Joemella C. Dozier
Columbia
Summary
Committed Licensed Practical Nurse with extensive expertise in behavioral health and medication management, supported by a background in claims coordination and healthcare administration.
Overview
10
10
years of professional experience
4
4
Certifications
Work History
Utilization Review Nurse
Three Rivers Behavioral Health
West Columbia
04.2025 - Current
- Documented utilization review findings in electronic health record systems with precision.
- Communicated authorization requests and outcomes effectively with providers.
- Participated in case conferences to evaluate patient progress and care approaches.
- Assessed patient medical records to verify appropriateness of requested services.
- Evaluated clinical documentation for accuracy to inform coverage determinations.
- Applied medical criteria and clinical judgment to analyze cases for decision-making.
- Monitored pre-authorization requests to ensure receipt of all required information.
- Conducted inpatient utilization reviews for compliance with admission and concurrent review standards.
Licensed Practical Nurse
Three Rivers Behavioral Health
West Columbia
07.2024 - Current
- Administer medications and treatments as prescribed, ensuring patient safety and adherence to treatment plans.
- Assess and evaluate patients' mental and physical health status to inform care strategies.
- Develop and implement individualized care plans in collaboration with multidisciplinary teams.
- Monitor patients' mental and physical status, responding promptly to behavioral and medical emergencies.
- Educate patients on treatment plans, coping strategies, and wellness resources.
- Coordinate with psychiatrists to optimize patient care and treatment outcomes.
- Accurately document patient progress, treatment responses, and medication administration in medical records.
Licensed Practical Nurse / Dosing Nurse
New Seasons Treatment Center
Columbia
03.2025 - 01.2026
- Managed dosing schedules and inventory for opioid treatment programs adhering to regulatory standards.
- Set up and dispensed medications, including Methadone and Suboxone, following strict protocols.
- Monitored medication inventory levels and reported discrepancies to pharmacist promptly.
- Scheduled medication inventory to ensure compliance with all regulatory requirements.
- Accurately charted medication administration in nursing notes and patient records.
- Processed physician orders and phase change requests with efficiency.
- Participated in treatment team meetings to evaluate patient progress and recommend adjustments.
Claim Coordinator
Blue Cross Blue Shield of South Carolina
Columbia
08.2015 - 06.2024
- Managed claims processing, ensuring compliance and efficient communication across departments.
- Trained new hires in claims policies and procedures, enhancing team performance.
- Streamlined claims workflows, reducing processing times and improving accuracy.
- Prepared detailed claims summaries, loss stratification reports, and root analysis reports.
- Maintained compliance with federal and state regulations governing claims processes.
- Managed high-volume caseloads, prioritizing tasks to meet deadlines and reduce delays.
- Proactively identified and addressed potential issues in claims to prevent escalations.
Education
Practical Nursing Diploma - Nursing
ECPI University
Columbia, SC01-2024
Skills
- Electronic medical records management
- Medication reconciliation and dispensing
- Patient care planning and coordination
- Claims management and processing
- Regulatory compliance and clinical adherence
- Emergency response strategies
- Inventory management systems
- Team collaboration and communication
- Documentation accuracy and reporting
- Utilization review processes
- Patient assessment techniques
- Prior authorization and insurance verification
Certification
Licensed Practical Nurse
Timeline
Utilization Review Nurse
Three Rivers Behavioral Health
04.2025 - Current
Licensed Practical Nurse / Dosing Nurse
New Seasons Treatment Center
03.2025 - 01.2026
Licensed Practical Nurse
Three Rivers Behavioral Health
07.2024 - Current
Claim Coordinator
Blue Cross Blue Shield of South Carolina
08.2015 - 06.2024
Practical Nursing Diploma - Nursing
ECPI University