Audrey Lee
Katy,TX
Summary
Dynamic Lead Concurrent Review Nurse specializing in healthcare documentation and evidence-based judgment. Known for fostering interdisciplinary collaboration and developing educational resources that elevate care quality while ensuring adherence to regulatory guidelines.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Lead Concurrent Review Nurse
Centene Corporation
St Louis, MO
01.2025 - Current
- Facilitated concurrent reviews to verify compliance with medical necessity criteria and regulatory guidelines.
- Coordinated with healthcare providers to facilitate effective care transitions and support efficient resource utilization.
- Developed and implemented educational programs for nursing staff focused on concurrent review best practices to optimize overall team effectiveness.
- Established trust with medical directors and peers by employing active listening and a genuine dedication to implementing best practices.
- Applied clinical insights to champion patient care and ensure adherence to prescribed treatment protocols.
- Enhanced organizational learning culture by remaining informed on industry trends and facilitating knowledge exchange among peers.
Concurrent Review Nurse 2
Centene Corporation
St Louis, MO
04.2019 - 01.2025
- Executed thorough evaluations of patient care plans to uphold regulatory compliance standards.
- Designed resource guide to enhance understanding of concurrent review techniques and ensure adherence to compliance standards.
- Coordinated efforts with interdisciplinary teams to streamline care delivery and elevate patient outcomes.
- Conducted evaluations and optimizations of concurrent review methodologies and best practices, providing guidance as a preceptor and subject matter expert in concurrent reviews.
Registered Nurse Case Manager
United Health Group, Optum
Minneapolis, MN
04.2013 - 04.2019
- Collaborated with healthcare teams to design and implement patient care plans focused on delivering comprehensive services and improving health outcomes.
- Analyzed clinical assessments and modified care strategies to ensure optimal patient outcomes.
- Led collaboration with interdisciplinary teams to optimize healthcare processes.
- Provided comprehensive education to patients and families on treatment options and preventive care measures.
Education
Master of Science - Nursing-Specialization in Health Care Education
University of Phoenix
Tempe, AZ10-2009
Bachelor of Science - Nursing
University of Phoenix
Tempe, AZ03-2007
Skills
- Utilization review
- Interdisciplinary collaboration
- Medicare
- Medical record review
- Policy compliance
- Teamwork and collaboration
- Problem-solving abilities
- Effective communication
- Multitasking
Certification
Certified Case Manager (CCM)
Timeline
Lead Concurrent Review Nurse
Centene Corporation
01.2025 - Current
Concurrent Review Nurse 2
Centene Corporation
04.2019 - 01.2025
Registered Nurse Case Manager
United Health Group, Optum
04.2013 - 04.2019
Master of Science - Nursing-Specialization in Health Care Education
University of Phoenix
Bachelor of Science - Nursing
University of Phoenix