Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Brittany Davis

Pompano Beach,FL

Summary

Accomplished RN with a proven track record at Humana, adept in clinical judgment and research utilization. Excelled in coordinating care and managing chronic diseases, ensuring compliance with Medicare guidelines. Demonstrated expertise in EMR systems and HIPAA education, significantly enhancing patient outcomes and operational efficiency.

Overview

17
17
years of professional experience
1
1
Certification

Work History

RN Utilization Review

Humana
Pompano Beach, FL
06.2011 - 10.2024
  • Clinical Review Nurse - Medicare Part B outpatient services.
  • Conducted detailed reviews of Medicare Part B requests that include surgical and non-surgical treatments, durable medical equipment, home health, and genetic testing, to ensure compliance with Medicare guidelines and policies.
  • Assessed medical necessity, appropriateness, and accuracy of service requests based on clinical criteria and Medicare regulations.
  • Coordinated with healthcare providers and facilities to obtain additional documentation or clarify medical information as needed.
  • Applied regulatory knowledge to identify potential overutilization, or inappropriate billing practices.
  • Maintained records of review outcomes, including approvals, denials, or requests for additional information.

RN

Univitahealth
Pompano Beach , FL
01.2009 - 03.2011
  • Developed discharge plans for patients transitioning from home health services to other settings.
  • Coordinated medical equipment rentals and installations for home use.
  • Educated patients and families on disease management and prevention techniques.

RN

Mount Sinai Health System
Miami Beach, FL
06.2007 - 01.2009
  • Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
  • Administered medications and other treatments prescribed by physicians.
  • Observed patient's heart rate, blood pressure and respiration for signs of distress.

Education

Bachelor of Science - Nursing

University of Miami
Miami, FL
05-2007

Skills

  • Research utilization
  • Clinical judgment
  • Discharge coordination
  • EMR systems
  • Chronic disease management
  • HIPAA education

Certification

  • Florida RN license RN# 9270790 - compact license
  • Illinois RN license

Timeline

RN Utilization Review

Humana
06.2011 - 10.2024

RN

Univitahealth
01.2009 - 03.2011

RN

Mount Sinai Health System
06.2007 - 01.2009

Bachelor of Science - Nursing

University of Miami

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