Nicole T. Washington
Kenner,USA
Summary
Experienced Registered Nurse with a robust background in clinical judgment and patient assessment, consistently enhancing patient care through collaboration with multidisciplinary teams. Demonstrated expertise in documentation and regulatory compliance has led to marked improvements in patient outcomes and experiences. Dedicated to advancing quality care standards and optimizing healthcare delivery practices.
Overview
28
28
years of professional experience
1
1
Certification
Work History
RN Utilization Management Coordinator
River Oaks Hospital
New Orleans, LA
05.2024 - Current
- Documented all utilization review activities, findings, and decisions in patient records and databases.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Assisted with appeals processes related to denied claims or requests for additional information from payers.
- Investigated denials from payers for lack of medical necessity or level of care issues.
- Ensured that all documentation is complete and accurately reflects the services provided by physicians.
- Reviewed and evaluated patient information to determine appropriate level of care and services required.
- Communicated authorization decisions to providers and patients in a timely manner.
- Maintained accurate data entry into a computerized system related to UR activities.
- Liaised between patients, healthcare providers, and insurance companies to clarify coverage and authorize services.
- Contacted insurance carriers to obtain authorizations for services delivered to patients.
- Established relationships with external vendors providing utilization review services.
- Utilized Milliman Clinical Care Guidelines and InterQual to assist in determining the medical necessity and appropriateness of inpatient care.
Registered Nurse IOP
River Oaks Hospital
New Orleans, LA
01.2023 - 05.2024
- Worked as a Registered Nurse in the Intensive Outpatient Program and Partial Hospitalization Program (Psych and Addiction)
- Completed RN admission assessments.
- Participated in a treatment team meeting to discuss patient issues and develop individualized treatment plans with a multidisciplinary team.
- Patient medication education.
- Assist patients with medical concerns and needs.
- Communicated with the psychiatrist to resolve patient issues and concerns.
- Documented patient progress notes accurately and efficiently in the patient's medical record.
- Performed urine drug screens and breathalyzers as ordered by the physician
- Participated in discharge planning and coordination of aftercare appointments to ensure continuity of care.
- Conducted nursing education groups weekly.
- Conducted nursing education groups on acute psychiatric adult unit and chemical dependency detox unit biweekly
Registered Nurse/ Supervisor
Ochsner Hospital
New Orleans, LA
05.2013 - 12.2022
- Assist with joint commission preparation, initiation, and monitoring of performance improvement projects, educating staff on policy and procedures, reviewing staff's annual competencies and maintaining them, safety environmental rounds and inspections, placement and overseeing of work orders to ensure our environment of care is safe for our patients, monthly pharmacy inspections, monthly sample audit completion, patient injections, patient call backs, patient triage coordination, and completing prior authorizations and medication refills, responding to calls from patient relations in a timely manner.
- Managing complaints from patients and families in our department, diffusing agitated patients in the clinic area, and problem-solving scheduling issues.
- Supervising and managing the phone receptionist.
- Conducts performance evaluations and promotes ongoing education and staff development, monitoring and creating systems to improve ACD scores.
- Enforcing Ochsner policies to increase accountability and professionalism in our clinic, assisting with scheduling and authorizations for ECT.
- Serving as a resource to other departments in the organization, who have questions about psychiatric patients and the coordination of their care.
- Coordination of admissions to the acute inpatient unit when necessary.
- Escorting a PEC'd patient to the ER for evaluation and placement, with proper supervision and transfer of care for a patient who is suicidal.
- Maintains professional relationships with physicians to ensure continuity of patient care, maintains confidentiality of all patients and patient records in the clinic, and is diligent in compliance with regulations regarding infection control.
