Oretha Johnson
Lutherville,MD
Overview
18
18
years of professional experience
1
1
Certification
Work History
RN Care Coordinator
HealthCare Access Maryland
Baltimore
02.2018 - Current
- Responsible for providing care coordination and case management services to Baltimore City residents
- Responsible for providing medical assessments to members telephonically and face to face
- Responsible for outreaching, assessing, and assisting members in the coordination of their health care needs and to ensure access to covered Maryland Medicaid services
- Provided education regarding HealthChoice and MCO information and system navigation in addition to linkage to local health department and community services
- Responsible for providing education to Medicaid and Maryland Managed Care Organizations (MCO) beneficiaries about their health benefits and services, and on how to access and utilize these benefits and services
- Provide education to high-risk pregnant and postpartum women and adults with chronic disease about disease processes, medication and effects, health promotion and health prevention
- Assess pregnant member’s risk and eligibility for referrals to Baltimore City’s Home Visiting Programs according to established vulnerability index criteria and guidelines
- Refer members to appropriate resources and linkage to community programs and services
- Refer clients with complex medical or psychosocial needs to their provider, MCO Case Manager, or behavior health community resources
- Responsible for facilitating team meetings with team members to discuss complex cases, best practices, trends, and sharing resources and ideas
- Team Leader responsible for providing guidance, direction, and instruction to team members
- Provide education to team members about best practices, health education, and company updates and goals.
Nurse Assessor (contract)
Quality Home Care LLC
Owings Mills
07.2017 - 07.2018
- Responsible for conducting geriatric assessments for long term care and life Insurance companies to determine member benefit eligibility
- Responsible for providing an objective picture of the insured or applicant’s current health status, and cognitive and functional abilities
- Responsible for documenting my findings and providing the vendor with a complete assessment in a specified time frame.
Volunteer Caseworker for Services to Armed Forces
American Red Cross
Baltimore
02.2017 - 11.2017
- Responsible for coordinating the delivery of emergency communication messages to active-duty military service members
- Responsible for providing emotional support and guidance to military service members and their families during emergencies or crises
- Responsible for following up on cases generated by military service members, military family members, and veterans during emergencies
- Responsible for connecting military service members, their families, and veterans to community resources.
Graduate Practicum
Community College of Baltimore County
Baltimore
10.2013 - 12.2015
- Responsible for working with nursing students in the campus and simulation lab which included, observing, demonstrating, and instructing students on the correct way to perform fundamental nursing skills and procedures
- Participated in planned campus laboratory activity such as role modeling, role playing, simulations, and debriefings
- Responsible for utilizing my clinical experience, knowledge, and expertise as a guide for instructing and providing feedback to student’s performing fundamental nursing procedures
- Responsible for being a clinical resource and guide for the students during their clinical rotations
- Responsible for developing debriefing questions to present to students after each simulation activity
- Prepared and presented lectures related to health problems and concerns of various populations
- Responsible for assisting students in the campus lab during skills practice and skills testing.
Quality Nurse Coordinator
MedStar Family Choice
Baltimore
11.2013 - 03.2014
- Researched, reviewed, investigated, and followed up on quality issues and complaints involving Medstar Family Choice members and practitioners
- Generated a report regarding my findings on quality issues and submitted the report to the medical director for final evaluation and decision
- Performed Pre-HEDIS activities which included audit preparation.
Intermediate Care Unit Registered Nurse
Favorite Staffing
Baltimore
07.2006 - 07.2013
- Utilized the nursing process to provide professional nursing care and treatment to cardiac, renal, diabetic, neurological, medical-surgical, geriatric, and post cardiac catheterization patients
- Provided education and instructions to patients and their families about disease processes, health promotion, health prevention, safety, and medications and their effects
- Participated in interdisciplinary meetings with the healthcare team.
HEDIS Chart Review Nurse
UNIVAL
Ann Arbor, MI
01.2006 - 05.2013
- Responsible for reviewing electronic and paper medical records obtained from healthcare providers offices, clinics, and hospitals accurately and efficiently
- Communicated and provided feedback to the Project Manager and Review Coordinator
- Maintained courtesy and professionalism while communicating with providers, other healthcare workers, clients, and staff members.
Education
MS -
Stevenson University
BSN -
College of Notre Dame of Maryland
Skills
- Proficient in computer skills, typing, ie, Microsoft Windows, Outlook, Excel, Word, PowerPoint, and Internet browsers
- Experience using Milliman or InterQual criteria, utilization review experience and claims auditing
- Quality Improvement
- Compassion and Empathy
- Basic Life Support
- Community Health
- Geriatric Care
Certification
- Faculty Academy & Mentorship Initiative (Intro-FAMI) Course, Salisbury University, 01/2022, 02/2022
- PCCN, 2008
Timeline
RN Care Coordinator
HealthCare Access Maryland
02.2018 - Current
Nurse Assessor (contract)
Quality Home Care LLC
07.2017 - 07.2018
Volunteer Caseworker for Services to Armed Forces
American Red Cross
02.2017 - 11.2017
Quality Nurse Coordinator
MedStar Family Choice
11.2013 - 03.2014
Graduate Practicum
Community College of Baltimore County
10.2013 - 12.2015
Intermediate Care Unit Registered Nurse
Favorite Staffing
07.2006 - 07.2013
HEDIS Chart Review Nurse
UNIVAL
01.2006 - 05.2013
MS -
Stevenson University
BSN -
College of Notre Dame of Maryland
- Faculty Academy & Mentorship Initiative (Intro-FAMI) Course, Salisbury University, 01/2022, 02/2022
- PCCN, 2008
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