Mikesha Sartin
Atlanta,GA
Summary
Utilization Review Nurse considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers.
Passionate Telephone Triage Nurse assessing patient condition both in person and over phone. Assists individuals in need of medical attention in understanding insurance coverage and urgency of medical conditions. Supporting comprehensive recovery through education and sound medical advice.
Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, triage and care coordination in fast-paced environment.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse/Advice Nurse/Clinical Nurse Educator
Piedmont HealthCare
06.2023 - Current
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Enhanced patient satisfaction by collaborating with interdisciplinary teams to develop individualized care plans, ensuring appropriate level of care.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Streamlined the case management process by effectively prioritizing high-risk cases for timely intervention and followup.
- Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices in utilization review nursing.
- Collaborated with insurance companies to verify coverage, clarify benefits, and facilitate authorization for medical services, reducing delays in patient care delivery.
- Served as a vital liaison between patients, healthcare providers, and insurance companies, fostering effective communication and coordination among all parties involved in the care process.
- Performed prior authorization review of services requiring notification.
- Supervised and maintained all utilization review documentation through Epic/CGX.
Utilization Review Nurse/Advice Nurse/Clinical Nurse Educator
Baylor University Medical Center
06.2022 - 06.2023
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Enhanced patient satisfaction by providing timely and accurate medical advice over the phone.
- Enhanced patient outcomes by developing and implementing evidence-based educational programs for clinical staff.
- Improved nursing competency through the creation and delivery of targeted training sessions and workshops.
- Collaborated with leadership to devise initiatives for improving nursing satisfaction, retention and morale.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
- Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
- Streamlined triage process for more efficient patient support and reduced wait times.
- Worked with healthcare team to develop new dialysis treatment flow sheet and other log forms, improving clinical documentation and accountability.
Registered Nurse/Advice Nurse/CMA
WellStar Health System
10.2019 - 06.2022
- Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
- Reduced hospital readmissions through effective discharge planning, patient education, and follow-up care coordination.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
- Streamlined medication administration processes for increased safety and accuracy during busy shifts.
- Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients with multiple comorbidities.
- Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
- Promoted a culture of safety within the healthcare facility by participating in quality improvement initiatives, identifying potential hazards, and advocating for best practices in nursing care delivery.
- Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Contributed to interdisciplinary team meetings by presenting relevant clinical data about patients'' progress toward reaching established goals of care.
- Provided support for patients'' families during difficult medical decisions or end-of-life care, serving as a liaison between the healthcare team and loved ones.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Implemented evidence-based fall prevention strategies, resulting in a significant decrease in patient falls within the unit.
- Enhanced patient satisfaction by providing timely and accurate medical advice over the phone.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Monitored patient condition by interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
- Oversaw delivery of care for patients on medical-surgical unit, providing direct care, delegating nursing assignments and supervising team comprised of nurses, LPNs, technicians, and unit clerks.
Certified Medical Assistant/Nurse Intern
Grady Memorial Hospital Emergency Room
08.2018 - 10.2019
- Improved patient satisfaction by providing efficient and accurate medical assistance during appointments.
- Improved patient satisfaction by providing efficient, accurate, and timely blood draws.
- Enhanced laboratory efficiency through proper specimen handling and labeling procedures.
- Reduced wait times for patients by maintaining an organized schedule and swiftly preparing examination rooms.
- Enhanced clinic efficiency by thoroughly documenting patient information and updating electronic health records.
- Provided compassionate care for patients, addressing their concerns and ensuring a positive experience.
- Streamlined communication between healthcare providers, facilitating timely treatment plans and decision making.
- Increased patient safety by meticulously following infection control protocols and maintaining a sterile environment.
- Streamlined the blood collection process through proficient venipuncture and capillary puncture techniques.
- Provided support during emergencies by administering first aid treatments under physician supervision until further assistance arrived.
- Empowered patients through education on self-management techniques for chronic conditions such as diabetes or hypertension.
- Scheduled appointments, registered patients, and distributed sample pharmaceuticals as prescribed.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Prepared lab specimens for diagnostic evaluation.
Medical Assistant / Educator
Peachtree Spine Physicians
05.2016 - 06.2017
- Enhanced patient care by developing and implementing comprehensive nursing education programs.
- Established a supportive learning environment by providing guidance and mentorship to nursing staff.
- Evaluated the effectiveness of training programs, making necessary adjustments to optimize learning outcomes.
- Collaborated with interdisciplinary teams for the development and implementation of evidence-based practice initiatives.
- Improved patient safety by designing and conducting simulation exercises that strengthened nurses'' critical thinking skills.
- Promoted professional growth among nursing staff through continuous education opportunities, conferences, and workshops.
- Assessed competency levels among nursing staff, identifying areas of improvement for targeted interventions.
- Maintained strict adherence to infection control protocols by following proper sterilization techniques for medical equipment.
- Provided support during emergencies by administering first aid treatments under physician supervision until further assistance arrived.
- Performed phlebotomy tasks efficiently while ensuring minimal discomfort for patients during blood collection procedures.
- Empowered patients through education on self-management techniques for chronic conditions such as diabetes or hypertension.
- Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Completed EKGs and other tests based on patient presentation in office.
- Prepared lab specimens for diagnostic evaluation.
- Measured patient pulse oximetry.
- Supported duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.
Education
Master of Science - Nurse Executive Leadership/ Nurse Educator
Chamberlain University School of Nursing
Downers Grove, IL06.2024
Bachelor of Science - Nursing
Chamberlain University School of Nursing
Atlanta, GA06.2021
Bachelor of Science - Biology
Georgia Southern University
Statesboro, GA05.2015
Skills
- Utilization Management
- Medical Coding
- Documentation And Reporting
- Discharge Planning
- Interpersonal and written communication
- HIPAA Compliance
- Inpatient Care
- Health Promotion
- Telemedicine
- Clinical assessment
- Nursing Documentation
- Diabetes management
- Case Management
- Critical Care
- Emergency Response
- Patient Management
Certification
- CPR AHA/RedCross
- Licensed Registered Nurse RN308791
- Medical Surgical Certified Nurse
- Renal /Peritoneal Dialysis Nurse
Timeline
Utilization Review Nurse/Advice Nurse/Clinical Nurse Educator
Piedmont HealthCare
06.2023 - Current
Utilization Review Nurse/Advice Nurse/Clinical Nurse Educator
Baylor University Medical Center
06.2022 - 06.2023
Registered Nurse/Advice Nurse/CMA
WellStar Health System
10.2019 - 06.2022
Certified Medical Assistant/Nurse Intern
Grady Memorial Hospital Emergency Room
08.2018 - 10.2019
Medical Assistant / Educator
Peachtree Spine Physicians
05.2016 - 06.2017
Master of Science - Nurse Executive Leadership/ Nurse Educator
Chamberlain University School of Nursing
Bachelor of Science - Nursing
Chamberlain University School of Nursing
Bachelor of Science - Biology
Georgia Southern University
- CPR AHA/RedCross
- Licensed Registered Nurse RN308791
- Medical Surgical Certified Nurse
- Renal /Peritoneal Dialysis Nurse
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