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Click here or scroll down to respond to this candidateCandidate's Name
EMAIL AVAILABLEEDUCATIONUniversity of Michigan-Flint, Flint, MI MBA-Health Care Administration Oakland University, Rochester, MI BS Biology, BS Nursing Course Highlights: Pathophysiology, Fundamentals of Nursing, Health Assessment, Pharmacology, Nursing for Wellness, Clinical Nursing Skills & Techniques, Nursing Diagnosis, Psych-Mental Health Nursing, Med- Surg Nursing, Legal Aspects of Healthcare Admin, Business Economics, Organizational Behavior, Financial Management, Applied Qualitative Analysis, Health Policy, Communications, and Operations Management. Computer Experience: Epic, Soft ID, Microsoft Windows XP, Apple Pages, Notes EXPERIENCE:Clinical Research Nurse, Beaumont Hospital, Royal Oak, MI April 2022-Present Senior Analyst-PPO Provider Administration, BCBSM, Detroit, MI March 2019 January 2022 Analyze and collaborate with medical consultants, Business Practice Profiles and other profiles to mon- itor utilization and to ensure provider are following TRUST PPO Network Standards on utilization. Enforce corrective action and work with providers to achieve PPO Network utilization standards. Spine/Neuro Coordinator, St. Joseph Mercy-Oakland, Pontiac, MI November 2017-October 2018 Coordinate surgical procedures between 1-4 OR rooms per day and with 8 neurosurgeons by secur- ing proper equipment, staff, instruments, implants, bone, vendors, and misc patient/surgeon specific information.RN Appeals Auditor, BCBSM, Detroit, MI May 2014-November 2017 Accept and review appeal requests, medical documentation from Michigan facilities to determine if monies should be recovered as a result of overpayments. Recovered monies are based on facility adherence to BCBS Guidelines and by determining medial necessities. By having a clinical back- ground, waste and necessities are easier to recognize. This will allow for better utilization in the de- livery of care.Clinical Nurse II, Nursing Resource Pool, Beaumont Hospital, Troy, MI May 2013-Present MICU, SICU, CICU- Nurse To keep nursing skills and knowledge of advancements in medical technically current.Circulator, UnaSource Surgery Center, Troy, MI October 2012-May 2014 Ambulatory Surgical Center- Circulator RN,Clinical Nurse II, William Beaumont Hospital, Troy, MI May 2010-April 2015 Charge Circulator in Main OR-Weekends, Area D-Surgical Services Clinical Nurse II, William Beaumont Hospital, Troy, MI November 2007-May 2010 PCU Nurse-Responsible for nursing, monitoring, and supervising care of 4-5 patients on a Progres- sive Cardiac Care UnitCERTIFICATIONS/LICENSURES Currently pursuing CCRN (Certified Critical Care Nurse with American Association of Critical-Care Nurses) Advanced Cardiac Life Support Certified (ACLS) Basic Life Support Certified (BLS) Medical Billing and Coding Certification |
