Nykita Penn
Kansas City,MO
Summary
Driven Registered Nurse with 20 years of experience caring for patients within multiple healthcare settings. My nursing career focused on utilization management including case management and managing chronic complex conditions. I have experience working with both Interqual and Milliman software. As a case manager my primary focus was to ensure that patients are at the right level of care, that quality of care was maintained and to collaborate with other interdisciplinary team members when necessary. I have working with Medicare Advantage members to help them manage their complex chronic conditions, helping them to have a better quality of life, and helping them to access community resources available. Dedicated to providing top quality care within multidisciplinary team environment.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Registered Nurse
Favorite Healthcare Staffing
Overland Park, KS
11.2013 - Current
- Duties include psychosocial assessment, medication administration, managing groups, interacting with interdisciplinary teams when necessary to meet the patient's needs
- Completing concurrent reviews and prior authorization reviews using Milliman guidelines
- Review of medical documents to abstract data for certain measures related to HEDIS
- Inbound and outbound calls to patients with multiple sclerosis (MS), referring patients to community resources when necessary.
- Ensured compliance with standards of professional practice as well as state and federal regulations related to health care delivery services.
Registered Nurse, Quality Director
Carondelet Place/Ascension Living
Kansas City, MO
06.2020 - 11.2020
- Performed daily rounds with primary care providers and other medical team members
- Performed patient assessments and managed nursing care coordination
- Developed and implemented infection control plans, performance improvement plans
- Focused on infection control, new employee training, in-services, and overall general operation of the nursing home.
Registered Nurse, Nurse Case Manager
Landmark Health
Overland Park, KS
11.2018 - 01.2020
- Collaborate with interdisciplinary teams to ensure quality of care for the member
- Telephonic evaluation of patients to determine the appropriate level of care
- Monthly telephonic outreach calls to high acuity patients, completing assessments and creating care plans
- Maintain consistent communication with community providers to ensure continuity of care
- Follow up within three days of discharge from a facility to ensure discharge needs are met and member understands discharge instructions.
Concurrent Review Nurse
Centene/Sunflower Health Plan
Lenexa, KS
04.2016 - 11.2018
- Review medical charts for members admitted inpatient to acute medical care, acute rehab, and skilled nursing facilities for medical necessity
- Utilize Interqual to ensure medical necessity is met and quality standards are adhered to
- Work closely with medical advisors, case management, and other departments to ensure members' needs are met and they are at the right level of care.
LPN/RN/Case Manager
Kindred healthCare LLC
Kansas City, MO
06.2016 - 11.2013
- Float nurse responsible for medication administration, total patient care, wound care, and trach care
- Case manager RN carrying a caseload of patients
- Utilize Interqual to ensure patient meets medical necessity for appropriate level of care
- Work with Medicaid, Medicare, and privately insured patients to assist with collaboration of care
- Work as a discharge planner and collaborate with an interdisciplinary team.
Education
Associate Degree in Nursing -
National American University
11.2011
Licensed Practical Nursing -
Concorde Career Institute
01.2003
Skills
My skill set includes the following; HEDIS, Nursing, Medication Administration, Case Management, Medical Records review, Utilization review, discharge planning, infection prevention, quality management, office management and psychiatric nursing
Certification
- Missouri, Registered Nurse, 04/2025
- Kansas, Registered Nurse, 02/2026
Timeline
Registered Nurse, Quality Director
Carondelet Place/Ascension Living
06.2020 - 11.2020
Registered Nurse, Nurse Case Manager
Landmark Health
11.2018 - 01.2020
LPN/RN/Case Manager
Kindred healthCare LLC
06.2016 - 11.2013
Concurrent Review Nurse
Centene/Sunflower Health Plan
04.2016 - 11.2018
Registered Nurse
Favorite Healthcare Staffing
11.2013 - Current
Associate Degree in Nursing -
National American University
Licensed Practical Nursing -
Concorde Career Institute
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