Home Health Prior Authorization

Cortney Callahan

**** ******* ***** *** * Mount Joy, PA 17552 Phone: 717-***-**** E-Mail: ad8w3o@r.postjobfree.com

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Experience

Capital Blue Cross Harrisburg, PA September. 2019 – Present Prior Authorization Nurse

• Review specialty injectable medical prior authorizations, including biologics, chemotherapy and immunotherapy and other specialty drugs.

• Send cases for services to advisor if criteria not met, Prepare EPR as instructed (outside peer review).

• Collaboration with co-workers and advisors as needed

• Independent research and education as needed.

Aerotek (PA Health and Wellness) Camp Hill, PA May 2019 – July 2019 Prior Authorization Nurse

• Review LTSS and medical cases and determine eligibility using InterQual and InterRAI tools

• Send cases/ requests for services to advisor if criteria not met

• Collaboration with co-workers and advisors as needed

• Charting, sending approval letters to participants and other tasks as assigned Aveanna HomeCare Harrisburg, PA February 2019 – Current Home Health LPN

• Care for pediatric patients in the home setting who are on ventilators, have trachs, peg tubes

• Administer medications both P.O. and via peg tube

• Charting, vital signs

• Follow Plan of Care; communicate as needed to PCP, family, RN case manager and all other tasks as assigned and ordered OSS Health Mechanicsburg, PA August 2018 – February 2019 Clinic LPN

• Room patients, take vital signs, medication reconciliation

• Remain in charge of medication closet, order medications and injections based upon physician’s schedules

• Order pertinent tests, such as MRIs, CT scans, physical therapy

• Triage for physicians while they are seeing patients in the clinic

• Schedule surgeries, as needed

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Omni Home Care Harrisburg, PA February 2018 – June 2018 Home Health LPN

• Make home health nursing visits as scheduled on employee calendar, seeing between 3-5 patients/ day

• Perform medication reconciliation with each visit

• Obtain labs, INR via finger stick, and other specimens as ordered by physician and drop off in timely manner at appropriate lab location

• Patient disease education, wound care as ordered by physician. Call physician with any abnormal results/ findings.

• Documentation finished and synced within 24 hours of visit

• Communicate with case manager on a daily basis with updates on patients Homeland Home Health Harrisburg, PA September 2016 – February 2018 Home Health LPN

• Make home health nursing visits as scheduled on employee calendar, seeing between 5-7 patients/ day

• Perform medication reconciliation with each visit

• Obtain labs, INR via finger stick, and other specimens as ordered by physician and drop off in timely manner at appropriate lab location

• Patient disease education, wound care as ordered by physician. Call physician with any abnormal results/ findings.

• Documentation finished and synced within 24 hours of visit

• Communicate with case manager on a weekly basis with updates on patients Affilia Home Health Harrisburg, PA June 2015- September 2016 Inpatient Home Health Liaison LPN

• Screen and accept patients appropriate for home health from the acute care setting

• Communicate and act as liason with case managers, social workers, physicians, physician assistants, NPs and other hospital staff

• Meet potential patients

• Obtain homecare orders, input into homecare documentation system as well as other pertinent clinical information

• Coordinate all aspects of home health so that patient has a smooth transition from acute to outpatient setting Colonial Park Care Center Harrisburg, PA July 15, 2014- January, 2015 Licensed Practical Nurse

• Administer medications as ordered by physician

• Documentation of vital signs, changes in residents’ condition, interventions and assessments

• Supervision of nursing aides

• Communication with families as to changes in residents’ medications, doctor’s appointment’s, etc.

• Assist nursing aides as needed

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Education

Hanover Practical Nursing Program Hanover, PA July 1, 2013-July 10, 2014 Lancaster General College of Nursing Lancaster, PA August 2005-May 2008 University of New Hampshire Durham, NH August 1998-May 2000 Skills

While in LPN school, I worked in the clinical setting to establish strong assessment skills, charting and documentation. I have experience with tracheostomies, ventilators, giving medications through peg tubes, putting catheters in both male and female patients, wound changes and wound vacs. I have experience in home health, acute, LTC and the office setting. I am eager to learn and love being challenged on a daily basis. I have a great work ethic and strive to better myself on a daily basis.

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