Ann Mohney
San Antonio
Summary
Dedicated RN with 35 years of experience in the healthcare setting. Eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Skilled in working under pressure and adapting to new situations and challenges to best meet the veteran's needs. Excellent reputation for resolving problems and improving customer satisfaction.
Overview
36
36
years of professional experience
1
1
Certification
Work History
RN, Community Care Utilization Review
Veterans Affairs
Orlando, FL
10.2021 - Current
- As a Utilization Review RN for the VA Community Care, I follow my assigned veterans who present to non-VA medical facilities for care.
- Using the Emergency Care Reporting (ECR) Tool notification system, I enter the Community Care Emergency Room (ER) template into CPRS for my assigned veterans with the ER and, if applicable, admission details. For veteran's sent to the ER via VA consult, I process these using the Community Care- Care Coordination Plan note.
- I access each assigned facility's EMR system and update the VA CPRS note with hospital records, summarizing the veteran's stay daily in CPRS for the PACT to follow. I keep in close contact with the veteran's Care Managers at the outside facilities and assist them in discharge planning to facilitate a safe discharge plan for the veteran. If the veteran needs DME, hospice, home health care (HHC), or placement assistance, I assist in coordination of care with the necessary departments.
- Additional roles include representing the UR department as a member of the VA National Compact Act Team, as well as being an active member of our Community Care Unit Practice Council.
- Also, in 2024, I took on the task of representing our department in a pilot program for the Community Care Tracking List (CCTL). After the pilot period, I presented our findings to the National Project Leadership Team. This participation, as well as my development of a One Note UR Orientation packet, helped me to achieve my goal of earning my Nurse 3 VA promotion.
RN, Community Care Utilization Review
Orlando Lake Nona VA Medical Center
Lake Nona, FL
06.2018 - 10.2021
- Full-time (80 hrs/pay) dual role Case Manager/ Utilization Review RN for Orlando VA Healthcare System
- Coordinate and lead Interdisciplinary (IDT) rounds for assigned team(s)
- Perform Interqual reviews on each assigned veteran using NUMI, determining medical necessity and proper level of care
- Coordinate with Bed Management to determine proper unit assignment for each veteran
- Partner with physicians, social workers, direct care nursing staff, activity therapists, nutritionists and other disciplines to develop and implement individualized discharge plans and documented all patient interactions and interventions in electronic charting system (CPRS)
- Address disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency
- Equipped patients with tools and knowledge needed for speedy and sustained recovery
- Assist in coordination of post-hospitalization services, including skilled home health care and follow-up appointments.
Registered Nurse, Patient Aligned Care Team
Veterans Administration
Gaylord, MI
09.2017 - 06.2018
- Full-time (80hrs/pay) Case Management RN for busy VA patient aligned care team (PACT) in northern Michigan.
- Assigned duties included health promotion, disease prevention, and clinical management of veterans.
- Taught patients how to improve lifestyle choices, dramatically reducing chance of symptom reoccurrence.
- Informed patients and families of effective treatment options and at-home care strategies, enhancing long-term outcomes.
- Managed quality care for patients with varied conditions, including heart failure, end-stage renal disease and coronary artery disease.
- Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
- Worked with other disciplines, such as home health and Community Care, to connect veteran with needed outpatient services.
Registered Nurse, Care Management/Utilization Review Specialist
Munson Grayling Hospital
1100 E. Michigan Ave. Grayling, MI 49738
12.2016 - 05.2018
- Full-time (72hrs/pay) Dual role Case Manager/ Utilization Review RN for Munson Grayling Hospital
- Coordinated and lead Interdisciplinary (IDT) rounds for assigned team(s)
- Performed Interqual reviews to determine medical necessity and proper level of care
- Worked with insurance companies to obtain authorization for admissions and continued stays.
- Submitted cases to physician advisors for criteria failures and helped facilitate resolutions and approvals
- Partnered with physicians, social workers, activity therapists, nutritionists and other disciplines to develop and implement individualized discharge plans and documented all patient interactions and interventions in the electronic charting system (EPIC)
- Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability
- Placed skilled home health, hospice, durable medical equipment (DME), and skilled nursing facility consults
- Facilitated transportation assistance as needed
- Assisted with chart reviews for insurance denial appeals
Registered Nurse, Care Management/Utilization Review Specialist
William Beaumont Hospital
3601 W 13 Mile Rd Royal Oak, MI 48073
12.2013 - 12.2016
- Full-time (80hrs/pay) Dual role Case Manager/ Utilization Review RN for William Beaumont Hospital.
- Coordinated and lead Interdisciplinary (IDT) rounds for assigned team(s).
- Performed Interqual reviews to determine medical necessity and proper level of care.
- Worked with insurance companies to obtain authorization for admissions and continued stays.
- Submitted cases to physician advisors for criteria failures and helped facilitate resolutions and approvals
- Partnered with physicians, social workers, activity therapists, nutritionists and other disciplines to develop and implement individualized discharge plans and documented all patient interactions and interventions in the electronic charting system (EPIC).
- Addressed disruptions in patient care, including delays in discharge, postponed procedures and discharge equipment unavailability.
