Candice Fountain

Reviewed inpatient medical requests to ensure timely and cost-effective care for members. Participated in rounds with the Medical Director, assessing inpatient care appropriateness using evidence-based criteria and guidelines. Served as a subject matter expert (SME) in utilization management.

Triaged inbound expedited prior authorization requests, ensuring compliance with national standards and contractual requirements. Utilized clinical acumen to promote quality and cost-effectiveness of customer care, preparing documentation and performing audits of customer records. Participated in interdepartmental projects and maintained clinical information in multiple health management systems.

Managed complex and catastrophic cases, introducing the CM program to customers and collaborating on assessments, planning, and care coordination. Facilitated evaluation and advocacy for options and services to meet comprehensive health needs. Promoted quality and cost-effective outcomes through effective communication and resource utilization.

Facilitated healthy, sustainable behavioral change by challenging customers to identify their values and transform goals into action. Provided telephonic coaching to empower individuals in their health journeys.

Provided effective remote management of ICU patients, contributing to a 25-30% reduction in hospital mortality for ICU patients. Ensured patient confidentiality by meeting HIPAA regulations and conducted virtual rounds to assess patient conditions, receiving clinical data to maintain patient care. Evaluated, initiated, and coordinated emergency procedures in the Intensive Care Unit.

Provided individualized quality patient care consistent with organizational standards, developing patient care plans in partnership with physicians, interdisciplinary teams, and patient/family. Assumed responsibility and accountability for directly and indirectly implementing the patient's care plan in the Post Anesthesia Care Unit.

Provided comprehensive care before, during, and after interventional exams using advanced imaging modalities such as CT, Angiography, MRI, Ultrasound, and Nuclear Medicine. Monitored patients closely during procedures and administered IV medication for moderate sedation and pain relief.

Provided comprehensive care before, during, and after interventional exams using advanced imaging modalities such as CT, Angiography, MRI, Ultrasound, and Nuclear Medicine. Monitored patients closely during procedures and administered IV medication for moderate sedation and pain relief.

Triaged patients admitted into the Emergency Room, delivering first aid and preparing patients for examination by the emergency room physician. Assisted physicians in assessing patient condition and delivering assigned treatments, including wound care, medication dispensing, and infusions.

Coordinated and provided professional nursing care for assigned patients in the critical/coronary care unit. Evaluated, assessed, and documented the total critical care nursing process, performing standard concepts, practices, and procedures within CCU protocols.

Provided comprehensive and coordinated care to patients known or suspected of having gynecologic cancer. Managed patient care plans and collaborated with medical teams to ensure optimal outcomes.

Provided nursing care to patients in a psychiatric hospital setting. Assisted with patient assessments, medication management, and therapeutic interventions to support mental health recovery.

Graduated with a Bachelor's Degree in Nursing (BSN).

Graduated with an Associate Degree in Nursing (ADN).