Summary
Overview
Work History
Education
Skills
Timeline
AdministrativeAssistant

Nichole Layne

Dallas,TX

Summary

Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable in medicaid waiver program, community assessments, charting, medication administration and interdisciplinary collaboration focused on optimizing community care and support. Quality-focused and efficiency-driven leader.

Overview

13
13
years of professional experience

Work History

RN Service Coordinator

Amerigroup
08.2017 - Current
  • Coordinated nursing for the elderly with the assistance of NF staffing for health-related, therapeutic and support services to streamline service delivery.
  • Determined cases for members to return to community with services directed at individual care.
  • Developed and arranged professional consultations and therapy for patients.
  • Documented quarterly assessments for each member meeting deadlines for state requirements.

RN Service Coordinator

Cook Childrens Health Plan
08.2016 - 12.2017
  • Coordinated care for MDCP medically fragile children in their home setting.
  • Added services such as PAS, therapies, DME and other needs member to remain in home setting.
  • Developed plan of care with other medical professions with long term goals for best outcomes.
  • Documented assessment using the SAI Program and other computer applications per state requirements.

Utilization and Review Nurse

Department Of Aging And Disability Services
01.2011 - 07.2016
  • Reviewed six medicaid waiver programs for regulatory and fraud using Texas Administration Codes, and Medicaid Waiver rules.
  • Submitted cases for criteria failures and helped facilitate resolutions and approvals.
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Communicated with UR team members to plan, implement and enhance Texas code strategies.

Education

Associate of Science - Nursing

Excelsior College
Albany, NY
06.2010

Vocational Nursing Certificate - License Vocational Nursing

Extended Health Education
Arlington, TX
05.2003

Skills

  • Profitability Strategies
  • Patient Care Assessment
  • Clear Patient Communication
  • Community-Based Educational Programs
  • Facility Inspections
  • Delegation and Motivation
  • Nursing Performance Assessment
  • Compliance Issues
  • Code Compliance
  • Planning Processes

Timeline

RN Service Coordinator

Amerigroup
08.2017 - Current

RN Service Coordinator

Cook Childrens Health Plan
08.2016 - 12.2017

Utilization and Review Nurse

Department Of Aging And Disability Services
01.2011 - 07.2016

Associate of Science - Nursing

Excelsior College

Vocational Nursing Certificate - License Vocational Nursing

Extended Health Education

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Nichole Layne