LORITHA JOHNSON

**** **** ****** *****, ******, NC 28112 H: 980-***-**** C: 980-***-**** ac276g@r.postjobfree.com

PROFESSIONAL SUMMARY

Highly skilled Registered Nurse with more than 15 years of experience in medical services industry. Strong

bedside nurse with excellent Managerial Skills. Possess excellent assessment and evaluative capabilities in

high-stress situations. Applies critical thinking and knowledge in clinically appropriate treatment, evidence

based care and medical necessity criteria for appropriate utilization of services. Has excellent patient care

coordination skills and extensive knowledge of medical surgical nursing with specialization in Med-Surg,

Cardiac/Neuro, Dialysis (Peritoneal and Hemodialysis) and Substance Abuse/ Mental Health. As Medical Reviewer

and auditor, possess a superb knowledge of HIPAA, RAC, ZPIC, MIC, Review PREP, CODING/Charging

warnings, and documentation. Excellent use and Understanding of the ASAM Criteria for placement in all

levels of care. Operates Microsoft Word, Excel, Share Point and Outlook.

SKILLS

Communication Analysis

Public Speaking Clarification

Teamwork Evaluation

Time Management Explanation

Leadership Inference

Flexibility Interpretation

Personal Sound Judgement

Objectivity

Problem Solving

Reasoning

WORK HISTORY

Registered Nurse (RN), 08/2017 to 10/2017

Carolinas Continue CARE Hospital at Pineville – Pineville, NC

Utilized the nursing process to assess, plan, implement and evaluate patient care.

Assessed signs and symptoms indicating physiologic and psychosocial changes in the patient's

condition.

Collected, analyzed, and interpreted data and information from health care members and documented

actual and/or potential nursing diagnoses.

Documented the patient's plan of care using identified nursing diagnoses, expected patient outcomes,

and selected nursing interventions.

Performed interventions according to identified priorities, plan of care, and the hospital policies and

patient care outcome standard.

Revised the plan of care according to evaluation, changes in medical plan of care, and

effective/ineffective nursing interventions

Used clinical judgment in evaluation activities to meet patient care needs of an assigned unit/floor

including establishing priorities.

UR Nurse/Clinical Supervisor, 10/2009 to 06/2017

Carolinas HealthCare System Union – Monroe, NC

Analyzed patient records to determine legitimacy of admission, treatment, and length of stay in

health-care facility to comply with government and insurance company reimbursement policies

Obtained Initial Authorization based on medical necessity criteria guidelines.

Determined patient review dates according to established diagnostic criteria.

Reviewed application for patient admission and approved admission or referred case to medical director

for course of action when case fails to meet admission standards.

Monitored inpatient medical records to evaluate care confers with the patient's treatment to determine

legitimacy of treatment and length of stay.

Reviewed treatment plans and status of approvals from insurers.

Abstracted data from records and maintained statistics according to applicable policies and regulations.

Consulted with physician and treatment team as needed.

Implemented the development of an integrated nursing team approach.

Developed education, department competencies, evaluation, performance correction, patient safety and

customer service related issues for the nursing staff.

Assisted nursing and care staff in reaching their full potential at each stage of their professional

development.

Developed and enhanced clinical knowledge, technical skills, clinical decision- making skills,

professional performance standards and inter-personal skills that nursing and care staff use to provide quality

services.

RN Cardiac/Neuro, 09/2010 to 03/2012

Novant Health Hospital – Charlotte, NC

Evaluated and monitored heart devices, such as pacemakers and defibrillators.

Assessed the patient's condition and nursing needs, sets goals, and prescribed appropriate nursing actions

to meet those goals and the physical, psychological, social, and rehabilitative needs of the patient, including

discharge planning.

Assessed, intervened, and reassessed the patient's self-report/symptoms of pain promptly. Utilized an

appropriate tool for assessment and reassessment (0-10 numerical scale, FACES, or the FLACC.).

Demonstrated an understanding of medications with regards to action and side effects.

