Ella Taylor
Ashland City
Summary
Healthcare professional with substantial experience in utilization review and patient care management. Known for precision in evaluating patient treatment plans and making critical decisions to optimize resource use. Valued team collaborator with focus on achieving impactful results and adapting to dynamic healthcare environments.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse
eviCore healthcare
06.2015 - 06.2025
- 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.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices in utilization review nursing.
- Served as a vital liaison between patients, healthcare providers, and insurance companies, fostering effective communication and coordination among all parties involved in the care process.
- Demonstrated commitment to ethical practice by upholding patient confidentiality and advocating for individual rights in all interactions with stakeholders.
- Performed admission reviews based for medical necessity based upon company and contract specification.
LPN Supervisor
QCHC
03.2014 - 06.2015
- Improved patient outcomes by administering medications, monitoring vital signs, and documenting relevant information.
- Cared for wounds, provided treatments, and assisted with procedures.
- Assisted with admissions, appointments, transfers, and discharges.
- Collaborated with interdisciplinary healthcare teams to ensure continuous quality improvement in patient care delivery.
- Documented accurate and complete patient information to address patient problems and expected outcomes.
- Demonstrated excellent technical skills in wound dressing changes, catheter insertion, and other routine nursing procedures.
- Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
- Facilitated efficient communication between patients, families, and healthcare providers to promote continuity of care across settings.
- Performed routine evaluations of each patient's status, needs, and preferences.
- Adapted quickly to changing patient needs, adjusting care plans accordingly to ensure optimal outcomes in diverse clinical scenarios.
- Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.
LPN Staff Nurse /Certified Surgical Technologist
Vanderbilt University Medical Center
06.2004 - 03.2014
- Various positions, medical office, infusion clinic, operating room
- Setup operating and surgery rooms by preparing equipment and supplies for upcoming procedures.
- Demonstrated adaptability when faced with emergency situations or unexpected complications during surgeries, providing prompt support to surgical teams.
- Anticipated surgeons needs and handed instruments and supplies to surgeons during procedures.
- Assisted surgeons in complex procedures, ensuring efficient completion and minimized complications.
- Expedited surgery room turnover times by swiftly preparing operating rooms for subsequent surgeries, maximizing efficiency within the department.
- Reduced surgery time by effectively anticipating surgeon''s needs and providing timely assistance.
- Enhanced patient safety by maintaining a sterile surgical environment and adhering to strict protocols.
- Gathered and set up equipment, tools, and supplies and arrange instruments according to surgeons' preferences or instruction.
- Ensured proper handling of specimens during surgeries, aiding in accurate diagnostic results for patients.
- Evaluated procedure needs and set up equipment, tools, supplies, and instruments.
- Mentored junior staff members on proper techniques and best practices within the field of surgical technology, promoting professional growth among peers.
- Created unobstructive operative fields by using retractors, sponges, and suction and irrigating equipment.
- Performed accurate instrument counts, preventing potential surgical complications due to retained items.
- Contributed to reduced infection rates by diligently practicing proper sterilization techniques for instruments and equipment.
- Collaborated closely with interdisciplinary teams for optimal patient care throughout the entire perioperative process.
- Delivered exemplary assistance and support to surgeons during general, gynecological, orthopedic, neurological, and plastic surgery procedures.
- Prepared instruments for terminal sterilization and reset surgical suites for next procedure.
- Streamlined workflow by organizing instruments efficiently on the back table according to procedure requirements.
- Used sutures, staples, clips and other tools to close wounds.
- Created safe operating environments for invasive and non-invasive procedures.
- Collected, prepared and disposed of medical specimens.
- Supported colleagues by serving as a resource on surgical technology best practices, fostering a collaborative work environment.
- Introduced new staff members to training protocols regarding operating room procedures, infection control, safety standards, and overall facility policies.
- Expanded knowledge of surgical procedures through continuous professional development, staying current with industry advancements.
- Achieved consistent performance evaluations through dedication to excellence in patient care, teamwork, and adherence to established protocols.
- Maintained high infection control standards.
- Operated, adjusted, and monitored diagnostic equipment and other machines used during procedures.
