LPN Utilization Review & Care Coordination

Karen Newell

Amite, LA *****

*****.********@*****.*** 985-***-****

Professional Summary

Licensed Practical Nurse (LPN) with over 25 years of progressive experience in home health, care coordination, utilization review, and quality assurance. Proven expertise in clinical documentation audits, chart reviews, and intake coordination. Skilled in managing patient care transitions, collaborating with interdisciplinary teams, and supporting HEDIS and population health programs. Proficient in Epic, HCHB, and Focura with strong organizational and communication skills. Seeking a role in health coaching, utilization review, case management, or HEDIS abstraction.

Core Competencies

• Utilization Review & Documentation Audits

• HEDIS & Quality Measure Compliance

• Care Coordination & Transitional Care

• Health Coaching & Patient Education

• Face-to-Face & Intake Documentation

• Interdisciplinary Communication

• Epic, HCHB, Focura, MS Office

• ICD-10, Medical Terminology

• EMR/EHR Proficiency

Professional Experience

Clinical Manager Assistant / PCMA

Egan Home Health & Hospice / Audubon Home Health – Hammond, LA 2023 – Present

- Conduct chart audits and clinical authorizations for accuracy, completeness, and compliance.

- Support utilization review and quality assurance processes; monitor lab orders and DME tracking.

- Coordinate communication between clinicians, referral sources, and intake staff.

- Ensure proper consents and documentation (e.g., F2F) are completed for reimbursement.

- Liaise with marketing and field staff; assist with orders, lab results, and clinical questions.

- Utilize HCHB, Focura, and Epic systems for documentation and workflow management.

LPN Intake Specialist

Egan Ochsner Home Health – Hammond, LA Sep 2022 – Feb 2023

- Managed new patient intake and verified payer sources; documented in Epic & HCHB.

- Obtained F2F documentation and coordinated initial home health services.

- Educated patients and providers on available services; facilitated care planning with team.

LPN Intake / QA / Scheduler

Excel, Pinnacle, Delta, Modern, Key Home Health – LA 2000 – 2021

- Handled patient referrals, authorization verification, scheduling of clinicians.

- Audited notes for compliance; communicated closely with marketers and clinicians.

- Supported data entry, insurance approvals, and accurate documentation for billing.

Field Nurse (PRN / Full-Time)

Vital Link, Kindred, Healthlink, St. Helena Clinic – LA 1993 – 2018

- Delivered patient education, assessments, wound care, and medication management.

- Collaborated with interdisciplinary teams to support care plans and improve outcomes.

Education

Diploma in Practical Nursing

Florida Parish Technical Institute – Greensburg, LA 1992

Licenses & Certifications

• Licensed Practical Nurse – Compact License

• CPR Certified

• Nurse Licensure Compact (NLC)

Technical Skills

Epic HomeCare HomeBase (HCHB) Focura Microsoft Office (Word, Excel, Outlook) EMR Systems ICD-10 Coding Telehealth Support

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