Registered Nurse Case Management
Resume:
Crystal Johnson, RN BSN
**+Years Registered Nursing Experience
Hammond, LA
**************@****.***
Ambitious registered nurse with 18+ years of experience that includes extensive utilization review, case management, quality management, and corporate compliance with years of hands-on experience in fields such as Acute Rehab, Geriatric Psychiatric, Home Health, Telemetry, Surgical Step Down, Emergency Department, Acute Psychiatric, and Medical/ Surgical bedside nursing experience. I am a Strong believer in team building through professional equality, training, and leadership with proven positive outcomes that affect the overall morale and success of a department which ultimately impacts the entire company. I am Extremely motivated with extensive experience and knowledge of state and federal regulations along with hospital policy and procedures to adequately ensure all such regulations are met with consistency. I am an expert in the processes of chart review, auditing, analysis, action plan initiation, modification, and implementation of such plans with history of successful leadership.
Work Experience
Registered Nurse
Manager of Case Management and Facility Manager
Landmark of Baton Rouge
January 2024 to present
Manager of case management department which includes scheduling, performance reviews, leadership, training, managing patient home and community follow up to ensure continuity of care. Management of entire facility that includes staffing, training, leadership, and performance review of all staff including nursing, CNA, therapy, maintenance, and all other personnel. Work closely with DON and administrator to ensure all state and federal mandates are maintained and keeping patient care at highest regard. Coordinates with physicians, NP’s, and psychiatrists as needed to report any changes in patient status etc.
Registered Nurse
Charge RN Acute Inpatient Psychiatric Unit
Beacon Behavioral Hospital
February 2023 to January 2024
Charge Nurse on Acute inpatient psych hospital unit with management of all unit staff and coordination of care with reporting of patient needs and status to psychiatrist and Medical physician daily to ensure best patient outcomes. Obtained labs, vital signs, and Psychiatric assessment to all patients daily. Coordinated daily group training for patients. Completed staffing assignments, mentorship for nursing and mental health techs as needed. Filled in various roles as needed to ensure adequate staffing and safety on the unit for both patients and personnel. Worked with DON to perform management duties such as peer performance reviews, training, and delivered disciplinary actions as needed. Maintained state and federal mandates to ensure hospital was working within guidelines and coordinated action review plans for the unit and staff as needed.
Registered Nurse Contracts
Toney Healthcare
November 2021-January 2023
ER contract nursing at various facilities. Perform ER nursing that follows MD orders, specific company policies and procedures. Obtains patient and family trust and assurance of care. Updates MD and families along with patients as appropriate. Patient stability upon entrance to the emergency room and maintaining care during physicians work up until patient remains stable enough to be admitted to facility or discharged home with appropriate care that will prevent future emergency room visits.
RN Emergency Room Staff Nurse
Our Lady of the Lake Regional Medical Center - Baton Rouge
June 2021 to October 2021
ER nursing that follows MD orders, organizational policies and procedures. Obtains patient and family trust and assurance of care. Updates MD and families along with patients as appropriate. Stabilization of patients upon entrance to the emergency room and maintaining care during physicians work up until patient is stable enough to be admitted to facility or discharged home with appropriate care that will prevent future emergency room visits.
RN Corporate Compliance Officer
United Medical Rehab Hospital - Hammond, LA
July 2020 to March 2021
Effectively coordinated with Chief Compliance Officer to manage compliance according to CMS guidelines for three facilities. Developed audit tools and performed various audits with development of correction action plans. Developed and updated policies and procedures. Provided teaching and performance review for all disciplines in relation to the rehabilitation hospital.
•Collected and interpreted patient data
•Facilitated the plan of care
•Administered medication and treatments through Point Click Care
•Delivered patient education
•Formulated and evaluated health care plans
•Admitted patients
•Provided nursing care for up to 30 patients per shift
•Worked directly with physicians, pharmacists, therapists, social workers and agency coordinators
RN Field Nurse
Audubon Home Health - Hammond, LA
February 2020 to May 2020
Effectively coordinated with case managers, outpatient intensive programs, medical doctors, psychiatrist, families and patients to ensure overall health of patients in the home setting. Provided in home visits for medical and psychiatric care to ensure safe home living and teaching of medications and diagnosis. Maintained relationships with patients in the community and home health employees to keep patients free from hospitalizations and safe in the home with referrals to physical therapy, occupational therapy and social workers for needs individualized to specific patients.
Field Medical and Psychiatric RN
Apex Home Health
February 2018 to May 2020
Effectively coordinated with case managers, outpatient intensive programs, medical doctors, psychiatrist, families and patients to ensure overall health of patients in the home setting. Provided in home visits for medical and psychiatric care to ensure safe home living and teaching of medications and diagnosis. Maintained relationships with patients in the community and home health employees to keep patients free from hospitalizations and safe in the home with referrals to physical therapy, occupational therapy and social workers for needs individualized to specific patients.
RN AIR and LTAC Post-Acute Utilization Review-Telecommute
UnitedHealth Group
April 2019 to February 2020
Accurately completed post-acute inpatient utilization reviews based on MCG guidelines. Obtained MCG certification. Escalated cases to medical directors according to company policy in instances where services could have been provided at lower levels of care. Actively maintained up-to date knowledge of applicable state and federal laws and regulations. Jumped in to fill gaps for peers when necessary.
