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Click here or scroll down to respond to this candidateCandidate's Name
Street Address
H - M PHONE NUMBER AVAILABLEEMAIL AVAILABLEUtilization ManagementPROFILEA dedicated and patient-focused Registered Nurse with proven strengths in acute patient care, staff development, and family advocacy.Exceptional capacity to multi-task and manage her office time.Administrative and referral experience includes admissions, assessment, treatment, referral, and education for a wide range of patients.Excellent caregivera caring and compassionate nurse.Problem solver - utilization management authorizations for complicated cases.Medication Safety Committee, collaborating with team members to provide top quality care. She is solely responsible for scheduling the office staff.Interpersonal and communication skills stand out in her field; along with her superior accuracy in patient history, charting, and other documentation.Nominated for Cameos of Caring 2009-2010KEY SKILLSCertifications: Basic Life Support/CPRProficiencies: Medical/Surgery; Family Medicine; Utilization Management; MDS Coordination EXPERIENCEUPMC HEALTH PLAN-CLINICAL OPERATIONS 2015-2024Care Manager, Utilization ManagementAuthorize acute inpatient admissions after accurately obtaining the patient information for the admission stay and establish if the patient meets Interqual criteria.Provide authorizations for post acute care and continued stay reviews.Worked to establish a uniform Minimum Data Set (MDS) to allow the department to all follow the same format.Forged working relationships with many facilities outside of the UPMC umbrella.Proficiently adapted to the use of Health Planet; while being able to navigate Canopy and E- record.Proficient at navigating Interqual to establish medical necessity for admission Candidate's Name
804 MOUNT OLIVE ROAD ROCK, WV 24747M PHONE NUMBER AVAILABLEEMAIL AVAILABLEEXPERIENCE (CONTINUED)ST. MARGARET LAWRENCEVILLE FAMILY HEALTH CENTER 2006-2015 Professional Registered NurseCaring for patients in an office setting. Working triage & physician support.Actively on medication safety committee, work with team members to provide top quality care, and responsible for the employee schedule.Exhibit motivation, and provide a high standard of patient care. Follow through so patient receives quality care.Accurately obtain and document patient history and medication lists, assess individual conditions and needs, and select departmental referrals for acute and chronically ill patients.Managing cases as needed; with insurance authorizations, home care and hospice referrals.Actively ensuring patients receive adequate care with proper follow-up.Responsible for monitoring and auditing pain management patients to ensure proper adherence. UPMC ST. MARGARET HOSPITAL 2003-2006Staff Nurse, 6AProvided care for patients immediately after surgery and medical patients. Have cared for patients status post-surgery, chest pain, gastrointestinal bleeds and respiratory complications. Gathered and recorded patient information. Prepared patients for surgical and radiological procedures, initiated and maintained intravenous therapy, and operated 12-lead EKG. UPMC ST. MARGARET LAWRENCEVILLE FAMILY HEALTH CENTER 1999-2003 File Clerk/Office AssistantProvided assistance to the office flow and maintain medical records department. Worked as a front office person answering phones and scheduling appointments. Managed medical records department, which included pulling charts for appointments, making sure all the charts are available and processing medical record requests.EDUCATIONBSN ProgramRobert Morris University (Current Student)GPA 4.0, Graduation 2016: BSNDiploma in NursingSt. Margaret School of Nursing (2003)LicensureRegistered Nurse (RN), State of PennsylvaniaCompact Multi-state Endorsement |
