Ashton Heard
Pikeville
Summary
Organized and dependable Registered Nurse with seven years of diverse experience in direct patient care, staff supervision, clinical review, and utilization management. Skilled at multitasking and utilizing clinical nursing skills to support the coordination, documentation, and communication of medical services and benefit administration determinations.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Utilization Management Nurse
Blue Cross Blue Shield of TN
01.2024 - Current
- Utilized CMS databases and stayed up-to-date on current Medicare guidelines and chapter 7 criteria in order to accurately and proficiently complete utilization reviews.
- Utilized Microsoft Word, Outlook, and Excel daily to stay organized and complete job duties.
- Contributed to team success by consistently meeting productivity goals while maintaining high-quality standards in job performance while working with a team as well as working independently under general instructions from team leaders.
- Increased efficiency in utilization management case documentation by maintaining organized records and utilizing electronic medical record systems to complete authorization reviews.
- Participated in quality improvement initiatives to enhance the overall standard of care within the organization.
Registered Nurse
Centurion Health, Bledsoe Co. Correctional Complex
02.2019 - 12.2023
- Manage nurses in fast-paced environment at state intake correctional facility
- Assist with medical audits for Tennessee Department of Corrections facilities
- Care for over 3,000 inmates housed at Bledsoe County Correctional Complex
- Stabilize patients in acute distress and coordinated transport to appropriate off-site health care facility
- Monitor, record, and report symptoms or changes in patients' condition to medical provider
- Conduct staff meetings to relay general information or to address problems
- Order pharmacy supplies and keep check on inventory levels
Registered Nurse II
Tennessee Department Of Health
08.2021 - 07.2022
- Performed medical coding based off of current ICD-10 standards
- Managed patient care by referring patients to specialists, setting up patient appointments, and following up on referrals to ensure
exceptional service to patient - Performed Covid-19 testing and vaccination per state protocol
- Consulted and coordinated with health care team members to assess and evaluate patient care plans
- Kept accurate records and charts related to medications and treatments according to policies, procedures and physician orders
Registered Nurse, Emergency Department
Children's Hospital At Erlanger
06.2018 - 09.2019
- Achieved optimal patient outcomes by carefully monitoring conditions and delivering comprehensive support
- Intervened and stabilized patients during trauma events
- Resolved or reduced patient symptoms with intramuscular,
intravenous, and oral medicines - Tracked patients during anesthesia and reported on conditions
- Trained new hires and precepted nursing students
- Maintained accurate records and charted consistently in EHR system
- Participated in ongoing training to enhance own job skills and knowledge
Education
Associate of Science - Nursing
Lincoln Memorial University
Harrogate, TN05.2018
Skills
- Electronic Health Records, ie Epic, Citrix, CareAdvance
- Medicare Guideline Knowledge
- CMS Chapter 7 Utilization
- Treatment Planning
- Utilization Management
- Problem Solving
- ICD-10 Coding
- Microsoft Office and Microsoft Excel
- Critical Thinking and Strong Communication
- Quality improvement
- Patient confidentiality
Certification
- Registered Nurse, State of Tennessee, Multistate License #230686
- Basic Life Support Certification, American Heart Association
Timeline
Utilization Management Nurse
Blue Cross Blue Shield of TN
01.2024 - Current
Registered Nurse II
Tennessee Department Of Health
08.2021 - 07.2022
Registered Nurse
Centurion Health, Bledsoe Co. Correctional Complex
02.2019 - 12.2023
Registered Nurse, Emergency Department
Children's Hospital At Erlanger
06.2018 - 09.2019
Associate of Science - Nursing
Lincoln Memorial University
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