Payton Benson
Texarkana,AR
Summary
Dedicated and compassionate Registered Nurse with progressive career history in direct patient care, prior authorization and care coordination in fast-paced environment. Proven to handle both urgent and elective preservice reviews that are time sensitive. Able to skillfully handle complex prognosis to ensure appropriate care to improve patient outcomes. Consistently developing strong relationships with patients and families through empathetic communication, respectful attitude and excellent customer service. Works well with diverse patient populations and fosters trusting relationships to improve patient understanding of what medical treatments are deemed medically necessary and help to assess potential risks. Efficiently coordinates with healthcare professionals to advance patient care.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Preservice Review RN
United Healthcare Group (UMR)
01.2019 - Current
- Confirm plan effectiveness and coverage for medical necessity reviews of all inpatient & outpatient services that require prior authorization.
- Screen for applicable group nuances for large commercial and government-affiliated plans.
- Review clinical subjective & objective findings to ensure appropriate care is being implemented.
- Collaborate with physicians to assess urgent situations with verbal clinical when patient's clinical status is declining and considered life threatening, if not appropriately treated within 24 hours.
- Ensure guidelines are applied diligently to meet company policy.
- Educate patients, provider, and facility on coverage for medical necessity based on disease process and prognosis.
- Team with Case Management to ensure most efficient medical resources are provided to members.
- Train and expose new hires for prior authorization reviews
- Attend monthly mentor leadership meetings.
- Correlate and organize group projects within UM Department to better our staff, including creation of a Resource OneNote Binder inquiring all case review types.
Neonatal Intensive Care Nurse
Christus St. Michael Health System
06.2017 - 01.2019
- Attended level 3 deliveries of any high risk or preterm pregnancy
- Assessed, evaluated, and cared for neonate and pediatric patients.
- Communicated with family members and loved ones to provide information about patient care, treatments and medical options.
- Administered medications and fluids and checked vital signs on critically ill newborns.
- Collaborated with neonatal practitioners, neonatologist and respiratory therapists on appropriate implementation of patient care
- Followed policies, procedures and hospital regulations for protocol compliance and patient safety.
Newborn Nursery Float
Christus St. Michael Health System
06.2017 - 01.2019
- Attended level 1 deliveries
- Communicated and assisted in coordination of care with neonatologist, neonatal nurse practitioners and respiratory therapists
- Monitored vital signs, intake & output, and performed required labs and glucose monitoring as ordered
- Provided education to family and caregivers upon discharge home
Emergency Room Technician
Christus St. Michael Health System
05.2016 - 05.2017
- Performed phlebotomy and any minor lab intervention as ordered.
- Quickly responded to codes and cardiac monitor alarms.
- Received direction and assignments from physicians and nurses, providing efficient technical support to optimize patient care.
- Responded quickly and calmly to emergency situations, providing life-saving measures when necessary.
Education
Bachelor of Science - Nursing
Southern Arkansas University
Magnolia, AR05.2017
Skills
- Team Coordination
- Adaptable nature
- Ability to work well under pressure
- Outstanding communication skills
- Exceptional problem solving skills
- Effortless time management and data analysis
- Skilled in use of Microsoft office, including Excel, Word and PowerPoint
- Fluent with use of Milliman and InterQual guidelines, in addition to use of various medical record systems
- Familiarity with medical procedures, terminology and medical coding
- Eager to collaborate and participate in growth opportunities
Certification
- American Academy of Pediatrics -Neonatal Resuscitation Program
- American Heart Association- BLS for Healthcare Providers
- FEMA- National Incident Management System Certification
- InterQual Certification
Timeline
Preservice Review RN
United Healthcare Group (UMR)
01.2019 - Current
Neonatal Intensive Care Nurse
Christus St. Michael Health System
06.2017 - 01.2019
Newborn Nursery Float
Christus St. Michael Health System
06.2017 - 01.2019
Emergency Room Technician
Christus St. Michael Health System
05.2016 - 05.2017
Bachelor of Science - Nursing
Southern Arkansas University
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