Dawn Jaquith
Interim HealthCare
Corry
14
years of professional experience
Dedicated healthcare professional with over 13 years combined in nursing and utilization management. Skilled in quality improvement, interdisciplinary collaboration, and thorough documentation, driving successful outcomes in patient care and compliance.
Work History
Utilization Review Specialist
2 Years 6 Months- Conducted comprehensive reviews of patient treatment plans to ensure compliance with established guidelines.
- Collaborated with healthcare providers to assess the medical necessity of services delivered.
- Developed and maintained accurate documentation for utilization review processes and outcomes.
- Analyzed data trends to identify opportunities for improving patient care efficiency and resource allocation.
- Facilitated communication between clinical teams and insurance representatives for authorization approvals.
- Demonstrated strong analytical skills by interpreting complex medical records and synthesizing relevant information for utilization review purposes.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed admission reviews based for medical necessity based upon ASAM/MCG/Interqual criteria.
Private Duty Registered Nurse
8 Years- Administered comprehensive patient care plans tailored to individual needs.
- Collaborated with multidisciplinary teams to enhance patient outcomes and safety protocols.
- Monitored vital signs and medical conditions, ensuring timely interventions as necessary.
- Educated patients and families on health management strategies and medication adherence.
- Implemented patient-centered approaches, fostering trust and comfort during care delivery.
- Administered prescribed medication and treatment as permitted by state and local regulations in accordance with physician orders.
- Documented patient assessment, evaluation and responses to therapy to facilitate therapeutic intervention.
- Fostered strong relationships with clients and families to support comprehensive social, mental and physical care.
- Assisted patients with activities of daily living such as bathing, dressing, toileting, mobility support while maintaining dignity and independence.
- Provided skilled nursing care for patients with chronic illnesses, injuries, or disabilities in their homes.
- Improved patient outcomes through thorough assessments, appropriate interventions, and comprehensive documentation.
Registered Nurse
7 Years 6 Months- Administered medications and treatments in accordance with established protocols.
- Collaborated with interdisciplinary teams to develop and implement patient care plans.
- Monitored patient vitals, identifying changes and reporting critical conditions promptly.
- Educated patients and families on health management, enhancing understanding of treatment options.
- Mentored junior nursing staff, fostering professional growth and adherence to best practices.
- Implemented process improvements that enhanced patient care delivery efficiency within the unit.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
Education
Bachelor of Science - Nursing
Associate of Science - Nursing
Skills
HIPAA compliance
Quality improvement
Healthcare regulations
Medicare compliance
Utilization management
Milliman care guidelines
Medical necessity criteria
Private insurance policies
InterQual guidelines
Insurance verification
Documentation and reporting
Inpatient care
Outpatient care
Timeline
Utilization Review Specialist
Glenbeigh Hospital
01.2024 - CurrentRead More
Private Duty Registered Nurse
Interim HealthCare
07.2018 - CurrentRead More
Registered Nurse
Corry Memorial Hospital
10.2012 - 04.2020Read More
Chamberlain College of Nursing
Bachelor of Science from Nursing
Read More
Mercyhurst University
Associate of Science from Nursing
Read More