- Compassionate and serves as a patient advocate
- Communicates and delegates effectively to ensure proper utilization of resources Demonstrates pride and commitment to the nursing profession and to my department
Registered Nurse
Ochsner Hospital
New Orleans, LA
09.2012 - 05.2013
- Primary care, assessment, and evaluation of adult psychiatric patients
- Charge nurse on twelve bed acute psychiatric unit Charge nurse promoted to Operations Coordinator Completed Environmental Rounds, completed chart audits, initiated and updated treatment plans, member of Interdisciplinary Practice Council, Safety Rounds, Supervision and managing of staff on the unit, Supervision of patient care on an acute psychiatric unit, assisted with preparation for Joint Commission Survey, Educated staff on unit safety, Discharge planning, Maintaining standards and regulations specific to psychiatry
- Coordination of care with other specialties in the hospital to assure patient needs were met
Director of Nursing Services/Charge Nurse
Seaside Behavioral Center
New Orleans, LA
01.2010 - 06.2012
- As charge nurse directed care on a 19 bed geriatric-psychiatric unit; assessed acuity of geriatric patients with numerous health concerns; supervised licensed practical nurses, certified nurse's assistants, and mental health technicians Worked as Director of Nursing on a 19 bed geriatric psychiatric unit My duties included' supervise and direct clinical services, recruitment, interview, and termination of staff; maintain patient confidentiality and customer satisfaction; maintain clinical staff schedule; prepare, review, revise patient care plans, employee health screenings; infection control tracking, incident report tracking; performance improvement, maintaining budget, ordering unit supplies; maintaining environmental standards, lead hospital through DHH surveys, lead hospital through accreditation surveys; intake coordination; utilization review; chart audits; review and initiating policy and procedures; filling in to meet staffing needs, staff education, payroll, and overseeing daily operations After the birth of my daughter, I relinquished my director position and became day charge nurse My duties in this position included nursing assignments, acuity assessment; intake coordination, supervision of staff; facilitation of transfers of med surg patients who became medically unstable for our unit; treatment team participant, communicating information directly to physicians to unsure continuity of care, assist with daily staffing; supervise and direct daily unit activities
Registered Nurse 3/Charge Nurse
LSU DePaul
New Orleans, LA
01.2009 - 01.2010
- Primary care, assessment, and evaluation of adult psychiatric patients
- Charge nurse on a nine bed acute psychiatric unit Worked as Charge nurse on a adult psychiatric unit Also opened up a 9 bed unit to accommodate patient load My duties included
- Daily assignments; acuity assessment, documentation, chart audits; medication administration, care plans, treatment team; supervision of staff, patient and family education; discharge planning Also worked as weekend supervisor
Registered Nurse (Agency)
Nurses Have Options (NHO)
Metairie, LA
06.2007 - 01.2009
- Primary care, assessment, and evaluation of med-surg, telemetry, step down, and psychiatric patients in local hospitals
Registered Nurse (Agency)
Advantage Nursing Service
Metairie, LA
02.2007 - 06.2007
- Primary care, assessment, and evaluation of med-surg, telemetry, and step down patients
- Worked as a RN in different facilities in the New Orleans Area
- Units include
- Adult psychiatry, med-surg, telemetry, step down Duties include
- Assessment, documentation, medication administration, patient and family education
Registered Nurse (Travel)
Corona Regional Medical Center
Corona, CA
10.2006 - 02.2007
- Primary care, assessment, and evaluation of med-surg, telemetry, and emergency room patients
- Worked as a Travel RN at Corona Regional Medical Center in Corona, California Units included: med surg, telemetry, ER, ER holding Duties included patient assessment, documentation, medication administration, and patient and family education
Registered Nurse (Travel)
King Drew Medical Center
Los Angeles, CA
07.2006 - 10.2006
- Primary care, assessment, and evaluation of med-surg patients
- Worked as a Travel RN at King Drew Medical Center in Los Angeles, California
