Summary
Overview
Work History
Education
Skills
Timeline
Generic

Annette Thorne

Lansdowne,PA

Summary

Dynamic Utilization Review Nurse at Independence Blue Cross with expertise in documentation and compliance. Proven ability to enhance patient care through effective discharge planning and interdisciplinary collaboration. Skilled in InterQual criteria and telephonic nursing, ensuring adherence to regulatory standards while fostering strong communication with healthcare teams and families.

Overview

25
25
years of professional experience

Work History

Utilization Review Nurse

Independence Blue Cross
Philadelphia, PA
08.2017 - Current
  • Reviewed and analyzed patient treatment plans for appropriateness and adherence to guidelines.
  • Assisted in coordinating communication between healthcare providers and insurers regarding utilization management.
  • Supported the documentation process for authorization requests, ensuring compliance with regulatory standards.
  • Learned to utilize electronic health record systems for tracking patient care metrics and outcomes.

Discharge Planner

Independence Blue Cross
Philadelphia, PA
08.2000 - 08.2017
  • Coordinated patient discharge plans, ensuring seamless transitions to post-acute care settings.
  • Collaborated with multidisciplinary teams to assess patient needs and develop individualized care plans.
  • Conducted thorough evaluations of patient readiness for discharge, addressing potential barriers proactively.
  • Streamlined communication between healthcare providers and families, enhancing support networks for discharged patients.

Education

Nursing

Thomas Jefferson University
Philadelphia, PA
06.1985

Skills

  • Documentation and reporting
  • InterQual criteria
  • Utilization review
  • Records analysis
  • Clinical assessment
  • Interpersonal and written communication
  • Prior authorization
  • HIPAA compliance
  • Discharge planning coordination
  • Managed care
  • Discharge planning
  • Utilization management
  • Compliance procedures
  • Medicare
  • Telephonic nursing
  • Case management

Timeline

Utilization Review Nurse

Independence Blue Cross
08.2017 - Current

Discharge Planner

Independence Blue Cross
08.2000 - 08.2017

Nursing

Thomas Jefferson University
Annette Thorne