New User
@newuser5
Talented Nurse with expertise in case management and holistic care.
What I'm looking for
I am a dedicated Licensed Practical Nurse with extensive experience in various healthcare settings, including long-term care, rehabilitation, and case management. My journey in nursing began with a strong educational foundation, earning my LPN certification in 2011. I have continually sought to expand my knowledge and skills, thriving in environments that challenge me to grow. My military background as an Aircraft Structural Journeyman has instilled in me a strong work ethic and attention to detail, which I carry into my nursing practice.
Throughout my career, I have demonstrated my ability to provide high-quality patient care, whether in staffing agencies or clinical settings. I have honed my skills in IV infusions, holistic care, and geriatric homecare, ensuring that I meet the diverse needs of my patients. My role as an Appeals Nurse has further developed my analytical skills, allowing me to navigate complex medical necessity determinations while advocating for patients. I am passionate about delivering exceptional care and am eager to contribute to a healthcare team that shares my commitment to excellence.
Experience
Work history, roles, and key accomplishments
Licensed Practical Nurse
Gale / Nurse Dash / Amidon
Jun 2023 - Present (2 years)
Worked PRN as a Licensed Practical Nurse for staffing agencies, addressing nursing shortages in various facilities. Adhered to all established policies and procedures.
Licensed Practical Nurse
Nursing and Rehabilitation Center of New Port Richey
Jun 2024 - Present (1 year)
Oriented new patients to a skilled nursing environment and performed comprehensive patient care and administrative duties. Assisted with admissions, discharges, and transfers, while providing individualized patient education.
Appeals Nurse
Centene
Oct 2022 - Present (2 years 8 months)
Facilitated medical necessity appeals and denials, reviewing clinical information against company policies and NCQA guidelines. Prepared case reviews for Medical Directors and generated appeal resolution communications.
Utilization Management / Clinical Reviewer and Post–Acute Care Nurse
CareCentrix
Aug 2019 - Present (5 years 10 months)
Managed utilization and reviewed clinical information for service requests, determining medical necessity approvals or recommending denials. As a Post-Acute Care Nurse, managed length of stay for various facilities and collaborated with key personnel to develop timely discharge plans.
Prior Authorization Nurse
Humana Medicaid
Nov 2018 - Present (6 years 7 months)
Reviewed prior authorization requests for appropriate care settings, following guidelines and policies. Completed medical necessity and level of care reviews, educating providers on utilization and medical management processes.
Infusion Nurse
Utopia Wellness Clinic
Mar 2017 - Present (8 years 3 months)
Provided IV infusion treatments, reconstituted IV bag solutions, and performed wound care. Managed PICC line and port accesses, conducted lab draws, and coordinated care with physicians.
Licensed Practical Nurse
ClinicallRN / Genentech / Quintiles / Avella Specialty Pharm
Oct 2016 - Present (8 years 8 months)
Managed, enrolled, and retained patients for Genentech Biotechnologies and Avella Specialty Pharmacy through a remote call center. Followed up with current patients, contacted new patients, and answered inquiries, while managing patient charts and enrolling them in care programs.
Licensed Practical Nurse
Accountable Healthcare
Jul 2013 - Present (11 years 11 months)
Worked PRN as a Licensed Practical Nurse for a staffing agency, addressing nursing shortages in long-term care, rehab, and psychiatric facilities. Adhered to all facility and agency policies and procedures.
Licensed Practical Nurse
Credentia
Jul 2013 - Present (11 years 11 months)
Provided PRN nursing services for HPH Hospice, including homecare crisis care and facility work. Performed patient assessments, administered medications, provided wound care, and educated patients and families on care and the dying process.
Infusion Nurse
Altus Infusion / Suncoast Internal Medicine / Gulfcoast Medi
Jul 2013 - Present (11 years 11 months)
Infused patients with biologics for autoimmune diseases via various access points, including IV, chest port, and PICC line. Conducted lab draws, reviewed labs, and documented patient information in E-Clinicals.
Nurse Case Reviewer / Manager
ERP International & ATC Healthcare / USAR
Mar 2012 - Present (13 years 3 months)
Collaborated with surgeons and medical centers to identify and assess the medically non-ready (MNR) population, coordinating medical options for soldiers. Assisted soldiers with referrals for care and individual medical readiness support.
Infusion Nurse and Case Manager
Bay Area Infectious Disease Associates
Mar 2011 - Present (14 years 3 months)
Performed peripheral IV insertions, infusion treatments, and IM/subcutaneous injections. Managed PICC/port/Midline infusions, provided extensive wound care, and conducted blood draws and lab report analysis.
Restaurant Manager
Arby’s Restaurant Group
Apr 2007 - Present (18 years 2 months)
Managed restaurant operations, including customer service, scheduling, and front/back of house responsibilities. Trained team members, managed inventory, and met budget requirements using the P&L system.
Education
Degrees, certifications, and relevant coursework
Pasco Hernando Community College
Licensed Practical Nurse, Nursing
Completed the Licensed Practical Nurse program, gaining essential skills and knowledge for nursing practice. This certification prepared me for various healthcare settings.
Clinical Solutions I Course
PN Cert Program, Nursing
Participated in the PN Cert Program, enhancing practical nursing skills and theoretical knowledge. This program provided hands-on experience and advanced training.
American Heart Association
BLS Certification, Emergency Medical Services
Obtained BLS Certification from the American Heart Association, demonstrating proficiency in basic life support techniques. This certification is crucial for emergency medical responses.
Air Force Structures Technical School
Structural Journeyman, Aircraft Structures
Completed training at the Air Force Structures Technical School, earning the Structural Journeyman qualification. This involved comprehensive training in aircraft structural maintenance and repair.
Ridgewood High School
High School Diploma, General Studies
Graduated from Ridgewood High School with a High School Diploma. This foundational education prepared me for further academic and professional pursuits.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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