Years of professional experience in the nursing field
Terri Francis
Palm Coast,FL
Summary
Currently a Registered Nurse licensed in the State of Florida with Compact Nursing License . Licensed in Nevada also. Previous experience includes working in quality assurance and was a provider representative for a government guided insurance company. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
24
24
Work History
Compliance Nurse Auditor 2
Conviva/Primary Care Organization
05.2022 - Current
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Input data into computer programs and filing systems.
- Communicated effectively with staff.
- Maintained accuracy, completeness, and security for medical records and health information.
- Researched and resolved medical record discrepancies.
- Generated and maintained statistical data related to medical records within CMS and NSQA guidelines.
- Creates and maintained process flows, job aides and created educational Power points.
Utilization Management Nurse 2
Conviva/Primary Care Organization
09.2018 - Current
- Performed admission reviews based for medical necessity based upon inpatient specification
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations
- Strategically planned methods to achieve operational goals and targets
- As member of practice team, collaborated on strategic planning and ensuring that practice operations aligned with organizational mission, vision, and goals
- Performed admission reviews based for medical necessity based upon inpatient specification.
- Performed prior authorization review of services requiring notification.
Case Manager
Flagler Hospital
06.2018 - 10.2018
- Worked with different disciplines to provide cohesive care to patients
- Evaluated treatment plans against individual goals and healthcare standards
- Maintained hospital costs through review of options and standards of care
- Helped patients receive appropriate, high-quality care with reasonable results
- Facilitated on-going assessment of patient/family needs and implementation of interdisciplinary team care plan
- Partnered with team of registered nurses to achieve overall well-being of all patients
RN - Clinical Documentation Specialist
AdventHealth Palm Coast
09.2016 - 05.2018
- Conduct clinically based current and retrospective reviews of inpatient medical records to evaluate clinical documentation of clinical services
- Queries physicians regarding missing, unclear or conflicting health record documentation
- Communicates with coding professionals as needed to ensure accuracy of diagnosis for appropriate DRG assignment
- Collaborates and educates with appropriate staff and physicians to ensure accuracy of health record
- Uncovered discrepancies in health records and contacted physicians to provide further documentation to clarify concerns
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
RN - Charge
Florida Hospital Flagler
02.2015 - 07.2016
- Effectively supervised LPN and CNA for inpatient hospice unit.
- Pharmacological and non-pharmacological management and treatment of various disorders and diseases
- Self-directed with astute judgment skills. High level of personal accountability
- Diagnosed and treated patients with chronic and acute health problems
- Performed comprehensive assessments and direct admissions
- Trained new staff on quality control procedures
- Strong leader for nursing personnel assigned to unit/shift
Staff Nurse, Hospice
Florida Hospital Flagler
04.2008 - 02.2015
- Performed pharmacological and non-pharmacological management and treatment of various disorders and diseases
- Self-directed with astute judgment skills. High level of personal accountability
- Provided for end of life care directly with patients and family members
- Administered medications, tracked dosages and documented patient conditions
Staff Nurse
Florida Hospital Flagler - Medical/Surgical Unit
09.2000 - 02.2008
- Chronic and acute patient care in med-surgical unit, adeptly handling all aspects of treatment from medication to wound care and monitoring for number patients per shift
- Primary care, assessment and evaluation of post operative patients
- Pharmacological and non-pharmacological management and treatment of various disorders and diseases
- Assisted with primary care for post-operative patients through discharge
Education
Bachelor of Science - Nursing
Western Governors University
Salt Lake City, UT2017
Associate of Science - Nursing
Daytona State College
Daytona Beach, FL2014
Associate of Arts - General Studies
Daytona State College
Daytona Beach, FL2012
Diploma - Practical Nursing
Daytona State College
Daytona Beach, FL1995
Skills
- Strong clinical judgment
- Preceptor
- High level of autonomy
- Hospice and palliative care experience
- Acute care hospital experience
- Thorough physical assessment and planning of care
- MS Office
- Discharge planning coordination
- Documentation and reporting
- Interpersonal and written communication
- ICD-10-CM using Nuance, Iodine, and 3M
- Cultural Awareness
- Quality improvement
- Healthcare regulations
- Healthcare systems
- Policy adherence
- Utilization review
- Interdisciplinary collaboration
- Records analysis
- Medicare
- Teamwork and collaboration
Affiliations
National League of Nursing
American Nurses Association
Alpha Delta Nu
Timeline
Compliance Nurse Auditor 2
Conviva/Primary Care Organization
05.2022 - Current
Utilization Management Nurse 2
Conviva/Primary Care Organization
09.2018 - Current
Case Manager
Flagler Hospital
06.2018 - 10.2018
RN - Clinical Documentation Specialist
AdventHealth Palm Coast
09.2016 - 05.2018
RN - Charge
Florida Hospital Flagler
02.2015 - 07.2016
Staff Nurse, Hospice
Florida Hospital Flagler
04.2008 - 02.2015
Staff Nurse
Florida Hospital Flagler - Medical/Surgical Unit
09.2000 - 02.2008
Bachelor of Science - Nursing
Western Governors University
Associate of Science - Nursing
Daytona State College
Associate of Arts - General Studies
Daytona State College
Diploma - Practical Nursing
Daytona State College
Similar Profiles
Sara AhmedSara Ahmed
Staff Nurse at Primary Health Care OrganizationStaff Nurse at Primary Health Care Organization
Ruth ThomasRuth Thomas
RN Care Navigator at Conviva Care SolutionsRN Care Navigator at Conviva Care Solutions
Emily HernandezEmily Hernandez
Referral Coordinator/UM Administration Coordinator at Conviva Care CenterReferral Coordinator/UM Administration Coordinator at Conviva Care Center
Nelson Ferreira Jr.Nelson Ferreira Jr.
Heavy Equipment Operator at P&S Paving Inc.Heavy Equipment Operator at P&S Paving Inc.
Emilio Febres-CorderoEmilio Febres-Cordero
Dishwasher at Marist College Dining ServiceDishwasher at Marist College Dining Service