Paula Bailey
Ridgeland,MS
Summary
Registered Nurse with 20+ years of nursing experience, including LPN and RN roles, specializing in home health, case management, and remote patient care. Experienced in clinical review, medical necessity assessment , referral coordination, and utilization management. Strong background in wound care, chronic disease management, and interdisciplinary collaboration. Proven ability to manage complex patient cases, coordinate services, and support optimal outcomes in a remote environment. Seeking a remote role in infusion referrals, clinical review, or case management.
Overview
15
15
years of professional experience
Work History
Registered Nurse- Home Health Navigator/RN Case Manager
AccentCare Home Health and Hospice
Flowood
10.2020 - Current
- Conduct comprehensive patient assessments to determine appropriate level of care and service needs.
- Coordinate care across multidisciplinary teams to ensure timely and appropriate interventions.
- Review physician orders, referrals, and documentation to support medical necessity and plan of care.
- Monitor patient progress and adjust care plans based on clinical findings.
- Facilitate care transfusions and ensure continuity of care.
- Educate patients and families on treatment plans, disease management, and available resources.
- Document clinical findings and care coordination activities in EMR systems.
Utilization Review Nurse LPN/ Case Manager
G.V. Sonny Montgomery VA Medical Center
Jackson
08.2018 - 10.2020
- Assisted with or supported authorization processes or coverage determinations.
- Reviewed physician orders and treatment plans for appropriateness.
- Conducted comprehensive reviews of patient medical records to determine medical and appropriate level of care.
- Applied evidence- based guidelines and clinical criteria to support treatment decisions and resource utilization.
- Collaborated with physicians and interdisciplinary teams to develop and adjust patient care plans.
- Provided authorization for skilled nursing facility placements for appropriate levels of care in consultation with primary care provider and RN case manager
- Reviewed health plan participants in acute care facilities daily and communicated with health plan primary care provider and RN case manager to achieve efficient and appropriate discharge planning.
Licensed Practical Nurse- Wound Care/Med-Surg/Hyperbaric Technician
Baptist Medical Center
Jackson, MS
10.2010 - 08.2018
- Provided specialized wound care, including assessment and treatment of complex wounds.
- Assisted in hyperbaric oxygen therapy treatments and patient monitoring.
- Collaborated with interdisciplinary teams to support patient recovery and outcomes.
- Communicated with insurance companies and handled the prior-authorizations.
Education
Associate of Applied Science in Nursing -
Hinds Community College
Jackson, Mississippi12-2024
Certification - Licensed Practical Nurse -
Hinds Community College
Jackson, Mississippi07-1999
References
- Aimee Victor, RN, Director of Home Care Navigation, 601-939-2978, 4905 Lakeland Dr., Flowood, MS
- Dr. Ralph Bell, 601-968-1488, 1225 N State Street # B1, Jackson, MS
Timeline
Registered Nurse- Home Health Navigator/RN Case Manager
AccentCare Home Health and Hospice
10.2020 - Current
Utilization Review Nurse LPN/ Case Manager
G.V. Sonny Montgomery VA Medical Center
08.2018 - 10.2020
Licensed Practical Nurse- Wound Care/Med-Surg/Hyperbaric Technician
Baptist Medical Center
10.2010 - 08.2018
Certification - Licensed Practical Nurse -
Hinds Community College
Associate of Applied Science in Nursing -
Hinds Community College