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Experienced nursing professional bringing clinical expertise, leadership skill, and technical knowledge highly motivated to take on new challenges. Collaborative and motivational leader with expertise in training new nursing staff while providing top-notch service to members. Focused on continuously driving innovation and improving member and employee satisfaction and outcomes.

Focused RN with 20+ total years in medical care delivers consistent and professional work for every assignment. Offers 10 years in Utilization Management industry and top-notch abilities in being a detail-oriented team player with strong organizational skills, deliver 95% and above accuracy on audit scoring. Ability to handle multiple projects simultaneously with a high degree accuracy. Trained in Prior Auth & CCR review/Managed Care: Medicare, Medicaid, and Commercial coverage. Experienced in EMR, InterQual & MCG. Unrestricted Compact State Iowa Registered Nursing License with ability to transfer RN license to different state if required. Working knowledge of Word, Excel, PowerPoint and strong typing skills.
Registered Nurse with extensive experience in utilization management, skilled in evaluating medical records and clinical documentation against established criteria such as InterQual and MCG. Demonstrated ability to assess the appropriateness of proposed treatments and coordinate care by collaborating with healthcare providers to ensure compliance with regulatory standards. Proven track record of identifying care gaps and implementing policies that enhance patient outcomes while adhering to strict timelines for review processes. Committed to maintaining accurate documentation and facilitating effective communication among interdisciplinary teams to optimize patient care delivery.

Experienced nurse case manager with a strong background in clinical practice, critical thinking, and problem-solving skills. Seeking an opportunity to utilize and further develop these skills while delivering high-quality patient care and achieving positive outcomes. Committed to providing compassionate and evidence-based care, dedicated to collaborating with interdisciplinary teams to ensure the best possible treatment plans for patients. Proven track record of effectively managing complex cases and coordinating resources, confident in ability to make a meaningful impact in a healthcare setting.

 Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Seeking a telecommute position which will utilize prior authorization, review expertise and incorporate comprehensive healthcare and case management experiences. 

Barbara Mace

Work History

NICU Inpatient Authorization RN

Inpatient Authorization Denial Team

Inpatient Authorization Team

Case Manager/UR

MMA Concurrent Review Nurse

UR Coordinator

Registered Nurse

Education

Bachelor of Science - Nursing

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Timeline

NICU Inpatient Authorization RN

Inpatient Authorization Denial Team

Inpatient Authorization Team

Case Manager/UR

UR Coordinator

MMA Concurrent Review Nurse

Registered Nurse

University South Florida

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