Angie Chivers
Knoxville,IL
Summary
Registered Nurse with 20+ years of healthcare experience spanning utilization management, clinical review, care coordination, post-acute care, hospice, admissions, quality assurance, and case management. Experienced in applying Interqual and MCG criteria, collaborating with interdisciplinary teams, evaluating medical necessity, and ensuring regulatory compliance. Proven ability to improve care transitions, support appropriate level-of-care determinations, and deliver exceptional patient-centered outcomes. Seeking to leverage extensive clinical expertise in a Utilization Review or Clinical Quality role.
Overview
1
1
Certification
13
13
years of professional experience
Work History
Preservice Coordinator RN
Optum
Eden Prairie, Minnesota
05.2020 - Current
- Developed productive working relationships with post acute referral sources and acute care hospital sources.
- Maintained 100% compliance with documentation standards and regulatory requirements while supporting utilization management workflows.
- Managed caseload of up to 25 individuals.
- Initiated contact with appropriate referral sources to schedule peer to peer reviews.
- Reviewed 20+ authorization requests weekly using InterQual and MCG guidelines to support timely and appropriate level-of-care determinations.
- Collaborated with medical directors.
Registered Nurse
DD Homes Network
Galesburg, IL
06.2020 - 04.2024
- Provided direct patient care in residential settings for individuals with disabilities.
- Administered medications and monitored patient responses to ensure safety and comfort.
- Utilized critical thinking skills to assess clinical situations quickly and accurately.
- Monitored vital signs, administered injections, and provided assistance with medical procedures.
- Documented patient progress notes accurately and efficiently in the electronic medical record system.
- Administered medications and treatments, monitoring patients for reactions and side effects.
RN Clinical Liaison
RML Specialty Hospital
Hinsdale, Illinois
03.2014 - 05.2020
- Coordinated patient care plans with multidisciplinary teams for optimal treatment outcomes.
- Facilitated communication between healthcare providers and patients to enhance service delivery.
- Managed referrals and ensured timely follow-up for continuity of care.
- Conducted regular assessments of patient's medical needs during their stay at the hospital.
- Developed and maintained relationships with physicians, nurses, case managers and other healthcare professionals to ensure quality patient care.
- Reviewed utilization data on a regular basis to assess appropriateness of services rendered.
- Utilized InterQual criteria for admission appropriateness.
Triage Registered Nurse
Heartland Hospice
Madison, Wisconsin
07.2017 - 12.2019
- Assessed patient needs through telephone consultations and triage protocols.
- Provided clinical advice based on established nursing guidelines and protocols.
- Collaborated with healthcare teams to ensure seamless patient care coordination.
- Prioritized urgent cases for immediate response by medical personnel.
- Maintained compliance with regulatory standards in telehealth practices.
Education
Associate of Applied Science - Nursing
Joliet Junior College
Joliet, IL12-2009
Certificate of Technical Studies - Nursing
Carl Sandburg College
Galesburg, IL06-2001
Skills
- InterQual guidelines
- Electronic health records
- Care coordination
- Quality assurance
- Patient advocacy
- Evidence-based practices
- Healthcare compliance
- Team collaboration
- Problem solving
- Critical thinking
- Effective communication
- Verbal and written communication
- Time management
- Multitasking and organization
- Deadline management
- MCG Guidelines
- Utilization Management
Certification
Registered Nurse
Timeline
Registered Nurse
DD Homes Network
06.2020 - 04.2024
Preservice Coordinator RN
Optum
05.2020 - Current
Triage Registered Nurse
Heartland Hospice
07.2017 - 12.2019
RN Clinical Liaison
RML Specialty Hospital
03.2014 - 05.2020
Associate of Applied Science - Nursing
Joliet Junior College
Certificate of Technical Studies - Nursing
Carl Sandburg College