RN Surgical Step Down
Ochsner Main Campus
November 2017 to February 2018
November 2017-February 2018
Care of post-surgical patient s/p ICU on the step-down unit with high acuity needs. Provided daily administration of medications, teaching of surgical care and coordinated with surgeons and physicians based on individualized needs. Care of trauma, GI, Head and Neck and various post-surgical needs that required intensive nursing care.
RN Acute Care Utilization Review
UnitedHealth Group
November 2014 to November 2017
Actively completed inpatient utilization reviews based on MCG guidelines. Obtained MCG certification. Escalated according to company policy to medical directors in instances where services could have been provided at lower levels of care. Actively maintained up-to date knowledge of applicable state and federal laws and regulations. Assisted with teammates queues to maintain turnaround times. Coordinated with facilities.
RN Case Manager/Utilization Review
Amerigroup/Wellpoint-Managed Care Organization
March 2012 to November 2014
Completed prior authorizations based on Interquel guidelines and escalation to medical directors for medical necessity. Helped to establish a denial team for the new health plan while working directly with the administrator of clinical services. Completed inpatient utilization reviews. Mentored and trained other nurses for prior authorization and denial processes. Actively maintained up-to date knowledge of applicable state and federal laws and regulations. Sourced and implemented new performance appraisal process. Regularly evaluated employee performance, provided feedback and coached/disciplined staff as needed.
Floor RN/Case Manager/Supervisor
Northlake Support and Services Center
August 2009 to March 2012
Provided direct patient care to citizens with developmental disabilities on the acute unit for two years. Pt with dual diagnosis of mental illnesses and developmental disabilities. Daily tracheostomy care and enteral tube feedings along with coordination of physicians for daily needs. Promoted to case management where I met with physicians and therapy staff to conduct reviews and implement changes to personalized plans of care. Promoted to house supervisor where I actively jumped in to fill gaps for on call rotation when necessary. Regularly evaluated employee performance, provided feedback and coached/ disciplined staff as needed. Monitored the nursing and operation of support departments to ensure that resident's needs were completed and facility was properly maintained. Established and maintained positive relationships with government regulators, residents/family members, other area health care providers, physicians and community at large. Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines.
RN Charge Nurse
Southeast LA State Hospital
August 2008 to August 2009
Actively met with psychiatrist three times a week along with patients and other staff members to incorporate or change daily plans of care. Directed patient care for acute disease processes along with psychiatric diagnosis. Observed strict confidentiality and safeguarded all patient related information. Professional led a care team that consistently and effectively managed care of the psychiatric patient in the
acute care setting with comorbidities. Held group sessions for patients as part of their daily therapy plans. Oversight and management of LPN's and patient care techs on a daily basis. Completed daily rounds of the nursing department to verify that all nursing service personnel were performing their work assignments in accordance with acceptable nursing standards. Evaluated nursing notes to confirm that they accurately and completely described care provided.
Field RN
Pinnacle Home Health
May 2008 to August 2008
Developed patient care plans, including assessments, evaluations and nursing diagnoses. Assisted patients with multiple chronic diagnoses. Ensured efficacy of treatments through monitoring of treatment regimens. Provided treatment within scope of practice as defined by state law. Maintained all confidential files, licensing and CPR compliance records. Liaison between patients and physicians to assist patients
RN Geri-Psych/Telemetry Weekend
North Oaks Medical Center
May 2007 to May 2008
Directed patient care in the telemetry, acute inpatient rehabilitation and Geri-psych departments. Recorded patient medical histories, vital statistics, and test results in medical records. Monitored patient reactions to medications and treatments and carefully documented progress of individuals participating in clinical trials. Acted as patient advocate and implemented total patient care as part of a nursing team covering high acuity patients. Ensured HIPPA compliance. patients about their treatments. Provided diagnosis and treated patients with chronic and acute health problems. Served as a liaison between patients and physicians to assist patients in understanding their treatment plans.
Education
Bachelors Degree of Science in Nursing
Grand Canyon
University
2011
Associate Degree of Science in Nursing
Southwest Mississippi
Community College
2007
Good Samaritan
Baton Rouge, LA
1998
Phlebotomy with 4.0 completion
Skills
•EMR Systems
•Tube Feeding
•Medication Administration
•Hospital Experience
•Critical Care Experience
•Corporate compliance
•Auditing
•Implementation of action plans
•Trending and Analysis
•CMS
•Employee Evaluation
•Epic
•Employee Orientation
•Case Management
•Utilization Review
•Medical Records Auditing
•Patient Care
•Vital Signs
•Acute care
•Veni puncture
•Home Care
•Managed Care
•Quality Assurance
•Microsoft office
•Experience Administering Injections
•ICD-10
•Coordination of care
•Medical Billing
•Compliance Management
•Medical Coding
Awards
… Presidents List
July 2011
Presidents List as a student at Grand Canyon University for completion of bachelor's degree in nursing with overall GPA of 4.0
Certifications and Licenses
Registered Nurse (RN)Compact Licensure
May 2007 to present
Louisiana State Board of Nursing RN118595
BLS Certification
ACLS Certification
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