Nurse High School
Resume:
Queonna L Jackson
Email: abo84a@r.postjobfree.com
Address:
City: St. Charles
State: MO
Zip: 63303
Country: USA
Phone: 636-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Professional Objective: Seeking a Registered Professional Nurse position which will enhance my knowledge and skills while providing an opportunity for career and personal growth.
Educational Background:
High School Dipolma from Webster University, Webster Groves MO 1/2001 to 12/2009 (Nursing)
High School Dipolma from Webster University, Webster Groves MO 1/2001 to 10/2012
High School Dipolma from Jewish Hospital College of Nursing and Allied He, Webster Groves MO 1/2001 to 10/2012
High School Dipolma from, Webster Groves MO 1/2001 to 10/2012
Job History / Details:
Professional Summary
Professional Objective: Seeking a Registered Professional Nurse position which will enhance my knowledge and skills while providing an opportunity for career and personal growth.
Licenses
Missouri State Nursing License
Illinois State Nursing License
Professional Experience
March 2009 to Current
Charlevoix Nursing and Rehab Center
Charge Nurse/Night Supervisor PRN
Charge Nurse (Long-term care environment).
Participate in the development and maintenance of orientation programs and materials.
Provide pre- and post-training support to licensed/non-licensed personnel as needed.
Establish effective working relationships with all levels of staff and management team.
Collect blood, tissue and other lab specimans and prepare them for lab testing.
Ensure compliance with State and Federal regulations.
January 2012 to June 2012
Department of Veterans Affairs St. Louis, Mo.
Revenue Utilization Review Nurse
Organize and coordinate the clinical components for the authorization of non-VA services in response to individual health care needs along and care continuum and in multiple settings.
Utilize comprehensive knowledge of advanced clinical practice and case management principles to assess appropriate level of care and to ensure compliance with established Fee authorities and guidelines resulting in approvals and or denials for non-VA care.
Conduct clinical reviews to interpret and evaluate complex data directly related to diagnosis, condition and treatment to assure appropriate medical necessity, care coordination and timely utilization of non0VA health care services.
Function as a team advocate and or facilitator promoting goal directed accomplishments through group interaction and collaboration with both VA and non-VA care providers.
Utilize cost benefit analysis for purchased care requests as applicable.
April 2006 to January 2012
Group Health Plan St. Louis, Mo.
July 2010 to December 2011
Group Health Plan St. Louis, Mo.
Supervisor of Concurrent Review
Disciplined, energetic employee who quickly establishes rapport with patients and colleagues.
Supervised 15 employees, and responsible for the daily supervision of the Concurrent Review department.
Provides oversight and direction to staff members in the area of concurrent review including, staffing, training, monitoring, and evaluating.
Reviews the timeliness, appropriateness, and medical necessity of the utilization processes performed by the staff.
Prepare reports detailing the monitored activities.
Actively participates in the development, implementation, and oversight of the departments activities; serves in an adjunct role for policy and procedure development and implementation.
Assists in the identification of issues which may adversely impact the attainment of department goals/initiatives.
Collaborates with other departments to educate providers/vendors and members regarding network providers/specialists benefits and utilization management policies and procedures.
April 2010 to July 2010
Group Health Plan St. Louis, Mo.
Team Lead-Concurrent Review
Responsible for working the pend and the claim queues using clinical criteria with responsibility for meeting established turnaround times.
Acts as the initial resource for on-site concurrent review coordinators.
Promotes effective and efficient utilization of clinical resources; assists in the identification of issues which may adversely impact the attainment of department goals/initiatives.
Severs in an adjunct role for policy and procedure development and implementation; and assists with identification of departmental performance improvement activities.
Monitors referral status updates/corrections to assure accurate bed days reporting.
Participate in high dollar case review.
Handles fast track inpatient appeals and coordinates with the QIO.
March 2006 to April 2010
Group Health Plan St. Louis, Mo.
Senior Telephonic Concurrent Review Coordinator
Monitors all inpatient care provided to members, in conjunction with and under the supervision of physicians.
Evaluate and provides feedback to treating physicians regarding a member's discharge plan and available covered services, including identifying alternative levels of care that may be covered.
Coordinates, directs, and performs concurrent and retrospective reviews, and monitors level and quality of care.
Coordinates the interdisciplinary approach to supporting continuity of care and identifying covered services, including utilization management, transfer coordination, discharge planning, and issuing all appropriate authorizations for covered services as needed for outside agencies regarding continued care/treatment or hospitalization.
Consults with physicians, health care providers, and outside agencies regarding continued care/treatment or hospitalization.
Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
November 2005 to November 2009
Eldercare of The Valley Florissant, Mo.
Charge Nurse (Longterm care facility) PRN
Administered nursing care to resident's in a longterm care environment.
Performed all tasks with a patient centered focus, while seeking opportunities for improvement of processes and treatments.
Implement the residents treatment plan of care as ordered by the physician and evaluate the response.
Mentor/train clinical and non-clinical staff
Implement floor assignments based on evaluation of staffing requirements.
