m ab9wj1@r.postjobfree.com ● ( ***) *** - **** 1

M ARQUITTA BARNES-ALLEN

R N, BSN, LNC, CCM

PROFESSIONAL SUMMARY

R egistered Nurse

S killed nursing professional with 15 plus years of experience in healthcare industry.

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C ost saving focus of Managed Care Plans (Medicare Advantage, Commercial and Administrative

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Only (ASO) employer groups).

R ecent areas of focus include: Telephone Case Management, Utilization Review, Clinical Research

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and Homecare.

S pecial interest in education, conducting interviews, health promotion, preauthorization,

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retrospective and catastrophic reviews.

P roficient in documentation and chart review to ensure accuracy and confidentiality.

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O utstanding interpersonal, communication skills and exceptional accuracy of data collection.

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C REDENTIALS

C ase Manager-Board Certified 2010

L egal Nurse Consultant Certificate 2010

Registered Nurse Compact License 2005

Registered Nurse License (FL, IN, IL) Active

Licensed Practical Nurse 1996-2005

EXPERIENCE

C omplex Case Manager 2 010-Present

C oventry Healthcare, St. Louis, Missouri

U tilization Review Nurse 2 009-2010

C oventry Healthcare Hazelwood, Missouri

S taff Nurse 2 008-2009

B JC Home Care, St. Louis, Missouri

S taff Nurse 2 007-2008

B JC Mental Health, St. Louis, Missouri

R esearch Patient Coordinator 2 005-2007

W ashington Univer sity, S t. Louis, Missouri

S taff Nurse 2 003-2005

S SM Home Care, St. Louis, Missouri

E DUCATION

L egal Nurse Consultant 2 01 0

S t. Louis Community College

B achelors of Science in Nursing 2 007

W ebster University

A ssociates of Science in Nursing 2 005

D eaconess College of Nursing

D iploma of Practical Nursing 1 996

S t. Louis Board of Education

m ab9wj1@r.postjobfree.com ● ( 314) 715 - 4904 2

C omplex Case Manager-Transplant/Clinical trials

● P erform telephonic pre-authorization, concurrent and retrospective review of transplant and clinical trial requests.

● R eview clinical documentation, member eligibility and educate members on their benefits.

● C ommunicate with staff at transplant facility and assist members through transplant process.

● C oordinate denied services with assigned Medical Director.

● P roactive management of chronically ill individuals with the objective of improving quality of health and decreasing

c ost.

● M aintain confidentiality of protected health information.

U tilization Review Nurse-Workers Compensation

● T elephonic U tilization review of w orker compensation related services.

● D etermine medical necessity for each request, applying appropriate medical criteria to first l evel reviews utilizing state

recommended guidelines.

● A pprove medically necessary services to promote quality care.

● A ssist in determination of medically complicated treatment authorization requests.

● R efer cases to physician reviewer when treatment r equest does not meet necessity guidelines.

● R eview, document and communicate all utilization outcomes.

● T riage and assess members or others acting on member’s behalf who request non-routine worker’s compensation care.

S taff Nurse-Home Care/Hospice

● E ducate homebound terminally patients and their families on management of illness and treatment.

● C oordinate individual care with other health professionals and initiate care plan.

● I nitiate medication protocol and adjust as needed under the direction of Hospice Medical Director.

● D evelop and implement individualized plan of care.

● E stablish priority of home health referrals according to patient’s needs.

● E valuate patient’s need for on-going home health need.

● P rovide on-going head to toe assessments and implement Medical Director’s protocol as appropriate.

S taff Nurse-Mental Health

● A ssist patients in identification of behavior requiring inpatient admission.

● E valuate patient's response and modify plan of care accordingly.

● A dminister medications and treatments according to protocol and prioritize nursing actions.

● P rovide professional leadership necessary to develop, implement and evaluate plan of care.

● A ssist physician during electroconvulsive therapy, document procedure outcome and assess treatment status.

● U tilize behavior modification.

● R einforce therapeutic skills necessary for transition in the community.

R esearch Patient Coordinator-Psychiatry

● T rain and supervise staff assigned to work on c linical research projects.

● I dentify, sc reen and enroll study patients; collect various data including basic demographic information, medical history,

blood, urine and consented patients according to protocol.

● P repare and maintain research study related documents .

● C ommunicate with physician and other members of the research team to ensure protocol is followed appropriately.

● T rack, monitor and document patients during outpatient treatment.

● O btain informed consent for participation in clinical trial.

● M anagement of International Air Transport Association (IATA) certification for shipment of dangerous goods.

m ab9wj1@r.postjobfree.com ● ( 314) 715 - 4904 3

S taff Nurse-Home Care

● E ducate homebound patients and their families on management of illness, treatment and ongoing clinical care.

● C oordinate individual care with other health professionals and initiate care plan.

● I nitiate medication protocol and adjust as needed under the direction of Home Care Medical Director.

● D evelop and implement individualized plan of care.

● E stablish priority of home health referrals according to patient’s needs and resources available.

● E valuate patient’s need for on-going home health need.

● P rovide on-going head to toe assessments and implement Medical Director’s protocol as appropriate.

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