MOJISOLA ADIGUN
Indianapolis,IN
Summary
Accomplished Utilization Management Coordinator with a proven track record at HCSC, enhancing patient care through effective discharge planning and strong clinical judgment. Experienced Registered Respiratory Therapist with over four years acute care and trauma, and pediatric care. Skilled in EPIC, CERNER and MCG guidelines, I excel in fast-paced environments, demonstrating exceptional interpersonal communication and leadership by mentoring staff. Achieved significant improvements in care coordination and patient advocacy.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Utilization Management Coordinator
Ascension St Vincent's Hospital
12.2022 - Current
- Perform concurrent review, discharge planning and care coordination in accordance with approved departmental guidelines.
- Perform admission reviews based on medical necessity utilizing Milliman Care Guidelines MCG and medical policies.
- Devise or identify solutions for irregular requests and issues.
- Perform prior authorization review of services requiring notification.
- Facilitated workgroup meetings with interdisciplinary team such as physicians, pharmacist, social worker and other case managers to find effective solutions to members' issues.
- Perform ongoing assessments to evaluate member's needs, working with multidisciplinary team to develop, initiate, manage and modify individualized plans of care.
- Evaluate medical guidelines and benefit coverage to determine appropriateness of services within the scope of the plan.
- Submit cases to a Medical Director for criteria failures and help facilitate resolutions and approvals.
- Utilize critical thinking skills and work in a fast paced environment with minimal supervision.
- Maintain accurate records of all members, adhere to the company policy in safeguarding HIPPA and release of Patient health information PHI.
- As a team lead, assist other staff with UM process questions and help management in coordinating day to day activities.
- Train new staff and act as a mentor, providing resources and communicate company goals.In addition, inspire and motivate staff.
- Ability to utilize and safeguard electronic medical records,EPIC and other software.
Respiratory Care Practitioner
Ascension St Vincent Hospital
08.2021 - 10.2022
- Examined patients who have pulmonary diseases, disorders, or complications
- Conducted, performed, and analyzed diagnostic and function tests to assess lung capacity and capability
- Worked with physicians and nurses to create treatment plans
- Treated patients with aerosol medications and chest physiotherapy
- Evaluated progress of treatment
- Documented care by updating charts and records in EPIC
- Operated mechanical ventilators and other machines
- Completed discharge planning by working with other members of the medical team
- Trained patients how to administer treatments and use equipment on their own
- Recommended equipment and treatment for outpatient or home health
Registered Respiratory Care Practitioner
IU Health
07.2020 - 07.2021
- Utilized CERNER to document data related to patient care such as medications, interventions and patient responses.
- Managed patients with pulmonary and respiratory illnesses including asthma, COPD, lung transplants and other conditions.
- Managed care for post-operative patients from initial recovery through discharge.
- Participated in respiratory simulation activities, evidence-based practice project implementation and competency development to further nursing education.
- Managed care from admission to discharge, including patient assessments, care planning, health educations and discharging support to provide comprehensive care to over 10 patients daily.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
- Precepted respiratory therapists, respiratory care students providing guidance on unit functions and individual roles, hospital policies and procedures and nursing best practices.
- Provided direct patient care, stabilized patients and determined next course of action.
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Education
Bachelor of Science - Public And Allied Health
University of Southern Mississippi
Hattiesburg, MS05.2024
Associate of Science - Respiratory Therapy
IvyTech Community College
Indianapolis, IN05.2020
Skills
- Discharge planning coordination
- Interpersonal and written communication
- Patient and family advocacy
- Strong clinical judgment
- EMR / EHR
- Medication Administration
- EPIC, CERNER
- MCG guidelines
- Microsoft office
Certification
- BLS
- ACLS
- RRT
Timeline
Utilization Management Coordinator
Ascension St Vincent's Hospital
12.2022 - Current
Respiratory Care Practitioner
Ascension St Vincent Hospital
08.2021 - 10.2022
Registered Respiratory Care Practitioner
IU Health
07.2020 - 07.2021
Bachelor of Science - Public And Allied Health
University of Southern Mississippi
Associate of Science - Respiratory Therapy
IvyTech Community College
- BLS
- ACLS
- RRT
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