Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Tiesha C. Burrows

Utilization Review Nurse
Mesquite,TX

Summary

Hands-on professional proudly offering more than 13 years of expertise in nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight and performance improvement.

Overview

4
4
Certifications
5
5
years of post-secondary education
17
17
years of professional experience

Work History

Remote Concurrent Review Nurse

Wellmed Medical Management
01.2016 - Current
  • Performed admission reviews for medical necessity based upon Interqual/Milliman specification.
  • Submitted cases to Medical Director for criteria failures and helped facilitate resolutions and approvals.
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Supervised and maintained all utilization review documentation through Trucare EMR.
  • Participate in continuing training and education to improve processes.
  • Team Lead for Market Pod-Analyzing quality metrics, auditing documentation for process improvement, onboarding new hires

Post-surgical Nurse

Eminent Medical Center
12.2016 - Current
  • Managed patients recovering from medical or surgical procedures.
  • Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
  • Communicated medical information and discharge instructions to patients and families to reduce return visits.
  • Assessed patients immediately following surgery to identify and resolve potential complications.
  • Connected with patients and families from variety of cultural and economic backgrounds to establish and maintain open communication for improved patient outcomes.
  • Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
  • Explained course of care and medications, including side effects to patients and caregivers in easy-to-understand terms.
  • Provided skilled, timely and level-headed emergency response to critically-ill patients.

Inpatient Nurse

Texas Institute for Surgery
01.2011 - 01.2015
  • Observe and monitor the overnight day surgery patient.
  • Provide discharge teaching on home medications, wound care, dressing changes, etc per surgeon’s instructions, as well as blood pressure, diabetes and cholesterol maintenance and education.
  • Provide appropriate triage and care for emergency room patient-including assessing, stabilizing and transferring the emergent patient to a higher level facility, such as cardiac emergencies, illnesses, post-surgical complications and occasional employee injuries and sicknesses.
  • Acting Charge Nurse and support person for night shift staff and agency personnel.
  • Preceptor for new hires on night shift.

Staff Nurse

Baylor University Medical Center
Dallas, TX
01.2008 - 06.2010
  • Administer medications safely and accurately according to Five Rights.
  • Assist Doctors with bedside procedures.
  • Educate patients and family on disease process and medications.
  • Provide accurate and concise documentation for care provided.
  • Day Shift Representative for Skin and Wound Assessment Team.
  • Floor Representative for Medical Service Line Quality Improvement Committee.
  • Recipient of Service of Excellence Award in 1/2009.
  • Recipient of Service of Excellence Award in 2/2010.

Education

Bachelor of Science - Nursing

The University of Texas At Arlington
08.2002 - 12.2007

Skills

    EMR / EHR

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Certification

BLS- Expires 6/2023

Timeline

Post-surgical Nurse

Eminent Medical Center
12.2016 - Current

Remote Concurrent Review Nurse

Wellmed Medical Management
01.2016 - Current

Inpatient Nurse

Texas Institute for Surgery
01.2011 - 01.2015

Staff Nurse

Baylor University Medical Center
01.2008 - 06.2010

Bachelor of Science - Nursing

The University of Texas At Arlington
08.2002 - 12.2007
Tiesha C. BurrowsUtilization Review Nurse