Utilization Review Medical Specialist
Resume:
Andrea HughEs
Conway, SC *****
***********@*****.***
Authorized to work in the US for any employer
Work Experience
LPN Field Nurse, Wound Care Nuse
Liberty Home Care and Hospice - Myrtle Beach, SC
November 2017 to Present
Work as a field nurse performing wound care, urinary catheter insertion/removal and care of, medication management, disease process instruction as well as injections and venipunctures. At times assisted with intake and chart audits as well as utilization review. LPN Staff Nurse
Medustrial Healthcare Staffing - Georgetown, SC
October 2017 to Present
Staff relief in facilities and hospitals, working as a member of their team with all responsibility's of a staff/ floor nurse Did assist with scheduling and discharge planning. LPN Insurance Examiner
Exam One/Quest - Columbia, SC
February 2015 to Present
Field examiner for insurance exams. Collected through health histories, assessments, blood draws, urine and drug screening, EKG's and pulmonary testing. Also work at wellness fairs doing blood pressure, blood sugar and cholesterol screening as well as flu shots. Made my own scheduled and handled all intake and reviews.
LPN Homecare Nurse
Pruitt Home Health - Myrtle Beach, SC
March 2021 to May 2022
Homecare nursing performing medical disease instruction, chronic disease management, medication instruction, wound care, foley catheter management and anything needed in a homecare setting Lpn Head Nurse
Tidelands Health - Murrells Inlt, SC
June 2020 to January 2021
Head nurse to MD in an oncology clinic setting. Performing intake and registration as well as health history of patients. To follow with check out and scheduling labs and any tests needed. EMR. Utilization reviews and audits.
LPN (Licensed Practical Nurse)
Atlantic Urilogy - Conway, SC
August 2019 to April 2020
Urology clinic nurse to MD assisting with procedures, intake and patient care coordination for MD. Chart review and utilization management experience. Set appointments and performed necessary ordering for what patients needed.
Nursing Supervisor/RCC
The Lakes at Litchfield - Pawleys Island, SC
June 2015 to September 2017
Responsibilities
Total care responsibilities of 70 residents to include 25 bed memory unit. Performed intake and utilization review process as well as chart audits. Use of the EMR system and handled all medication management, working closely with Winyah pharmacy. Worked on discharges and education of staff and families. Ordered Equipment and anything necessary for patient. Education
Diploma in nursing education and biology
Niagara University
1983 to 1987
High school diploma
Tonawanda Senior High
1979 to 1983
Nursing Licenses
PN
Expires: April 2024
State: SC
Skills
• CPR certified, IV certified, med med management, extensive wound care management and experience, supervision and management skilks, Certified dementia practitioner. 25 plus years spent furthering education specifically directed at dementia and Alzheimer's disease. As well as working closely with these residents., phlebotomy certified, medication certified with winyah pharmacy, CNA certifed for education and instruction, LPN, Staff Nurse. Proficient with scheduling, utilization review, EMR, and intake. I have worked with Meditech, Cerner, Auria, Homecare Homebase, and Rabbit. To name a few. Linkshttp://***********@*****.*** (10+ years)
• Clinical laboratory experience (10+ years)
• Utilization Management (10+ years)
• EMR Systems (10+ years)
• Nursing (10+ years)
• Medication Administration (10+ years)
• Microsoft Office (10+ years)
• Triage (10+ years)
• Hospice Care (10+ years)
• Experience Administering Injections (10+ years)
• Excel (10+ years)
• Caregiving (10+ years)
• Case Management (10+ years)
• Home health (10+ years)
• Computer literacy (10+ years)
• Respiratory therapy (10+ years)
• Vital Signs
Military Service
Branch: Army Reserve
Rank: E4
March 1982 to December 1993
Was a medical specialist which involved chart review, EKG’s. Chart review and preparing enlisted for their physicals.
Certifications and Licenses
LPN
January 1989 to April 2024
LPN licensure began in NY where I attended Nursing School. Moved to SC and currently practice in SC. BLS/CPR
October 2022 to October 2024
LVN
Assessments
Patient-Focused Care — Expert
March 2020
Addressing concerns and using sensitivity when responding to needs and feelings of patients Full results: Expert
Electronic Health Records: Best Practices — Proficient March 2020
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Proficient
Home Health Aide Skills — Highly Proficient
March 2020
Providing care to patients in a home setting.
Full results: Highly Proficient
Basic Computer Skills: PC — Proficient
June 2020
Performing basic computer operations, navigating a Windows OS, and troubleshooting common computer problems.
Full results: Proficient
Medical Terminology — Proficient
September 2019
Understanding and using medical terminology
Full results: Proficient
Verbal Communication — Highly Proficient
September 2020
Speaking clearly, correctly, and concisely
Full results: Highly Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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