Lacie Johnson

Served as RN Case Manager in a 328-bed Level I Trauma teaching hospital, coordinating patient care plans to support optimal outcomes. Managed pre-authorization and denials appeals (including peer-to-peers) while handling discharge planning, home health referrals, and HIPAA-compliant documentation.

Provided clinical trial education and ongoing support to healthcare staff to ensure adherence to Good Clinical Practice (GCP) and regulatory requirements. Assessed educational needs, developed tailored training, and evaluated effectiveness through feedback, assessments, and performance metrics.

Served as RN Supervisor/Utilization Reviewer overseeing infection control and critical incident improvements while stabilizing patients and directing next steps in care. Led utilization management, monitored utilization trends, ensured payer/organizational compliance, and managed continuum of care from admission to discharge for highly acute patients.

Worked remotely in Medicare/quality-related utilization review and supported required quality activities for timely, accurate reporting to departmental management. Wrote narrative reports interpreting regulatory specifications and managed documentation for ongoing quality improvement functions.

Provided nursing services across hospitals, home care, hospice, occupational health, and nursing facilities while performing assessments and coordinating care plans with multidisciplinary teams. Managed vital signs and patient documentation, including OSHA 300 log entries, and led occupational preventive care for manufacturing employees.

Performed utilization review and supervisory duties at a 529-bed Level II Trauma teaching facility by evaluating the appropriateness and necessity of requested services and ongoing care needs. Supported patient management through clinical monitoring and documentation, including telemetry/EKG interpretation, medication administration, and specimen handling.

Provided utilization review and supervisory support while managing rehabilitation and recovery goals. Evaluated patient capabilities, directed therapy per physician orders, tracked progress after sessions, and supported patient feedback and goal-setting.

Performed utilization review and led case management, including writing appeals to overturn denials and adding clinical documentation to support appeal success. Coordinated safe discharges through collaboration with payors, facilities, patients, and families while maintaining comprehensive clinical records.

Led COVID response team crisis intervention and follow-up care across LTC, SNF, hospital, home health, hospice, behavioral health, and home care settings. Ensured care plan adherence, maintained confidentiality of health information, and supported execution of healthcare operations across multiple sites.

Conducted quality assurance reviews for utilization and customer interactions by entering required documents into the company CRM and reviewing agent phone/email adherence to scripts and protocols. Monitored QA compliance, resolved non-compliance issues, and educated providers on utilization and medical management processes to improve consistency and customer experience.

Pursuing a Doctor of Nursing Practice (DNP) degree at Walden University.

Earned a Bachelor of Science in Nursing from Christian Brothers University in 2022.

Earned a Master of Science in Healthcare Administration from Belhaven University in 2017.

Completed an Associate of Arts in Psychology/General Studies at Goodman Community College in 2002.

Completed a Licensed Practical Nurse program at Belhaven University in 1996.

Completed a Bachelor of Arts in Liberal Arts/General Studies at the University of Mississippi in 2013.