Jacqueline Parker, RN, BSHA, MSN-FNP
Elverta,CA
Summary
Highly skilled, resourceful, focused and enthusiastic leadership professional with over 20 years of expert level experience in Inpatient Utilization Management.
Ability to strategize, develop and implement efficient processes to meet cost effective goals.
Development and implementation of managed care policies for inpatient medical management for the commercial HMO, PPO, Medicare and Medi-Cal patient population.
Collaboration, oversight and implementation of Inpatient Utilization Management processes for the newly qualified (ACA) Medi-Cal population for the Los Angeles County Department of Health Services. Analyze, interpret and report key metrics to senior leadership.
Progressive leadership skills and the ability to foster and lead healthcare teams to meet and excel in performance objectives for outcome excellence.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Nurse Practitioner -Seeking Career Redirection
APDSS /AIMS
06.2019 - Current
- Patient education on disease prevention and management strategies, promoting healthier lifestyles.
- Assessed and diagnosed patients, determining appropriate treatment plans in a timely manner.
- Prescribe and manage pharmacological and non-pharmacological treatments to treat underlying causes and relieve symptoms.
- Assesse patients to determine individual needs and develop care plans in coordination with multidisciplinary healthcare professionals.
- Prevent complications by identifying early warning signs of potential issues through careful examination and history-taking techniques.
Manager, Health Care Services
Health Net of CA
01.2006 - 06.2019
- Oversight and management of licensed staff doing Inpatient Utilization Management for multiple lines of business including Medicare, Medi-Call Commercial HMO, PPO and EPO
- Regions include: Los Angeles, San Bernardino, Contra Costa, Solano, San Francisco and Santa Clara Counties
- Oversight and collaboration with LADHS in the repatriation process for OON, OOA, OOS hospital admissions
- Oversight and collaboration with other delegated entities in the repatriation process of OON, OOA, OOS and OOC
- Improving resource management, productivity metrics and team performance
- Reporting key metrics to senior leadership and identify areas of improvement
Supervisor - UM
Hill Physicians Medical Group
01.2005 - 01.2006
- Oversight and active management of inpatient concurrent review, discharge planning and outpatient case management
Supervisor Health Services
Lakeside Medical Group
01.2002 - 01.2005
- Working supervisor and onsite review at local hospitals in the Glendale / Burbank area
Onsite concurrent review nurse
Pacificare of California
01.1999 - 01.2002
- Onsite concurrent review, discharge planning and collaboration with hospital and outpatient ancillary services to reduce patient readmission - multiple regional hospitals in the Los Angeles Metropolitan region
Onsite concurrent review nurse
MedPartners of CA
01.1996 - 01.1999
- Onsite concurrent review, discharge planning and collaboration with hospital and outpatient ancillary services to reduce patient readmission- multiple regional hospitals in the Los Angeles Metropolitan region
Onsite concurrent review nurse (Direct Network)
Sierra Health Services / Health Plan of Nevada
01.1995 - 01.1996
- Onsite concurrent review nurse and discharge planning (Direct Network) - multiple hospitals in the Las Vegas Metropolitan area
Education
Master of Science - Nursing - Family Nurse Practitioner
Samuel Merritt University
Oakland, CA12-2018
Bachelor of Science - Health Care Management And Hospital Administration
University of Phoenix
Sacramento, CA10-2016
RN Diploma -
Los Angeles County USC Medical Center School of Nursing
01-1988
Skills
- Expert level Utilization Management
- Experienced Interdepartmental Collaboration and Communication
- Experienced in Healthcare Compliance and Regulations
- Expert in Medicare and Medi-Cal Inpatient Utilization Management and Discharge Planning
- Expert in Commercial HMO, PPO and EPO inpatient Management
- Strong Organizational Skills
- Operational Efficiency
- Effective Communication
- Strong Leadership Skills
Affiliations
Member of CANP
Licensecertifications
- RN 545986- 9/30/2025
- NP License - 95011433
- NPI - 1982264156
- DEA - MP5275046
- BLS and ACLS - 7/2026
- FNP-BC - 2026
Certification
- Board Certified Family Nurse Pracitioner
Languages
Spanish
Native or Bilingual
Timeline
Nurse Practitioner -Seeking Career Redirection
APDSS /AIMS
06.2019 - Current
Manager, Health Care Services
Health Net of CA
01.2006 - 06.2019
Supervisor - UM
Hill Physicians Medical Group
01.2005 - 01.2006
Supervisor Health Services
Lakeside Medical Group
01.2002 - 01.2005
Onsite concurrent review nurse
Pacificare of California
01.1999 - 01.2002
Onsite concurrent review nurse
MedPartners of CA
01.1996 - 01.1999
Onsite concurrent review nurse (Direct Network)
Sierra Health Services / Health Plan of Nevada
01.1995 - 01.1996
Master of Science - Nursing - Family Nurse Practitioner
Samuel Merritt University
Bachelor of Science - Health Care Management And Hospital Administration
University of Phoenix
RN Diploma -
Los Angeles County USC Medical Center School of Nursing