Amy Charles
Saxonburg,PA
Summary
Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Overview
13
13
years of professional experience
Work History
Utilization Review Nurse
Cigna
03.2018 - Current
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing in a remote setting.
- Strong knowledge in ICD, CPT and HCPCS coding.
- Proficient in Learning Management Systems (LMS)
- Experienced with health care technology such as EMR and coding software
- Independent and self sufficient in current remote position
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services
- Adaptable and proficient in learning new concepts quickly and efficiently.
Senior Professional Staff Nurse
UPMC Passavant Emergency Department
05.2013 - 03.2018
- Contributed to quality improvement initiatives by conducting thorough audits of nursing practices to identify areas for enhancement.
- SANE trained and initiated a department wide training to ensure efficiency, along with organized training materials to provide exceptional care
- Participated in committee work focused on improving patient care outcomes across the organization through research-driven approaches and innovative solutions.
- Led process improvement efforts within the department aimed at enhancing workflow efficiency without compromising patient safety or quality of care.
- Facilitated the onboarding process for new hires, expediting their integration into the nursing unit and enhancing their clinical competencies.
- Precepted student nurses and oriented new hires, providing guidance and mentorship when teaching on hospital policies, emergency procedures, and nursing best practices.
- Championed a positive work environment by modeling professionalism, empathy, and respect in all interactions with colleagues and patients.
- Acted as a liaison between management and nursing staff, advocating for resources needed to maintain high-quality patient care services.
- Supported optimal patient outcomes by sharing best practices and up-to-date clinical knowledge with colleagues.
- Enhanced patient care by providing specialized clinical instruction and guidance to nursing staff.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Participated in quality improvement initiatives within the emergency department, contributing ideas for process enhancements based on clinical experiences and patient feedback.
- Mentored new nursing staff in emergency room procedures and techniques, promoting team cohesion and a supportive learning atmosphere.
- Leveraged feedback and process improvement opportunities to create safer and healthier environment and increase patient satisfaction.
- Implemented Rapid Response Kit and conducted one on one training to improve patient mortality.
Professional Staff Nurse
UPMC Mercy Spinal Cord Injury Rehabilitation
07.2011 - 05.2013
- Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
- Streamlined communication between patients, families, and healthcare providers to ensure comprehensive understanding of care plans.
- Educated patients and families on diagnosis, neurological conditions and processes, treatments and expected outcomes.
- Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Self-motivated, with a strong sense of personal responsibility.
- Passionate about learning and committed to continual improvement.
- Proven ability to learn quickly and adapt to new situations.
Education
Associate of Science - Nursing
Community College of Allegheny County
Pittsburgh, PA06.2011
Skills
- Utilization Management
- Milliman Guidelines
- Continuous Improvement
- Time management abilities
- Interpersonal Communication
- Analytical Thinking
- Delegation and Motivation
- Adaptability and Flexibility
- Organizational Skills
- Team Collaboration
- Strong Clinical Judgment
- Healthcare regulations
Accomplishments
- Supervision - Headed onboarding process for new nursing staff.
- Collaborated with team of 3 in the development of Sexual Assault Nurse Examination (SANE) initiative to educate staff and gather training materials to accommodate different learning styles.
- Instrumental in developing and introducing curriculum for end of life care, and organizing all mandatory procedures with a checklist to ensure accuracy,
- Experienced in Word, Excel, and Powerpoint
Timeline
Utilization Review Nurse
Cigna
03.2018 - Current
Senior Professional Staff Nurse
UPMC Passavant Emergency Department
05.2013 - 03.2018
Professional Staff Nurse
UPMC Mercy Spinal Cord Injury Rehabilitation
07.2011 - 05.2013
Associate of Science - Nursing
Community College of Allegheny County
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