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Telehealth Healthcare Claims Examiner

Location:
Osceola, AR
Posted:
January 24, 2022

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Resume:

Mary R Johnson RN

*** **** ****** ***

Osceola, AR 72370

adp0qk@r.postjobfree.com

870-***-****

Highly motivated and goal-oriented Nurse with 27 years Nursing experience; including multiple years of Case Management and Supervisory Experience. An excellent Team worker who maintains professionalism within an interdisciplinary environment through accountability and dependability. Dedicated to providing the highest quality of care through consistent delivery of the best practices. Maintains continuous improvement through ongoing education, and precise organizational skills. A compassionate Patient Advocate who embraces the rewards and challenges of responsible patient care. Authorized to work in the US for any employer

Work Experience

HealthCare Examiner RN Remote

General Dynamics Information Technology - Osceola Arkansas January 2021 – Present

Currently providing support and instruction of COVID-19 and COVID Vaccinations for the residents of the state of North Carolina remotely through phone calls or emails; utilizing good computer skills and excellent communication skills in a team environment. Staying updated on new trends and education through the myLMS portal and Zoom Trainings. Maintaining a good rapport with supervisors through daily communication and accountability; as well as dependability. Assists others with COVID-19 related questions, maintaining good teamwork and collaboration with coworker.

Quality Assurance/Infection Control/Wound Rn

Heritage Square Nursing and Rehabilitation - Blytheville Arkansas November 2020 - January 2021

Responsible for testing employees and patients for COVID-19 with both the Antigen and PCR Methods. Instructed new orientees on infection control precautions. Attended weekly infection control zoom meetings; updated and submitted data to ADH and CDC per their guidelines. Performed daily quality assurance activities to include: med room inspection, daily narcotic reviews, eMAR treatment reviews, and assessment for Hot Rack Charting. Completed all wound care and nail care as ordered per MD. Attended training for the new Ipad documentation; and performed scheduled body audits. Worked closely with MD to assure proper healing and progression of wounds.

Behavioral Health RN

Perimeter Healthcare - West Memphis, AR

May 2017 to Present

Assessing clients (females ages: (10-17) {in a residential setting} physical, psychosocial, spiritual, and environmental status; identifying needs, and performing ongoing assessments and nursing care. Performed med pass. Provided crises stabilization for acute psychiatric symptoms in a safe and structured therapeutic setting. Working closely within a multi- disciplinary team and attending daily Team Meetings with Therapist and Tech supervisor as well as Case Manager.

RN Agency Manager

Absolute Care Management-Osceola Branch - Osceola, AR August 2015 to August 2017

Managed overall day to day operations of the office and activities; completing supervisory visits and reassessments as required by Medicaid guidelines; assuring that all clients were seen as scheduled and satisfied with their services. Performed PCA classes to certify new caregiver trainees to assure they were properly trained and ready to provide appropriate compassionate care for our clients. Provided weekly RN reports to Corporate; and conducted quarterly Caregiver Meetings.

DAAS Waiver RN

Department of Human Services - Blytheville, AR

September 2014 to March 2015

Assessed the physical, psychosocial, and environmental status of clients to determine their need of assistance in the home with personal care, adult companion, respite, and homemaking services. Completed primary care plan and forwarded to organization of Clients Choice to begin services. Managed and observed overall client care; and performed yearly re- assessments. Responsible for maintaining monthly reports and efficient flow of the program’s paperwork.

Prn Behavioral Health RN

WoodRidge Behavioral Care Center Northeast - Osceola, AR May 2014 to February 2015

Assessing clients (females ages 6-17); physical, psychosocial, spiritual, and environmental status; identifying needs, and performing ongoing assessment and nursing care. Performed med pass. Provided crises stabilization for acute psychiatric symptoms in a safe and structured therapeutic setting. Worked closely within a multi-disciplinary team. Mental Health Professional/ Team Leader RN Supervisor Mid-South Health Systems - Blytheville, AR

June 2010 to December 2012

Certified MHP who supervised Mental Health Paraprofessionals with an open-door-policy to promote the over-all best possible, individualized care as Director of Treatment. Maintained a census of 100-200 clients. Responsible for Treatment Plans and Treatment Plan Updates; following strict Medicaid Guidelines. Assisted clients in preparing SOAR documents to obtain Medicaid. Responsible for revising Peer Reviews/ Quality Assurance; and conducting quarterly supervisions, utilizing fairness and accountability. Conducted Individual/ Group Therapy utilizing accurate documentation skills. Attended Carrot Principal Supervisory Meetings; participated in MHP Weekly Meetings; and conducted weekly MHPP Meetings. Responsible for hiring all MHPP's and assisted in other MHP RN hiring process as requested per Coordinator. Performed Screening in times of crisis situations and assisted with hospital placement if necessary.

