Anita Motta
Nanuet,NY
Summary
Hands-on professional proudly offering more than 30 years of expertise in nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight and performance Knowledgeable in admissions and stay reviews
Overview
26
26
years of professional experience
Work History
Utilization Review Registered Nurse
Montefiore Medical Center Moses Division
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed admission reviews based for medical necessity based upon [Type] specification.
- Supervised and maintained all utilization review documentation through [Software].
Registered Nurse-Case Manger
Montefiore Medical Center Moses Division
03.2003 - 12.2013
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Responded promptly and professionally to patient questions and concerns.
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
- Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
- Performed evaluations on consistent basis to address changes in patient needs, conditions and medications, altering care plans when required.
Registered Nurse
Monteifiore Medical Center
01.1988 - 12.2013
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
Education
Master of Science - Nursing
School of Social Research
New York, NY09.1996
Bachelor of Science - Nursing
Mercy College
Dobbs Ferry, NY06.1984
Associate of Science - Nursing
Bronx Community College
The Bronx, NY06.1974
High School Diploma -
Rooselvelt High School
The Bronx, NY06.1970
Skills
- Leadership
- Clear Patient Communication
- Patient Review Instrument
Timeline
Registered Nurse-Case Manger
Montefiore Medical Center Moses Division
03.2003 - 12.2013
Registered Nurse
Monteifiore Medical Center
01.1988 - 12.2013
Utilization Review Registered Nurse
Montefiore Medical Center Moses Division
Master of Science - Nursing
School of Social Research
Bachelor of Science - Nursing
Mercy College
Associate of Science - Nursing
Bronx Community College
High School Diploma -
Rooselvelt High School