and new employees.
- Conducted and documented a thorough assessment of each patient’s medical status upon admission and throughout the patient’s course of treatment.
- Assisted in the development and implementation of an individualized treatment plan for each assigned patient.
- Performed appropriate pain intervention treatments as ordered by physician in an accurate and timely manner.
- Initiated emergency resuscitative measures according to adult resuscitation protocols.
- Provided appropriate Education for Diabetes, COPD, Heart Disease, Pain Management, Asthma, Hypertension, Parkinson’s Disease and Wound Care
- Assessed and monitored Patients who were going through physical and psychological withdrawal from chemical substances and provided proper medication to ensure the patient detoxed safely.
- Completed required documentation in an accurate and timely manner.
- Acted in compliance with hospital, regulatory and professional standards and guidelines.
- Adhered to facility policies and procedures and participates in facility quality improvement and safety programs.
- Discharged Patients with appropriate instructions, medications, and upcoming appointments.
Education
Bachelor's Degree in Nursing -
Grand Canyon University
09.2014
Associates Degree in Nursing - undefined
National American University
05.2010
Skills
- Competent on all medications, dosages, and side effects
- Excellent Clinical judgment and Evidence based practice
- Compassion and empathy, excellent customer service and communication skills
- Educator for health management, anxiety, nutrition, and emotional wellness
- Excellent time management skills
- Utilizes quality improvement and measures
- Able to handle difficult situations in a calm manner
- Participates in structuring the work environment to facilitate new evidence based practice policies
Certification
- BLS, RQI certified
- RMBC and CPI certification
Timeline
Senior Clinical Admin Telecommuter RN
United Healthcare
08.2025 - Current
Virtual BHIP Nurse Care Manager, BHIP/PACT Care Manager, and Mental Health Care Coordinator GS 02/8
U.S. Department of Veterans Affairs
10.2016 - 05.2017
Registered Nurse/Case Manager/Utilization Review
Jefferson Center for Mental Health
07.2015 - 10.2016
Charge Nurse/ Utilization Review
Lutheran Medical Center
04.2013 - 07.2015
Associates Degree in Nursing - undefined
National American University
Bachelor's Degree in Nursing -
Grand Canyon University
Additional Experience
- Haven Behavioral Health- Charge Nurse/Interim Nurse Manager from March 2011-April 2013
- Emeritus at Green Mountain- Charge Nurse SNF from September 2010-August 2013
- Professional Home Healthcare-Home Health RN from August 2010- December 2010
- Homewatch Caregivers- Certified Nurse aid/Medtech From 1996-2001
Licenses
North Carolina Compact Registered Nurse License
Colorado Compact Registered Nurse License
New York State Registered Nurse License
Minnesota State Registered Nurse License