Registered Nurse Medical

Harriet James

813-***-**** addlj6@r.postjobfree.com

Professional Profile:

8+ years’ experience as a Registered Nurse

Registered Nurse in the State of Florida #RN9329751

Solid foundation in Inpatient Nursing, Utilization Management Review

Discharge planning, Assessments, Treatment planning and Home health care experience

Knowledgeable of ICD-9 and ICD-10 coding

Medical Software Healthcare Management Systems (Meditech); Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)

Professional Experience:

Cognizant Technology Solutions Tampa, FL 11/2019 to Present

Utilization Management Nurse Reviewer

Review the day to day timely clinical and service authorization review for medical necessity and decision-making.

Review works with health care providers to ensure appropriate approval of plan benefits.

Review clinical information provided to assess medical necessity and the appropriateness of the treatment setting through the application of appropriate policies and criteria (Milliman)

Concurrent review of inpatient services, discharge planning, retrospective review, and special needs facilities (SNF).

Memorial Hospital of Tampa Tampa, FL 05/2015 to 11/2019

Medical/ Surgical Telemetry Nurse (PRN)

Performing assessments, planning, facilitating., making recommendations, and evaluating patients with acute conditions: Handled inpatient adults

Utilization Management Review

Gathering of patient’s information for Meditech documentation

Developing plan of care that included educational and discharge planning interventions

Conduct comprehensive assessments that includes medical, behavioral, pharmaceutical and social needs of patients

Fairway Oaks Center Tampa, FL 07/2012 to 11/2019

Continuous Care Nurse (PRN)

Making outbound calls in a day to family members, doctors and hospices for patient’s medication and conditional changes; Focused on Adults population

Performing chart audit, utilization management and documenting and maintaining chart audit results Conducts case management and serves as a liaison between patients, their families, and healthcare providers such as Medicare and Medicaid

Supervises medical and non-medical staff as well as residents and family and provides education to improve patient outcomes

Utilizes ICD-9 and ICD-10 to create patient codes used to help identify illnesses and treatments for medical billing and insurance purposes

Advanced Home Health Tampa, FL 01/2016 – 12/2017

Field Nurse (PRN)

Performed case management, care advising and conducted comprehensive assessments that includes medical, behavioral, pharmaceutical and social needs of patients

Assigned for the discharge and admission of patients

Manor Care Health and Rehab Tampa, FL 02/2007 to 09/2016

Rehabilitation Nurse/Continuous Care Nurse (Fulltime to PRN)

Provided care to patients after knee and hip surgeries

Administered prescribed medications for the diagnosis, treatment, and prevention of medical illness or condition

Assigned for the discharge and admission of patients

Accurately and promptly implemented physician’s order

Supervised CNAs and non-medical staff

Florida Hospital of Tampa Tampa, FL 01/2010 to 02/2012

Staff Nurse

Provided care for patients on a medical surgical unit; Handled inpatient adults and pediatrics

Admitted and discharged patients

Acquired and recorded patient information

Started and maintained intravenous therapy and blood infusion

Education:

University of South Florida

Bachelor of Science in Nursing

Master of Science in Health Informatics: Anticipated completion date: 12/2020

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