Jessica Killough
Milton,SP
Summary
Experienced Utilization Review Nurse specializing in conducting comprehensive medical necessity reviews and ensuring compliance with regulatory standards. Proven ability to enhance patient outcomes through critical thinking and effective team collaboration.
Overview
17
17
years of professional experience
Work History
Utilization Review Nurse
Ascension Sacred Heart Hospital
Pensacola, Fl
01.2024 - Current
- Conducted comprehensive medical necessity reviews to ensure compliance with regulatory standards.
- Monitored treatment outcomes and recommended adjustments based on clinical guidelines.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Minimized financial risk associated with denials or payment discrepancies through diligent validation of medical necessity prior to service provision.
RN Staff Nurse/Staff Relief Charge Nurse-Ortho
Ascension Sacred Heart Hospital
Pensacola, Fl
10.2021 - 01.2024
- Administered medications and monitored patient responses to ensure optimal care outcomes.
- Collaborated with interdisciplinary teams to develop and implement individualized care plans.
- Educated patients and families on health management, effectively improving patient understanding and compliance.
- Conducted thorough assessments and documented findings for accurate patient records and treatment planning.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
Clinical Lead Nurse
Cardiology Consults
Baker Fl
04.2021 - 10.2021
- Led nursing team in implementing patient care protocols for optimal cardiovascular health outcomes.
- Streamlined patient intake procedures to improve workflow efficiency within clinical operations.
- Fostered a positive work environment by promoting open communication, teamwork, and mutual respect among nursing staff.
- Promoted patient satisfaction by actively addressing concerns and maintaining open lines of communication between patients, families, and healthcare providers.
- Administered medications and treatments to manage patient's condition.
- Monitored patients, evaluated results, and recommended further courses of treatment to quickly improve patient outcomes.
Lead RN
West Florida Cardiology
Pensacola, FL
09.2019 - 02.2021
- Monitored patient progress, adjusting care plans based on clinical assessments and outcomes.
- Advocated for patients' needs, coordinating with healthcare providers to ensure comprehensive care delivery.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Educated family members and caregivers on patient care instructions.
- Evaluated patient histories, complaints, and current symptoms.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
Staff RN/Observation Unit
West Florida Hospital
Pensacola, FL
03.2019 - 09.2019
- Administered medications and treatments, ensuring compliance with safety protocols and patient care standards.
- Monitored patient vital signs, identifying changes in condition to communicate promptly to medical team.
- Assisted in developing individualized care plans based on patient assessments and healthcare goals.
- Educated patients and families on treatment processes, enhancing understanding and engagement in care plans.
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Achieved timely medication administration by utilizing effective time management skills and prioritizing critical tasks.
Staff RN/ Military Clinic@Camp Pendleton
Saratoga Medical Group
Oceanside, CA
07.2017 - 02.2019
- Administered comprehensive patient care, ensuring adherence to clinical protocols and safety standards.
- Collaborated with interdisciplinary teams to develop individualized care plans for diverse patient populations.
- Mentored junior nursing staff, fostering professional development and enhancing team performance in critical care situations.
- Streamlined medication administration processes, improving accuracy and reducing potential errors in patient treatment.
- Led training sessions on new healthcare technologies, ensuring competency among staff in utilizing advanced medical equipment effectively.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Assessed physical, psychological, physiologic, and cognitive status of patients.
RN Staff Nurse
Neighborhood Healthcare
Escondido, CA
08.2016 - 07.2017
- Administered patient care, including assessments and medication management, ensuring adherence to established protocols.
- Collaborated with interdisciplinary teams to develop personalized care plans for diverse patient populations.
- Educated patients and families on health maintenance and disease prevention, enhancing overall wellness understanding.
- Monitored vital signs and documented changes, providing timely interventions to improve patient outcomes.
- Assisted physicians during medical procedures, ensuring accurate delivery of care as prescribed by the healthcare provider.
- Administered vaccinations and conducted health screenings for early detection of illnesses or diseases among patients.
- Performed triage on incoming patients and determined severity of injuries and illnesses.
Staff RN
West Florida Cardiology
Pensacola, FL
10.2015 - 06.2016
- Administered medications and monitored patient responses to ensure optimal care outcomes.
- Collaborated with interdisciplinary teams to develop and implement individualized care plans.
- Educated patients on chronic disease management and preventative health strategies.
- Assessed patient conditions, documenting changes in health status for accurate treatment adjustments.
- Verified patients had information necessary for ongoing care, providing guidance on diagnoses, management of medications, and prevention methods.
- Identified patient care requirements by establishing personal rapport with patients and families.
LPN Office Nurse
West Florida Cardiology
Pensacola, FL
06.2012 - 06.2014
- Administered medications and monitored patients' vital signs for optimal care outcomes.
- Assisted in patient education regarding treatment plans and health maintenance strategies.
- Coordinated with healthcare team to ensure effective communication and continuity of care.
- Managed electronic health records for accuracy and compliance with regulatory standards.
- Assisted with minor surgical procedures, ensuring proper sterilization techniques and adherence to safety protocols.
- Served as a liaison between patients and healthcare providers, facilitating clear communication regarding treatment plans and expectations.
LPN Office Nurse
Jacksonville Family Clinic
Jacksonville, NC
07.2009 - 03.2010
- Developed strong rapport with patients and their families, fostering trust and open communication during sensitive medical situations.
- Provided health education to patients on various topics such as medication management, disease prevention, and self-care strategies.
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Administered medications and injections to patients.
- Took samples to complete diagnostic and routine assessment tests.
- Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
Education
Bachelor of Science - Nursing
University of West Florida
Pensacola, FL05-2018
Associate of Science - Nursing
Pensacola State College
Pensacola, FL08-2013
Practical Nurse - Vocational Nurse-LPN
Coastal Carolina Community College
Jacksonville, NC05-2009
Skills
- InterQual criteria
- Documentation and reporting
- Utilization review
- Records analysis
- Outpatient care
- Interpersonal and written communication
- Inpatient care
- Student precepting
- Patient transfers and transitions
Timeline
Utilization Review Nurse
Ascension Sacred Heart Hospital
01.2024 - Current
RN Staff Nurse/Staff Relief Charge Nurse-Ortho
Ascension Sacred Heart Hospital
10.2021 - 01.2024
Clinical Lead Nurse
Cardiology Consults
04.2021 - 10.2021
Lead RN
West Florida Cardiology
09.2019 - 02.2021
Staff RN/Observation Unit
West Florida Hospital
03.2019 - 09.2019
Staff RN/ Military Clinic@Camp Pendleton
Saratoga Medical Group
07.2017 - 02.2019
RN Staff Nurse
Neighborhood Healthcare
08.2016 - 07.2017
Staff RN
West Florida Cardiology
10.2015 - 06.2016
LPN Office Nurse
West Florida Cardiology
06.2012 - 06.2014
LPN Office Nurse
Jacksonville Family Clinic
07.2009 - 03.2010
Bachelor of Science - Nursing
University of West Florida
Associate of Science - Nursing
Pensacola State College
Practical Nurse - Vocational Nurse-LPN
Coastal Carolina Community College