Summary
Overview
Work History
Education
Skills
Timeline

Tanya Barker

Carencro,LA

Summary

Highly skilled and enthusiastic professional with more than 25 years of experience managing operations in patient-centric medical offices. Diligent nursing professional with demonstrated success in emergency patient care. Agile and responsive to dynamic patient needs and environmental conditions. Team-oriented and reliable with expert healthcare knowledge, clear verbal and written communication skills, and sound clinical judgment.

Overview

15
15
years of professional experience

Work History

Diabetes-Endocrine Healthcare Nurse (PRN)

Oschner Healthcare Systems
09.2023 - Current
  • Quickly building rapport and trust with patients through a compassionate demeanor
  • Efficiently managing processes and workflows to maintain smooth, seamless clinic operations and drive patient satisfaction
  • Prepared patients by assessing conditions, collecting information, and running basic tests
  • Monitored clinic flow by effectively handling scheduled and walk-in patients and prioritized daily tasks
  • Proficient with electronic medical record charting, effective verbal and written communication skills
  • Assisted physicians with exams, treatments, and procedures
  • Monitored vital signs, laboratory results, prescription refills and other health data
  • Provided patient assessments to assigned provider and educated patient on care plans.

Travel Contract Nurse

Healthcare Management-Maxim
11.2022 - 02.2023
  • Travel per diem contracts, COVID immunization nurse
  • Ensured that all documentation was completed in a timely manner and met all standards for accuracy.

Pre-Auth Specialist/ Utilization Management

Carenational Health System
03.2022 - 10.2022
  • Performed concurrent review of acute and sub-acute services, as well as precertification review for all services for Medicare / Medicaid state specific guidelines, benefits, and eligibility, & utilized clinical skills telephonically to provide and facilitate utilization review
  • Performed reviews of services, and determined for medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination
  • Obtained the information necessary to assess a member's clinical condition, identified ongoing clinical care needs and ensured that members receive services in the most optimal setting to effectively meet their needs
  • Responsible for appealing inpatient medical necessity/level of care denials using various applicable criteria such as Milliman (MCG), InterQual, other various denials using clinical based rationale.

Pre-Auth Specialist/ Utilization Management

Wellcare Health Plans
01.2018 - 07.2021
  • Ability to follow and apply all necessary regulatory requirements for assigned market/ LPO network or contracted provider and assist members to get the services that they are medically needing and requesting
  • Reviewed and collected medical information in order to determine the medical necessity of services requested by applying specific medical criteria
  • Ensures that services provided to eligible members are within benefit plan, and appropriate contracted providers are being utilized
  • MDR created for medical director review for EOC/ medically necessity depending on the request
  • Initiated and pipeline direct communication with healthcare providers involved with the care of the member to obtain complete and accurate information
  • Evaluating the necessity and efficiency of services through systematic monitoring of medical necessity and quality while maximizing the appropriate level of care that correlates to the member's benefit plan
  • Identifies appropriate clinical settings/ providers for services being requested and verify in - out network or noncontract providers and attempt to redirect member/provider
  • Identifies and refers cases appropriate for case management or social work assistance when is appropriate and member needing further assistance.

Assessment Nurse/Staffing Coordinator

Houston Metro Urology Surgical Center
09.2015 - 01.2018
  • Reviewing applicants' resume and research the best candidates based on the explicit need of the employer
  • Placing and assigning employees at clinics, hospitals, and other medical facilities to assigned managers
  • Communicating efficiently with employers and employees ensuring the needs of both are met in a timely and effective manner
  • Performing background checks on potential employees, as well as checking upon given references, transcripts, and credentials
  • Negotiating salary, problem-solving, and counseling, therein establishing a rapport with the job candidate.

Clinic Lead/Staffing Manager

Kelsey-Seybold Clinic
11.2013 - 06.2015
  • Coordinated the recruitment process and recommended nurses and providers for clinic site, managing the onboarding and new hire process
  • Monitored and assisted with clinic flow, followed up on provider recommendations and patient complaints, and ensured satisfactory rates
  • Conducted orientation and training of new staff, supporting and mentoring staff during the initial orientation
  • Developed and maintained relationships with potential job candidates
  • Developed and maintained relationships with office front desk staff, providers, and clinical staff members
  • Identified and filled temporary, contract, and permanent staffing needs for clients
  • Conducted interviews to evaluate applicants' qualifications and skills.

