Perform remote Health Risk Assessments for Medicare patients reviewing current health status, medical history, medications and adherence, social determinants of health and other risks to identify and close care gaps
Connect with patients and teammates utilizing Zoom, Doximity, and Slack
Collaborate with primary care providers and other members of the interdisciplinary team for collaborative patient care
Review and extract pertinent patient health information from Zus Health and Navina data platforms to accurately capture risk and ICD codes per guidelines
Evaluate patient vital signs collected by hybrid team members, escalating to the appropriate level of care when necessary
Educate patients on health promotion, disease prevention, and management of chronic conditions
Document accurately and timely using Elation EMR
Perform peer chart audits reviewing for completeness, accuracy, and supporting documentation
Family Nurse Practitioner
Independent Nurse Contractor
07.2023 - 07.2024
Collaborate with care teams, including insurance carriers (ie Medicare, Medicaid), pharmacies, and specialists to coordinate comprehensive care.
Manage care of a diverse patient population with a variety of diagnoses, clinical complexity, and conditions.
Diagnose and treat patient with chronic and acute medical conditions via in office and telehealth visits, as well as in assisted living facilities.
Document clinical assessments and perform care activities using EHR including Provide, Tebra, Point Click Care, secure video calling.
Educate and promote action for health promotion and disease management.
Maintain strict patient data procedures to comply with HIPPA laws.
Develop and adapt individualized treatment plans according to patient specific goals and needs that encourage health promotion and hospitalization prevention.
Utilize decision making to prescribe medications and order and interpret diagnostic testing.
Billing and coding compliant with insurance requirements.
Comply with and adhere to all professional standards of practice and relevant laws and regulations.
Student Nurse Practitioner
Clinical Rotations
05.2021 - 03.2023
Assistant Director of Nursing
AM Home Health Care
05.2018 - 09.2021
Gather and submit patient information along with personalized care necessity documentation for prior authorization approval from Indiana Medicaid.
Create patient-centered care plans by collaborating with providers, family, and other members of the healthcare team to ensure appropriate goals are developed and met and optimal care is delivered.
Perform preadmission evaluations to determine appropriateness of care needs and service utilization.
Audit and reviewed medical documentation as a quality assurance and patient improvement (QAPI) team member tracking hospitalizations, falls, and infection reports.
Safety, risk assessment, and budget committee participant.
Comfortable with technology and Electronic Medical Record documentation, including Alora Plus health care system, Microsoft Office, secure chat messaging and email.
Policy and procedure development for best practice implementation and state and corporate compliance.
Designed and implemented staff in-service training regarding Covid 19 per CDC guidelines resulting in a decrease in staff and patient Covid cases.
Performed skills competency checkoffs for new hires.
Liaison for patients and collaborated with outside vendors, ancillary staff, and medical providers for coordination of care.
Complete Oasis assessments (including admission, recertification, resumption, and discharge) within the required timeframe.
Fulfilled the role of immediate supervisor for 6 register nurse case managers and over 100 home health aides, by providing education, evaluations, and disciplinary action as needed.
Skilled in the management of acute and chronic medical conditions including COPD, chronic heart failure, diabetes, and renal failure in the home setting.
Registered Nurse
Bethlehem Woods Nursing and Rehab
03.2016 - 09.2018
Data analyzation and review of patient medical records including skin assessments, vital sign and blood glucose logs, and observation and event reports for a 90-bed facility to improve compliance and patient outcomes.
Developed individualized patient care plans with collaboration of providers, family, and other healthcare members with routine review to ensure optimal care delivery.
Maintained facility wound program with assessments and treatment and rounding weekly with the nurse practitioner.
Daily tasks performed utilizing computer programs including Microsoft and Matrix Health Care System.
Monitored for acute changes in patient status, performed assessments, and implemented physician orders while prioritizing multiple daily tasks.
Supervisor for at least two or more licensed nursing staff members at any time, performing duties such as delegating tasks, performance oversight, and coordinating staff assignments for maximum resource utilization.
Registered Nurse
Bowen Center
06.2017 - 05.2018
Answer incoming calls for the outpatient call center, assisting clients with all requests including medication refills, referrals, prior authorizations, medication education, etc.
Clinic nurse in the large outpatient opioid treatment program by initiating medication assisted treatment (MAT) medication as ordered (ie Suboxone, IM Vivitrol) and assessing (ie COWS) and monitoring client status.
Extensive computer documentation experience from regularly updating and entering healthcare information into client’s clinical chart and medication system.
Assistant Director of Nursing
Bethlehem Woods Nursing and Rehab
06.2015 - 03.2016
Staff interviews and participation in the hiring and onboarding process.
Acting supervisor for all nursing staff.
Manage in-house wound care program by assessing, monitoring, and treating skin impairment.
Participate in weekly care plan and nutritional assessment review meetings.
Documentation auditing to ensure state, federal, and corporation policy and procedure compliance.
Deliver bedside patient care as under the scope of a registered nurse.
Assistant Director of Nursing
Sunshine Home Healthcare
08.2014 - 06.2015
Acting supervisor for all R.N. case managers, field staff nurses, and home health aides.
Obtain, monitor status, and submit required documentation for prior authorizations for recipients of Indiana Medicaid services.
Supervisory home care visits with clients and staff ensuring policies and procedures are being followed, as well as ensuring appropriate care is delivered.
Recertification, resumption of care, start of care, and discharge assessments as scheduled in compliance with state regulations.
Skilled nursing visits in the client's home setting, including medication setup and administration, blood glucose monitoring, physical assessments, wound care, injections, bowel programs, etc.
Develop and maintain public relations.
Train and certify new home health aides using skills lab and state testing.
Education
Master of Science in Nursing - MSN
Herzing University
Milwaukee, Wisconsin
04.2023
Associate of Science - Nursing
Breckenridge School of Nursing
Fort Wayne, IN
12.2011
Skills
Ability to work independently, quick learner, ability to multitask, hardworking, detail-oriented, electronic medical records, data abstraction, interdisciplinary communication and coordination, education, management
Certification
Family Nurse Practitioner (FNP-C) – American Academy of Nurse Practitioners Certification Board (AANPCB)
Advanced Practice Prescriptive Authority – Indiana License
Advanced Practice Registered Nurse – GA, IL, IN, OH, NC, CA (pending)
Registered Nurse (RN) – Indiana State Board of Nursing, Compact/Multistate Licensure
Registered Nurse (RN) II (Critical/Intensive Care and stepdown) at Central Arkansas Veterans Health System (CAVHS)Registered Nurse (RN) II (Critical/Intensive Care and stepdown) at Central Arkansas Veterans Health System (CAVHS)