Weekend Registered Nurse Supervisor

Osceola HealthCare - Osceola, AR

May 2009 to June 2010

Supervised all Nursing duties for long-term care patients within a Nursing Home setting. Reviewed Q&A reports for accuracy. Maintained an open-door-policy to better manage a multidisciplinary team. Performed wound care in absence of wound care nurse. Passed meds in absence of LPN.

Med-Surg/Telemetry/Pediatric/Psychiatric Nurse

Great River Medical Center - Blytheville, AR

July 2008 to May 2009

Provided primary care nursing to a multitude of patients with diverse disease processes. Utilized excellent assessment, and supervisory skills, notifying MD promptly of any significant changes in status. Volunteered and participated in Health Fairs. RN Medicare Billing Specialist

Osceola HealthCare - Osceola, AR

January 2008 to July 2008

Worked independently, adhering to strict Medicare guidelines to provide the highest quality of care while maintaining billing schedules. Contributed to an overall 350% increase in Medicaid eligible patients. Noted as a dedicated team member, setting an example with fresh ideas and good integrity.

Orthopedic/Med Surg Nurse

St Bernards Hospital - Jonesboro, AR

July 2007 to January 2008

Provided compassionate nursing care to a census of 5-7 patients, utilizing excellent teaching, assessment, and hands-on skills. Provided experienced nursing skills through assessment, education, communication, and problem solving while carry out MD orders and maintaining up to date and accurate charting.

Home Health Case Manager/ Team Leader/ Float Nurse Arkansas Department of Health - Ash Flat, AR

August 2001 to July 2004

Delivered a complete range of RN services and expertise including but not limited to: Chemotherapy Administration, Multi-lumen CVL Care, and Wound treatment. Traveled to 3-5 counties on an as needed basis to assist other units. Accurately obtained and documented in- depth physical assessments. Formulated an individual Plan of Care. Created a tickler system to update schedule. Provided physicians with a computer generated 60-day summary of progress, to ensure the best possible individualized care. Contributed to an overall growth of 500% in patient census. Demonstrated service excellence by strengthening public relations; and increased referrals by instructing Public Health Nurses on Medicaid Guidelines for the Mother Infant Program (MIP). Participated in and assisted with the organization of multiple job fairs.

Home Health/Med-Surg/Telemetry/ER Nurse

Cherokee Village, AR

September 1996 to October 2000

Approached by DON and accelerated quickly from Home Health Nurse to RN Case Manager. Managed overall care of patients; assisted/coordinated multiple disciplines. Delegated patient visits among disciplines and performed annual evaluation visits to ensure correct policy and procedures were being incorporated with an ethical approach in patient care. Utilized excellent computer skills: HAMS, Microsoft Windows, and Excel; ICD Coding, preparing 485's and 60-Day Summaries. Frequently traveled to the Pocahontas AR Branch to serve as RN Case Manager. Provided all CPR Training. As Charge ER Nurse, provided primary, quality care to a multitude of patients. Successfully completed ACLS Certification. Received acknowledgement by patients and DON as a compassionate, caring, and efficient Nurse. Worked closely with AIR EVAC in times of extreme emergency.

Education

RN Diploma

Baptist Memorial Hospital School of Nursing - Memphis, TN 1994

Skills

• Case management

• Nursing

• Individual / Group Counseling

• Crisis Intervention

• Group Therapy

• ICD Coding

• Behavioral Health

• Microsoft Word

• Hospital experience

• Microsoft Office

• Time management

• EMR systems

• Home care

Assessments

Management Fit — Highly Proficient

September 2020

Measures the traits that are important for success in management positions. Full results: Highly Proficient

Attention to Detail — Highly Proficient

September 2020

Identifying differences in materials, following instructions, and detecting details among distracting

information.

Full results: Highly Proficient

Patient-Focused Care — Highly Proficient

March 2020

Addressing concerns and using sensitivity when responding to needs and feelings of patients. Full results: Highly Proficient

Nursing Aide Skills — Expert

September 2020

Providing nursing aid to patients using knowledge of relevant equipment and procedures. Full results: Expert

References Available Upon Request



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