Reported pertinent information to appropriate individual. Educated patients and significant others about

their medications. Demonstrated the ability to evaluate effectiveness of nursing interventions in

accomplished goals and intended patient care outcomes.

Maintained the standards of nursing care and implemented the policies and procedures of the hospital and

Nursing Dept.

Reported pertinent observations and reactions regarding patients to the appropriate person (i.e.

physicians, head nurse, charge nurse, and/or nursing supervisor) and recorded those observations accurately

and concisely. Provided quality care to patients and work with multi-disciplinary team to ensure

the highest patient satisfaction.

Med-Surg/Oncology RN, 02/2008 to 02/2010

Novant Health Matthews Medical Center – Matthews, NC

Administered patient care through the nursing process of assessment, planning, and evaluation.

Documented daily care such as vital signs, changes in status, continence issues diets and even visitors in

the patient's charts. Provided treatments, medication administration, patient and family education, IV

administration, wound care and patient support.

Managed high dose narcotic administration and provided end-of-life care and support for dying patients

and families.

Prepared and delivered chemotherapy and biological therapies to oncology patients. Administered patient

care through the nursing process of assessment, planning, and evaluation.

Served as patient and family advocate and educator.

Maintained meticulous records as to medication and treatment administration to ensure continuity of care

between nursing staff, physicians and other treatment team members.

Evaluated patient assessments and responses to interventions and takes appropriate action according to

established standards. Established and evaluated progress toward mutual goals and measurable outcomes

with patients and families.

RN/Home Hemodialysis and Peritoneal Dialysis Instructor, 09/2007 to 02/2008

DaVita Charlotte Dialysis – Charlotte, NC

Responsible for home dialysis program development;

Collected, analyzed and recorded relevant patient health data accurately; Analyzed assessment data to

identify patient problems;

Developed plans of care that described interventions to attain expected outcomes;

Implemented and recorded interventions to attain expected outcomes in EMR;

Evaluated patient progress toward attainment of identified goals;

Adhered to approved, research-based practice standards;

Performed and documented Point of Care(POC) testing and quality control in accordance with

established laboratory policies and procedures;

Provided patient care to CAPD/CCPD and Home Hemodialysis patients in the Home Therapies

program.

Documented care given in the patient's record and maintains a current record of all home dialysis

treatment-related data.

Provided education and training to Home Dialysis patients and their caregivers on how to perform

Peritoneal Dialysis or Home Hemodialysis in the home.

Coordinated the care of the home dialysis patients by following up on consultation referrals, obtaining

records and reports, and reviewing and documenting monthly laboratory results and medication regimes.

Acted as a resource for all medical and nursing staff regarding the care of hospitalized CAPD/CCPD and

Home Hemodialysis patients.

Medical Reviewer II, 01/2007 to 04/2007

Kelly Services, Inc. – Morrisville, NC

Reviewed medical records to determine whether patients met the standards for insurance reimbursement.

Clinical review performed for medical necessity of identified claims.

Documented clinical rationale supporting findings of the review.

Applied clinical judgment to make responsible decisions that promoted appropriate records review and

applications usage while keeping resources available to those most in need.

Excellent understanding of ICD- 9, CPT and HCPCS codes and their application in the US Health

insurance domain.

Reviewed and validated all information pertaining to the claim. Complied with procedures, regulations,

and rules in maintaining medical records.

Interacted on a continuous basis with other departments by directing activities towards positive outcomes

Provided appropriate determinations according to policies and regulations.

Developed and maintained documentation for quality improvement processes. Provided expertise

regarding administration, billing, and program regulations.

Conducted research as necessary to complete the review.

EDUCATION

Bachelor of Science: Nursing, 2010

Winston-Salem - Winston-Salem, NC

Associate of Applied Science: Nursing, 2010

Central Piedmont Community College - Central Campus - Charlotte, NC

AFFILIATIONS

American Nurses Association (ANA) Member

CERTIFICATIONS

Registered Nurse in NC, License number 130867, 1993

Basic Life Support (BLS) Certification 2019

Advanced Cardiac Life Support (ACLS) Certification 2019

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