- Placed skilled home health, hospice, durable medical equipment (DME), and skilled nursing facility consults.
- Facilitated transportation assistance as needed.
Registered Nurse
William Beaumont Hospital
Troy, Michigan
03.2008 - 12.2013
- Full-time (72hrs/pay) Inpatient RN in the ICU and step-down units, serving as a preceptor and charge RN as well as being involved in several nursing committees
- In 2012, transitioned to the role of RN Care Manager in the Emergency Room
- Performed admission reviews based for medical necessity based upon Interqual specifications
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services
- Obtained authorizations from multiple insurance carriers for various levels of care
- Submitted cases to physician advisors for criteria failures and helped facilitate resolutions and approvals
Remote Analyst- Medical Division
Litigation Management Inc.
Mayfield Heights, Ohio
02.2007 - 03.2008
- PRN remote analyst for a law firm in Ohio, reviewing medical records for pending litigation
- Average hours worked: 32/week
- Gathered, organized and input information into digital database
- Generated reports detailing findings and recommendations
- Evaluated and adopted new technologies to address changing industry needs
- Diagnosed, troubleshot and resolved network and system problems
Registered Nurse
Huron Valley Sinai Hospital
1 William Carls Drive Commerce, MI 48382
03.1992 - 03.2008
- Full-time (80hrs/pay) Float RN in a busy suburban hospital, rotating to all areas including the ER, ICU, step down units, and pediatric floors. I was a team leader and preceptor in the float pool, and served as charge nurse on several units during my 16 years at this facility
- Self-directed with astute judgment skills. High level of personal accountability
- Liaised between patients and physicians to ensure patient comprehension of treatment plans
- Closely monitored acute conditions
- Developed patient care plans, including assessments, evaluations and nursing diagnoses
- Delegated staff nurse duties
- Strong leader for nursing personnel assigned to the unit/shift.
Registered Nurse
Hackley Hospital
Muskegon, MI
08.1991 - 03.1992
- Full-time (80hrs/pay) RN on Orthopedic Surgical Unit
- Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care
- Developed patient care plans, including assessments, evaluations and nursing diagnoses
- Provided direct patient care, stabilized patients and determined next course of action.
- Taught patients how to improve lifestyle choices, dramatically reducing chance of symptom reoccurrence.
- Administered medications via oral, IV and intramuscular injections and monitored responses.
Registered Nurse
William Beaumont Hospital
Royal Oak, Michigan
03.1990 - 08.1991
- Full-time (80hrs/pay) RN on Medical/Surgical Unit
- Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care
- Developed patient care plans, including assessments, evaluations and nursing diagnoses.
Registered Nurse
Mercy General Hospital
Muskegon, MI
05.1989 - 03.1990
- Full-time (80hrs/pay) RN on Medical/Surgical Unit
- Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care
- Developed patient care plans, including assessments, evaluations and nursing diagnoses.
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Managed care from admission to discharge, including patient assessments, care planning, health educations and discharge support.
Education
Master of Science - Nursing, Nursing Informatics
Walden University
100 Washington Ave South Minneapolis2013
Bachelor of Science - Nursing
Davenport University
27650 Dequindre Rd Warren, Michigan2012
Associate of Science - Nursing
Mercy College of Detroit
4001 W. McNichols Rd Detroit, MI 482211989
Skills
- Excellent attention to detail
- Team player
- Communication Skills
- Highly dependable
- Training and mentoring
- Quality assurance
- Utilization review
- Case Management Certifications (RN-BC, CCM)
- Multidisciplinary team collaboration
- Staff leadership
- Patient education and advocacy
- Discharge planning coordination
Certification
- Registered Nurse in Michigan, License number 4704172971, 08/28/2026
- ANCC RN-BC (Case Management), Certificate number 2017029377, obtained on 11/30/2019
- CCMC Certified Case Manager (CCM), Certificate number 4247164, obtained on 01/01/2020
Memberships
American Nurses Association (ANA), Member ID 34293400, Expiration Date: 10/31/2026
Timeline
RN, Community Care Utilization Review
Veterans Affairs
10.2021 - Current
RN, Community Care Utilization Review
Orlando Lake Nona VA Medical Center
06.2018 - 10.2021
Registered Nurse, Patient Aligned Care Team
Veterans Administration
09.2017 - 06.2018
Registered Nurse, Care Management/Utilization Review Specialist
Munson Grayling Hospital
12.2016 - 05.2018
Registered Nurse, Care Management/Utilization Review Specialist
William Beaumont Hospital
12.2013 - 12.2016
Registered Nurse
William Beaumont Hospital
03.2008 - 12.2013
Remote Analyst- Medical Division
Litigation Management Inc.
02.2007 - 03.2008
Registered Nurse
Huron Valley Sinai Hospital
03.1992 - 03.2008
Registered Nurse
Hackley Hospital
08.1991 - 03.1992
Registered Nurse
William Beaumont Hospital
03.1990 - 08.1991
Registered Nurse
Mercy General Hospital
05.1989 - 03.1990
Associate of Science - Nursing
Mercy College of Detroit
Master of Science - Nursing, Nursing Informatics
Walden University
Bachelor of Science - Nursing
Davenport University