Charge Floor Nurse

Cambridge Psychiatric Hospital
04.2013 - 09.2013
  • Provided nursing care for patients all ages with mental illness and substance abuse issues
  • Preformed medication and psychological therapy groups
  • Collaborated with physicians, charge nurse, and social workers regarding patient progress/compliance
  • Monitored patients and follow up progress on their care plan during treatment
  • Assisted with Infection Control Program/ preform surveillance rounds on units
  • Utilization review to facilitate authorization for patients seeking inpatient mental health services
  • Maintain the monthly schedules for the mental health techs and nurses rotation and day off requests.

Diabetes/Endocrine Clinic Nurse

Texas Children's Hospital
05.2010 - 03.2013
  • Assisted pediatric patients and families with health maintenance activities, and to understand factors contributing to diabetes/endocrinology
  • Review Prior Authorization Requests to meet Medicare/ Medicaid criteria using nationally recognized evidence based guidelines such as InterQual, MCG and Health plan policy
  • Review requests with Clinical support manager and Medical Director as appropriate
  • Collaborate with RN for members with complex medical conditions
  • Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager Providing medication management and supervision.

Clinic Nurse-PRN

ALLERGY ASTHMA ASSOCIATES
10.2010 - 05.2011
  • Assessment and evaluation upon rooming patients for office visit (vital signs, peak flows)
  • Performed Pulmonary Function breathing test for asthma and respiratory patients
  • Demonstrated to patients use of inhalers, nasal sprays, eye drops and nebulizer treatment
  • Performed allergy skin testing (food, and environmental) and skin patch testing and readings
  • Administered allergy injection (Immunotherapy) and monitoring for allergy reactions
  • Organized and followed-up on prescribed medications and lab work for patient care
  • Triaged sick patient telephone calls to appropriate physician.

Home Health Intake Nurse

SYNERGY Home Health Care
10.2009 - 03.2010
  • Assessed patients for physical and mental status and notify M.D if needed
  • Assisted patient with medication ordering, and monitoring of daily medication administration
  • Provided emotional support to patient/ family and adequate information to help with patient diagnosis/treatment
  • Collected pertinent patient information and data for proper placement on field nurse assignment
  • Assessed patient health status and medical history to formulate a plan of care
  • Provided education to patients on preventative health measures, medications, treatments, and lifestyle changes
  • Conducted physical examinations and performed diagnostic tests such as X-rays or blood draws.

Education

Public Health Administration Associate's Degree -

Saint Christopher College, Carencro, LA
05.2023

Practical Nurse -

Gulf Area Technical College, Abbeville, LA
01.2005

Skills

  • Leadership Skills
  • Ability to Multitask
  • Effective Time Management
  • Critical thinking and problem solving
  • Utilization Management
  • Quality Assurance
  • EMR
  • Patient Care / Case management
  • Microsoft Office, Outlook, Excel, Teams

Timeline

Diabetes-Endocrine Healthcare Nurse (PRN) - Oschner Healthcare Systems
09.2023 - Current
Travel Contract Nurse - Healthcare Management-Maxim
11.2022 - 02.2023
Pre-Auth Specialist/ Utilization Management - Carenational Health System
03.2022 - 10.2022
Pre-Auth Specialist/ Utilization Management - Wellcare Health Plans
01.2018 - 07.2021
Assessment Nurse/Staffing Coordinator - Houston Metro Urology Surgical Center
09.2015 - 01.2018
Clinic Lead/Staffing Manager - Kelsey-Seybold Clinic
11.2013 - 06.2015
Charge Floor Nurse - Cambridge Psychiatric Hospital
04.2013 - 09.2013
Clinic Nurse-PRN - ALLERGY ASTHMA ASSOCIATES
10.2010 - 05.2011
Diabetes/Endocrine Clinic Nurse - Texas Children's Hospital
05.2010 - 03.2013
Home Health Intake Nurse - SYNERGY Home Health Care
10.2009 - 03.2010
Saint Christopher College - Public Health Administration Associate's Degree,
Gulf Area Technical College - Practical Nurse,

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Tanya Barker