Senita Dismute
Round Rock,TX
Summary
Accomplished Prior Auth Nurse with a proven track record at Accenture for enhancing patient care through expert navigation of the prior authorization process and implementing critical infection control measures.
Overview
25
25
years of professional experience
Work History
Prior Auth Nurse
Accenture
11.2013 - 07.2023
- Remained calm during high-stress, critical situations, demonstrating sustained focus and problem-solving in real-time.
Infection Control Nurse
Pin Oak Management
08.2010 - 11.2013
- Implemented isolation precautions for high-risk patients, minimizing exposure risks to others within the healthcare environment.
- Conducted regular audits of clinical practices related to infection control measures, identifying areas for improvement and providing targeted recommendations.
- Optimized environmental cleaning procedures, resulting in decreased transmission of pathogens within the facility.
- Set clear policies to improve success of infection control measures in departments.
Prior Authorization Nurse
TMHP
06.2007 - 08.2010
- Worked closely with case managers to facilitate appropriate utilization of healthcare resources through the prior authorization process.
- Collaborated with healthcare providers to ensure accurate submission of required documentation for timely authorizations.
- Tracked performance metrics within the department, identifying areas for improvement and implementing targeted interventions as needed.
- Enhanced patient care by assessing insurance coverage and obtaining prior authorization for medical procedures.
- Provided exceptional customer service to both patients and healthcare professionals, addressing concerns related to the prior authorization process.
- Supported organizational initiatives focused on improving patient access to care by providing expert guidance on the prior authorization process.
- Participated in interdisciplinary team meetings, collaborating with other healthcare professionals to ensure seamless coordination of care for patients requiring prior authorizations.
- Assisted in maintaining compliance with changing regulations and policies by staying up-to-date on industry trends and best practices.
WOUND CARE/LVN Floor Nurse
Cornerstone Hospital
08.1998 - 06.2007
- Participated in ongoing professional development opportunities to stay current on best practices in nursing care and maintain licensure requirements.
- Contributed to a safe working environment by following infection control protocols and accurately reporting incidents or concerns.
- Collaborated with physicians to develop customized treatment plans based on thorough assessments of patients'' medical histories, symptoms, and diagnoses.
- Acted as a liaison between patients, families, and healthcare providers to facilitate open communication and ensure all parties were informed of critical care decisions.
- Maintained accurate records of residents' healthcare treatments and responses.
- Delivered treatments and direct nursing care according to physicians' orders in [Type] environment.
- Utilized [Software] to document nursing assessments, treatments, medications and discharge instructions.
- Applied evidence-based practice principles to deliver accurate and effective nursing interventions, enhancing patient outcomes.
- Demonstrated strong clinical judgment when assessing patients, prioritizing needs, and initiating appropriate interventions.
- Communicated effectively with patients and family members to convey important instructions and discuss treatments.
Education
LVN - Nursing
District 189 School of Practical Nursing
East St Louis, IlSkills
- Medication Administration
- Medication and IV administration
- Patient Care
- Direct Patient Care
- Patient Assessment
- Clinical Documentation
- Patient Education
- Clinical judgment
- Wound Management
- Tracheostomy Care
- Ventilator care
- HIPAA protocol adherence
- Patient Assessment and Care
- NG tube insertion
- Policy and procedure compliance
- Gastrostomy tube care
Timeline
Prior Auth Nurse
Accenture
11.2013 - 07.2023
Infection Control Nurse
Pin Oak Management
08.2010 - 11.2013
Prior Authorization Nurse
TMHP
06.2007 - 08.2010
WOUND CARE/LVN Floor Nurse
Cornerstone Hospital
08.1998 - 06.2007
LVN - Nursing
District 189 School of Practical Nursing
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