Gyona Crawford, LPN

***** ****** ***** **.

Farmington Hills, MI 48335

313-***-**** ad1794@r.postjobfree.com

LPN with experience working with developmentally disabled, spinal cord injury, TBI and elderly patients. Extensive experience with pediatric treatment and care. Exceptionally knowledgeable and experienced in medical

offices, urgent care, homecare and other acute settings. Provides quality care, based on the highest standards of professionalism and compassion. Well-rounded in many aspects of medical care and a fast learner.

Professional Experience

Priority Health, Grand Rapids, MI

Utilization Review Nurse (April 2023-present)

This position is responsible for appropriately adjudicating Priority Health Preservice authorizations. Requests include Home Health, Inpatient Elective, Outpatient procedure and Durable medical equipment. Reviews consist of all products and plans priority Health offers. Essential Functions Performs medical necessity reviews for the Priority Health Preservice department. Preservice prior authorization reviews consist of initial reviews, retrospective reviews, oversight of scheduling peer to peers, appeal level 1 and appeal level 2 reviews. These reviews are adjudicated according to Interqual Criteria, Medicare Guidelines, Medical Policy, Plan Documents, etc. Collaborates with Priority Health Medical directors when denial or appeal adjudication is appropriate. Responsible for communicating with provider offices to ensure all appropriate clinical documentation is submitted. Maintains compliance with HIPPA, NCQA and CMS guidelines.

Molina Healthcare, Troy MI

Care Review Clinician, LPN Utilization Management (February 2017-present)

Works with members, providers and multidisciplinary team to assess, facilitate, plan, coordinate and review documentation in order to approve or deny authorization requests. Analyzes clinical service requests from providers against evidence based clinical guidelines and nursing judgment. Identifies appropriate benefits, eligibility and services for requested by providers. Applies knowledge and experience to help in other departments (i.e. Prior Auth, SNF, Case Management, HHC, DME, Physical/Occupational therapy, case coordination, etc.) whenever needed. Proficient using MCG and Interqual.

Evergreen Hospice, Farmington Hills, MI

Hospice Nurse (December 2022-present)

Collaborating on terminally ill patients' care with physicians, social workers, chaplains, nursing assistants, and other stakeholders. Preparing and adjusting patient care plans as needed. Frequently visiting patients to monitor vital signs and physical comfort levels. Performing prescribed treatments and administering pain management medications. Informing physicians about changes in patients' conditions. Providing loved ones and primary caregivers with patient care information, end-of-life education, and emotional support. Maintaining and updating medical charts, patient files, and health records. Notifying attending physicians, hospice staff members, and family members of patients' deaths when they occur. Advising grieving family members on coping techniques, counseling services, and available community resources.

Advantage Health Centers, Warren, MI

Community Health Nurse, Certified HIV Counselor (February 2015-March 2017)

Clinical supervisor for back office, Back office duties including, Assessments, Vitals, Histories, Venipunctures, Vaccine Administration, Completing physical and sports forms, Prescription call-ins, E-prescribing, Using EMR (Electronic Medical Records), Lab Results, Addressing inquiries, Assisting Physicians, and Documentation. Assisting with HEDIS audits. Supervising back office staff and managed the grant funded HIV program. Managed all HIV related events while educating the local community. Established protocols for testing. Monitored and documented all HIV testing with accuracy. Stayed abreast on reporting, surveillance and software for HIV care. Assisted in managing the care of these patients under the direct supervision of Infectious Disease Nurse Practitioner.

Acclaimed Healthcare, Southfield, MI

Licensed Practical Nurse (March 2014-August 2022)

Homecare Assignments, Wound care visits, assignments, Assessments, Vitals, Histories, Development of Nursing Care Plans, Implementing patients’ admissions and discharge process, Report changes in patients’ conditions and other matters of concern, Injections and Venipunctures, Catheterizations (male and female), Wound dressing and management, Feeding assistance, Dispensing of medication, IV therapy, Oxygen therapy, Pulse oximetry, Bladder scanning, Nasopharyngeal and oral suctioning, Tracheotomy care, Vent care, EKG’s, Personal hygiene and Dressing patients, Gait training, Transfers with belt and lifts, Clerical duties, and Supervision of Nursing support staff. Extremely experienced with dementia, TBI and spinal cord injury patients providing quality care with patience and compassion. Experienced in dealing with patients with contact precautions and hazardous exposure.

Centria Healthcare, Novi, MI

Licensed Practical Nurse (March 2012-March 2014)

Homecare and Nursing Home Assignments, Assessments, Vitals, Histories, Development of Nursing Care Plans, Implementing patients’ admissions and discharge process, Report changes in patients’ conditions and other matters of concern, Injections and Venipunctures, Catheterizations (male and female), Wound dressing and management, Feeding assistance, Dispensing of medication, IV therapy, Oxygen therapy, Pulse oximetry, Bladder scanning, Nasopharyngeal and oral suctioning, Tracheotomy care, Vent care, EKG’s, Personal hygiene and Dressing patients, Gait training, Transfers with belt and lifts, Clerical duties, and Supervision of Nursing support staff. Extremely experienced with dementia, TBI and spinal cord injury patients providing quality care with patience and compassion. Experienced in dealing with patients with contact precautions and hazardous exposure.

Education

Currently enrolled in Registered Nurse Program

Certificate of Completion, Licensed Practical Nurse Program, 2011

EVEREST INSTITUTE, Southfield MI

Licenses & Certifications

Michigan Licensed Practical Nurse, 2011

National Technical Honors Society 2001 & 2011

References available upon request