Registered Nurse Manager
Resume:
m *******.*****@*********.*** ● ( ***) *** - **** 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 *******.*****@*********.*** ● ( 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 *******.*****@*********.*** ● ( 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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