Shannon Taylor, RN, BSN

Transferred into Utilization Review from Nurse Case Manager role.

Responsible for

• Evaluating medical guidelines and benefit coverage to determine appropriateness of services.
• Performed 28 + medical reviews based for medical necessity based upon Interqual Criteria
• Supervising and maintaining all utilization review documentation through Midas.
• Submitting cases to Physician Advisor for criteria failures and help facilitate resolutions and approvals.
• Obtained authorizations from multiple insurance carriers for various levels of care

• Administered over 30 +vaccinations per day via intramuscular injection and completed proper documentation.
• Completed screening questions with patients following CDC guidelines.
• Wore face mask, eye protection, medical gloves, and PAPR.
• Documented patient care accurately and concisely in Cerner.
• Managed situations in compliance with legal requirements and with minimal risk to patient and institution

• Effectively communicated with physicians regarding patient needs, performance, medications and changes on 36 bed oncology unit.
• Completed initial assessments of patients and family to determine and address individual home care needs. ·
• Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
• Effectively communicated with physicians regarding patient needs, performance, medications and changes.
• Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.

• Supervised 8+ nursing staff and managing care on 23-bed unit.
• Served as Stroke Nurse for three years providing care to patients suffering from various neurological disorders.
• Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
• Performed patient assessments and adjusted care plans accordingly.
• Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
• Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
• Monitored patient condition by interpreting and tracking EKG readings, identifying irregular telemetry readings and updating team members on changes in stability or acuity.
• Managed caseload of 5 patients simultaneously by providing bedside care, treatments, IV therapy and wound care.
• Educated patients and families on medical-surgical procedures, therapeutic regimens and pain management techniques.
• Coordinated nursing care on unit through staff assignments, assisting and rounding with physicians, monitoring patient orders, and communicating with ancillary departments

• Managed caseload of 32 adult catastrophic motor vehicle accident patients.
• Collaborated with doctors, physicians, nurses, patients, caregivers, and auto insurance companies for arranging clinical resources and medical care for patients
• Conducted detailed assessments of patient's psychological and medical care needs to identify patients that are suitable for case management intervention on basis of criteria like case complexity, prognosis, etc.
• Helped patients receive appropriate, high-quality care with reasonable results.
• Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
• Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
• Evaluated treatment plans against individual goals and healthcare standards.