- Controlled bleeding during procedures by applying hemostatic clamps, suture ligatures and electrocautery equipment.
- Improved team communication through active participation in pre-and post-operative discussions, resulting in better patient outcomes.
- Promoted a culture of continuous improvement by actively participating in department meetings and offering constructive feedback on surgical processes.
- Optimized inventory management processes by routinely assessing supplies levels and promptly ordering necessary items for successful surgeries.
- Managed operating room setup by cleaning and sterilizing instruments and surfaces, maintaining supply inventories, and organizing surgical tools.
- Worked with vendors for speedy procurement of services and equipment.
- Maintained daily workflow, coordinating with operating room staff to prepare for scheduled and emergency cases.
- Supported surgeons during cosmetic surgeries, gynecological and orthopedic procedures and general appointments.
- Maintained specialty equipment, implant, and instrumentation inventories.
- Decontaminated, cleaned, assembled, packaged, sterilized, stored, and distributed reusable surgical instrumentation and equipment.
- Provided comprehensive support to surgeons specializing in sports medicine, total joint replacement, spine, and orthopedic trauma treatment.
- Proved successful working within tight deadlines and a fast-paced environment.
- Passed instruments and supplies to surgical team members to provide surgeons with necessary tools to complete procedures.
- Cleaned and maintained operating equipment to keep resources in good working condition and ready for use.
- Reduced infection risks and protected patients by maintaining sterile fields during procedures.
- Positioned patients and set up drapes to create comfortable surgical environment for patients.
- Obtained patient vital signs and input/output measurements from inpatients.
- Administered controlled narcotics, inserted IVs, and performed catheterizations.
- Managed time-sensitive tasks effectively under pressure while maintaining composure during critical situations or emergencies.
- Comforted and counseled patients and families throughout care process.
- Mentored new nursing staff to enhance professional development opportunities within the team dynamic.
- Educated patients and families on health promotion, disease prevention, and self-care management strategies.
LPN Surgical Stepdown and Post Op Floor Nurse
VA Nashville
09.2001 - 05.2004
- Contributed to cost-saving initiatives within the department without compromising the quality of nursing services provided.
- Implemented best practices in wound care management, reducing healing time for patients with chronic wounds.
- Reduced medication errors by implementing stringent protocols for medication administration and documentation.
- Maintained compliance with regulatory requirements and accreditation standards, ensuring the department consistently met or exceeded expectations.
- Served as an advocate for patients and their families, ensuring their needs were met throughout their healthcare journey.
- Ensured efficiency in nursing services, delegating tasks according to individual skillsets and expertise.
- Streamlined patient admission and discharge processes, minimizing delays and improving overall satisfaction.
Education
Medical billing in Billing and coding
Penn foster
10.2013
Lpn - Nursing
Mingo Career & Technical Center
Delbarton, WV08.2001
GED -
Burch High School
Delbarton, WV03-1998
Skills
- Utilization Management / Review
- Licensed practical nurse
- EMR Systems
- Medical Coding
- Case Management
- Medical Records
- Triage
- Medical Billing
- Medication Administration
- CPT coding
- Medicare
- ICD-10
- Patient monitoring
- ICD-9
- Epic
- Laboratory Experience
- Crisis Intervention
- Patient care
- Computer skills
- Organizational skills
- Time management
- InterQual criteria
- Documentation and reporting
- Utilization review
- Records analysis
- HIPAA compliance
- Insurance verification
- Quality improvement
- Inpatient care
- Medicaid
Certification
- PN
- Expires: March 2023
- LPN
Timeline
Utilization Review Nurse
eviCore healthcare
06.2015 - 06.2025
LPN Supervisor
QCHC
03.2014 - 06.2015
LPN Staff Nurse /Certified Surgical Technologist
Vanderbilt University Medical Center
06.2004 - 03.2014
LPN Surgical Stepdown and Post Op Floor Nurse
VA Nashville
09.2001 - 05.2004
Lpn - Nursing
Mingo Career & Technical Center
Medical billing in Billing and coding
Penn foster
GED -
Burch High School
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