October 2004 to April 2006
St. Alexius Hospital St. Louis, Mo.
Mental Health Nurse-PRN
Provide acute psychiatric nursing care (on a closed and open unit) to the adult and geriatric populations.
Document patient information obtained from interviews during the admission process.
Ensure compliance with HIPPA laws/regulations.
Accurately document all elements of nursing, assessments, treatments, medications, discharge instructions and follow up care.
February 2003 to August 2005
United Health Care Maryland Heights, Mo.
Nurse Patient Advocacy (RN)
The Patient Advocate Nurse is responsible for the clinical coordination of care and services for members prior to their provision: facilitating access to and coordinating clinical care and services for plan members who require acute care services.
Conduct both telephonic and on site clinical reviews as appropriate to evaluate for delays in care, facilitate discharge planning, arrange for alternative services, assess the quality of care and services, identify admission and readmission risk.
Additional care coordination activities may include coordination of home nursing services, initiation of pre-admission education and discharge planning and prospective review of specific outpatient services.
This position serves as a critical member of the Care Coordination Team, collaborating and communicating with other clinical staff to enhance the quality and efficiency of health care delivery and promote health and well being to plan members.
Reviews daily census and prioritizes daily work in accordance with Care C.
April 2005 to July 2005
United Health Care Maryland Heights, Mo.
Disease Management Case Manager
Placed outbound calls to assess the member's current health status and gain understanding of their chronic condition.
Identify gaps in care or barriers preventing the member from following through with a recommended treatment plan.
Provide education to assist with self- management.
Provide information on network access and identify and implementing interventions and resources that address and close gaps in care.
Worked primarily with members who have Diabetes and Coronary Artery Disease.
August 2001 to November 2002
Select Specialty Hospital St. Louis, Mo.
Longterm Acute Care Nurse (LTAC)
Provide long-term acute care in a hospital setting designed to meet the needs of medically complex, critically ill or catastrophically injured patients.
Able to communicate comfortably with all levels of hospital staff, physicians, patients and family members.
Serves as an educational resource for ancillary staff.
Supervise Licensed Practical Nurses, Certified Nursing Assistants, nursing students and new employees.
Use independent and interdependent judgment, while delivering quality nursing care.
November 1999 to August 2001
Care Partners (A Medicaid HMO) Clayton, Mo.
Senior Pre-Certification Nurse Specialist
Implement and document utilization management activities.
Informed health plan providers of authorization referrals, adverse determinations and appeals rights.
Identify and report Quality improvement issues.
Utilize appropriate nursing judgment and Interqual criteria to provide cost- effective level of care services.
Identify/ implement appropriate CPT/ICD 9 HCPCS coding, render authorization decisions within forty-eight hours of receiving all information necessary with which to conduct the review process.
Identify potential cases for case and disease management state.
Promote the use of network facilities and providers wherever appropriate.
Create non-par rate negotiation letters, pharmaceutical overrides, preauthorize outpatient surgeries and diagnostic testing and all in patient admissions.
Display a working knowledge of all providers contracts.
Provided monthly on-call coverage.
May 1999 to November 1999
Normandy Community Hospital Normandy, Mo.
Registered Nurse (ICU)
Provide critical care to patients in the ICU.
Assessed the patients physiological, emotional and social needs of critically ill patients.
A member of the Rapid Response Team, provided critical care to patients in cardiac/respiratory arrest throughout the hospital and the ER.
Served as a liaison between patients, physicians and family members.
Thoroughly skilled in family dynamics to effectively counsel patients and offer emotional/ spiritual support to the terminally ill and their families.
January 1999 to May 1999
St. Sophia Health and Rehabilitation Center Florissant, Mo.
Charge Nurse (LTC)
Responsible for comprehensive assessments and reviewing of medical history of resident's during the admission process.
Supervised patient care on an Alzheimer's Unit.
Coordinated patient care and other services with the interdisciplinary team.
Contributed to the orientation and professional development of the nursing staff.
Worked closely with Medicare and Medicaid to provide documentation within their guidelines.
November 1994 to January 1999
Deaconess West Hospital Des Peres, Mo.
Patient Care Technician
Provide patient care on a telemetry, medical/surgical, rehab and skilled nursing unit, psychiatric floor and the ICU.
Trained new patient care technicians/nursing students.
Collect vital signs and met the physical needs of hospitalized patients such as activities of daily living.
Education and Training
May 1997 Forest Park Community College St. Louis, Mo.
Associate of Arts Degree
December 2008 Webster University St. Louis, Mo
Bachelor's of Science Nursing
December 1998 Jewish Hospital College of Nursing and Allied He St. Louis, Mo.
Associate of Science Nursing,
Certifications: Basic Life Support, Dysrhythmias Interpretation, Medecision 3.1.1, Interqual Criteria
Additional Information
Proficient in the following computer applications.
Lotus Notes, CERMe, Microsoft Outlook, MS Word, Excel Spread sheets, PowerPoint, Microsoft Windows XP, DART Charting, Faxcom, IDX, CCMS, Amisys, TruCare, FileNet, VISTA, Huron and Care Coordination.
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