- I worked on a med-surg unit Duties included patient assessment, documentation, medication administration, and patient and family education
Registered Nurse (Travel)
Touro Infirmary
New Orleans, LA
03.2006 - 07.2006
- Primary care, assessment, and evaluation of med-surg patients Charge nurse on acute med-surg unit Worked as a Travel Nurse at Touro Infirmary in New Orleans, Louisiana
- Assisted in the reopening of a med-surg unit after Katrina
- Worked as charge nurse Med-surg/telemetry unit
Registered Nurse (Travel)
Miriam Hospital
Providence, RI
11.2005 - 02.2006
- Primary care, assessment, and evaluation of med-surg, telemetry, and emergency room patients
- Worked as a Travel Nurse at Miriam Hospital in Providence, Rhode Island
- Units include
- Med-surg, telemetry, oncology, ER, and ER holding
Registered Nurse
Ochsner Hospital
New Orleans, LA
05.2005 - 11.2005
- Worked as a Staff RN on a med-surg/telemetry floor (IMTA) Precepted by Ochsner Staff RNs
- Worked during the days of Hurricane Katrina on Team A
Licensed Practical Nurse
Ochsner Hospital
New Orleans, LA
01.2005 - 05.2005
- Worked as a Staff LPN on a med-surg/telemetry floor
Licensed Practical Nurse
DePaul Tulane Hospital
New Orleans, LA
01.2004 - 05.2005
- Primary care, assessment, and evaluation of acute child, acute adolescent, acute adult, chemical dependency, and eating disorder patients in an acute psychiatric inpatient setting
- Assisted with utilization review and safety rounds Worked as an LPN on several units in the hospital including
- Acute adult psych, acute child, acute adolescent, residential child/adolescent, charge nurse on eating disorder unit, charge nurse on chemical dependency unit Also worked in UR and assisted with chart audits in preparation for joint commission surveys
Licensed Practical Nurse
Abbeville General Hospital
Abbeville, LA
01.1997 - 12.1998
- Worked as a Staff LPN on a med-surg/telemetry floor
- Also worked on a 16 bed acute adult psychiatric unit
Education
Bachelor of Science - Nursing
Our Lady of Holy Cross College
New Orleans, LA01.2005
LPN Diploma -
Louisiana Technical College Gulf Area Campus
Abbeville, LA01.1996
Skills
- Clinical judgment
- Documentation
- Patient assessment
- Direct/Indirect patient care
- Regulatory compliance
- Deescalation Techniques
- Operations management
- Employee training
- HIPAA compliance
- Patient care coordination
- Scheduling appointments
- Patient flow
- Employee relations/Patient Relations
- Performance improvement
- Coaching and mentoring
- Crisis management
- Strong rapport building
- Complaint resolution
- Staffing coordination
- Staff education and training
- Team building and leadership
- Inter-department collaboration
- Staff management
- Excellent time management skills
Certification
- CPR Certified-current
- CPI Certified-current
References
- Beth Anderson, Activity Therapist, River Oaks Hospital, 504-914-7724
- Heather Myers, Social Worker, River Oaks Hospital, 504-559-1453
- Dr William Lo, Psychiatrist, River Oaks Hospital, 504-905-7662
Awards
Cynthia Ann Harris-Francis Psychiatric-Mental Health Nursing Award, 2005
Timeline
RN Utilization Management Coordinator
River Oaks Hospital
05.2024 - Current
Registered Nurse IOP
River Oaks Hospital
01.2023 - 05.2024
Registered Nurse/ Supervisor
Ochsner Hospital
05.2013 - 12.2022
Registered Nurse
Ochsner Hospital
09.2012 - 05.2013
Director of Nursing Services/Charge Nurse
Seaside Behavioral Center
01.2010 - 06.2012
Registered Nurse 3/Charge Nurse
LSU DePaul
01.2009 - 01.2010
Registered Nurse (Agency)
Nurses Have Options (NHO)
06.2007 - 01.2009
Registered Nurse (Agency)
Advantage Nursing Service
02.2007 - 06.2007
Registered Nurse (Travel)
Corona Regional Medical Center
10.2006 - 02.2007
Registered Nurse (Travel)
King Drew Medical Center
07.2006 - 10.2006
Registered Nurse (Travel)
Touro Infirmary
03.2006 - 07.2006
Registered Nurse (Travel)
Miriam Hospital
11.2005 - 02.2006
Registered Nurse
Ochsner Hospital
05.2005 - 11.2005
Licensed Practical Nurse
Ochsner Hospital
01.2005 - 05.2005
Licensed Practical Nurse
DePaul Tulane Hospital
01.2004 - 05.2005
Licensed Practical Nurse
Abbeville General Hospital
01.1997 - 12.1998
Bachelor of Science - Nursing
Our Lady of Holy Cross College
LPN Diploma -
Louisiana Technical College Gulf Area Campus
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