Medical Quality Assurance
Resume:
SHANITA NATOYA WILLIAMS- LIC# P******
P.O. BOX **61 BRANDON, MISSISSIPPI 39043
601-***-*********************@*****.***
Objective: To secure a responsible position where I may utilize my
abilities, experiences, and knowledge to succeed at any given job
task.
Qualifications Profile
Dedicated and patient-focused Licensed Practical Nurse with proven
strengths in acute patient care, staff development, and family advocacy.
> Exceptional capacity to multi-task: manage numerous, often competing
priorities with ease and foster the provision of superior patient
care.
> Administrative and referral experience including admissions,
assessment, treatment, referral, and education for a wide range of
patients.
> Widely recognized as an excellent care provider and patient
advocate.
> Demonstrated ability to forge, lead, and motivate outstanding
healthcare teams that provide top-quality patient care.
> Outstanding interpersonal and communication skills; superior
accuracy in patient history, charting, and other documentation.
Key Strengths:
> Sound knowledge of Medicare and Medicaid
> Comprehensive knowledge of medical terminologies, latest medical
treatments, legal terminology and transitional work practices
> Proficiency to analyze and interpret relevant case information and
medical records
> Ability to prepare medical events chronologically in order to
understand patient's medical history
> Multitasking ability without compromising on the quality of work
> Strong management, organizational, critical-thinking and communication
skills
Certifications and Proficiencies
Certifications: Basic life support CPR
Proficiencies: Med/Surg, Geriatric Care, ER, Care plan creation and
administration; NG/Sump & Peg tubes; Patient/family education;
Training and in-services; documentation. Utilization review process,
claim processing/insurance claims, Data entry/Spreadsheet Excel.
Authorize and unauthorized claim processing.
Professional Experience
Compere's Nursing Center Jackson, MS
4/2005(11/2006
CHARGE NURSE, GERIATRIC CARE UNIT, LPN
Serve as charge nurse caring for patients with acute illnesses, including
acute congestive failure, acute myocardial infraction, drug overdose,
massive trauma, respiratory failure, and disseminated intravascular
coagulopathy. Promote health and support patients and families in coping
with illness. Trach Care skilled.
. Provide strong contributions as key member of unit quality assurance
program designed to identify and evaluate problems, manage patient
census, and allocate staff assignments to CNA 's
. Exhibit motivation and dedication by providing the highest quality of
care to each patient
Forest Hill Nursing Center JACKSON, MS 6/2003(12/2008
GERIATRIC NURSE, LPN
Provided care for patients suffering from trauma, acute chest pain,
respiratory failure/complaints, drug overdoses, acute alcohol ingestion,
and gastrointestinal bleeds. Acquired and recorded patient information.
Prepared patients for surgical and radiological procedures.
Implemented and coordinated ongoing staff education program.
. Contributed substantially to successful JCAHO accreditation within the
department.
Hinds County Nursing Health and Rehab, Jackson, MS
2/2003-6/2007
Licensed Practical Nurse
Delivered a complete range of LPN services and expertise. Accurately
obtained and documented patient history and medication lists, assessed
individual conditions and needs, and selected departmental referrals for
acute and chronically ill patients. Prepared equipment and assisted
physicians during patient examinations and treatments. Monitored patient
reactions to drugs and carefully documented progress of individuals
participating in clinical trials.
. Repeatedly commended by patients and supervisors for outstanding
quality of care; received consistent mention in care-survey responses.
. Maintained a high degree of accuracy to achieve optimal patient acuity
monitoring.
. Significantly improved facility's public image by ensuring exceptional
patient satisfaction.
Serenity Place LLC, Pearl, MS
12/2008-Present
Clinical Review Nurse
. Implemented utilization management nursing functions.
Supervised current inpatient service management.
Monitored medical interventions for inpatients.
Provided healthcare benefits to patients via utilization management
nursing services.
Assisted and supported inpatients in obtaining finance and insurance
benefits.
Evaluated inpatient and outpatient services to determine medical
appropriateness.
Gathered and organized medical data to process medical benefits to
patients.
. Clinical care experience in health insurance industry
Deep knowledge of concurrent review, utilization management, and
discharge planning
Sound knowledge of Medicare, Medicaid, and Mill bill Care Guidelines.
Proficient in MS Office suite and health care documentation systems
(EPOCH, Clinical Care Advance, Med Decision)
Strong communication and interpersonal skills.
Superior organization and time management skills.
Outstanding ability to interpret policies and procedures and
communicate effectively.
Remarkable ability to make decisions and exercise good judgment in a
complex environment.
. Maintained medical standards for all clients based on their individual
health benefit plans.
Conducted pre-certification, retrospective, out of network and
appropriateness of treatment setting reviews within scope of
licensure.
Developed relationships to help improve health outcomes for members.
Ensured compliance to rules and regulation established by management.
Documented review information in computer and communicated results to
claims adjusters.
Recorded and reported all information within scope of authority.
Educational Background
High School Diploma (1997)
Brandon High School - Brandon, MS
Hinds Community College Nursing Allied Health (2002-2003)
Practical Nursing Program student
Licensure-P319505
Licensed Practical Nurse (LPN), State of Mississippi and Louisiana (2003)
Continued Education Online Learning (2011)
JACKSON STATE UNIVERSITY-Jackson, MS
BATON ROUGE COMMUNITY COLLEGE-Baton Rouge, LA
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