Chandanpreet Gill

• Collaborated with the Medical Director to conduct second-level reviews for prior authorizations and inpatient hospital stays.
• Analyze clinical data submitted by physician offices in order to approve or deny prior authorization requests.
• Review patient medical records to determine if requested services are medically necessary and appropriate for the diagnosis.
• Research complex cases that require additional information before determining approval and denial status.
• Assisted in special projects aimed at optimizing utilization management initiatives, involving the development of new forms and protocols to enhance the efficiency of processing prior authorizations.
• Educate case managers on prior authorization and inpatient concurrent review processes and guidelines through provision of education materials for utilization management
• Communicate with case managers and other healthcare professionals regarding patient care plans and outcomes.
• Provided guidance and support to staff members on prior authorization processes.
• Monitored trends in utilization patterns in order to identify potential issues that could affect quality of care outcomes.
• Developed strategies aimed at improving efficiency within the prior authorization process while maintaining high standards of accuracy and compliance.
• Assisted with special projects related to utilization management initiatives including developing new forms or protocols for processing prior authorizations more efficiently.
• Management of Clinical Staff 10-12 nurses with their daily work schedules, education, new hire orientation setup , assisting with complex cases with clinical expertise

• Concurrent review of medical records during hospital stay to ensure the member meets medical necessity.
• Collaborated with hospital case managers to provide authorization for requested services, when applicable, such as DME, SNF, or other lower levels of care, for safe transition home.
• Facilitated referrals between primary care providers and specialists when needed.
• Advised physicians regarding alternative levels of care when indicated such as skilled nursing facilities or hospice settings.
• Maintained accurate documentation of all case management activities in accordance with regulatory standards.
• Provided education to patients and their families on disease management, medications and other treatments.
• Attended continuing education courses related to case management topics such as chronic illness management, utilization review techniques and ethical considerations.

Family Nurse Practitioner Clinical Experience Rotations, September 2020 - April 2021.

Collaborated extensively with Anasuya Kulkarni and Bonnie Her, MD, resulting in the completion of over 600 clinical hours at Chestnut Ave #102, Fresno, CA 93720.

Family Practice-( Independent visits) Patient Assessment, Diagnosis, Treatment plan,
Review of laboratory results, Radiographic reports, prescribe medications, patient
education based on the diagnosis and applicable ICD 10 codes. (Adult Physicals, Well
child visits, School Physicals, Problem focused visits). Referrals to specialists as
indicated, focus on preventative care and scheduling based on last results and due
dates)

• Brittany Perez PNP
  726 Medical Center Drive West, Unit 201 Clovis, Ca 93611
• Pediatrics- Independent visits) Well child visits (focusing on the milestones for each
  age group), Problem focused visits with Assessments, Treatments plans, patient, and
  parent education. Referrals for further management and care for problem focused
  visits and failed milestones for well visits.

• Anasuya Kulkarni/Bonnie Her MD
  7095 N. Chestnut Ave #102 Fresno, Ca 93720
• Women’s Health- Problem focused care, Preventative care, PAP Smears, Abnormal
  PAP assessment (Colposcopy), Pregnancy visits.

• Ravneet Kaur FNP
  6069 N. First Street, 103 Fresno, Ca 93710
• Internal Medicine- (Independent visits) Focused assessments and treatment plans
  on chronic conditions such as management of uncontrolled Diabetes, Hypertension,
  COPD, CKD, Asthma, CHF, and common health problems.

• Tha Cha MD
  125 E Barstow Ave #118 Fresno, Ca 93710
• Pain Management- (Independent visits) Pain Management for chronic pain related
  to multiple conditions such as Spinal Cord injuries, Arthritis pain, Chronic pain post
  trauma and injuries, Rheumatoid arthritis, Fibromyalgia, and many other conditions.

• Conducted assessments on newly admitted patients.
• Developed individualized plan of care for each patient based on assessment data obtained from various sources such as labs, diagnostic tests and other health professionals' reports.
• Administered medications as prescribed by physicians, following established protocols and guidelines.
• Provided education to family members regarding post discharge homecare needs.
• Collaborated with multidisciplinary teams to ensure best possible outcomes for the patient.
• Interpreted cardiogram strips accurately and reported abnormal findings immediately.
• Assessed and monitored patient conditions using telemetry equipment.
• Responded quickly to any changes in patient's condition or vital signs.
• Administered intravenous fluids, medications and other therapies as ordered by physician.
• Evaluated effectiveness of interventions through patient response assessment.

• Nurse Liaison August2016-Oct 2018 (as needed)
  San Joaquin Valley Rehabilitation Hospital, Fresno Ca
• Onsite assessment and review of medical records to ensure the patient meets the criteria for inpatient rehabilitation.
• Recommend appropriate level of care based on patient's abilities, prior level of function, and needs.
• Educate patients and families on the importance of meeting the requirements for acute rehabilitation program, and the importance of cooperation and participation in the program to qualify for the services.
• Available as a resource to Case Managers for proper placement of patients based on their needs.
• Develop relationships with referral sources, clients, and their family members. Provide referral source with a cost-effective plan for rehabilitation.

• Nurse Supervisor, April 2014 - October 2018, San Joaquin Valley Rehabilitation Hospital, Fresno, CA, 93720.
• Schedule nurses' shifts based on Hospital's HPPD guidelines.
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• Coordinated staffing schedules among nursing personnel according to changing needs across shifts.
• Served as a liaison between hospital administration, nursing staff, physicians and other healthcare providers.
• Resolved conflicts between clinical staff members by providing coaching support when necessary.
• Ensuring to meet the nursing standards.
• Reports prepared are focused on the quality of care being provided.
• Always mindful of Joint Commission and regulatory requirements.
• Train new team members.
• Evaluate staff performance and competencies.
• Lead mock codes and evaluate team performance.
• Participate in the hiring of nursing staff employees.
• Delegate responsibilities to staff based on their qualifications.
• Coordinate and maintain the required training and competencies of staff.
• Conducted performance evaluations of staff members in order to provide feedback on their job performance.
• Provided strong leadership and guidance to nurses.

• Registered Nurse, September 2012 – April 2014, San Joaquin Valley Rehabilitation Hospital, Fresno, CA 93720.
• Assess and report changes in patients' condition to the physician.
• Accurate and timely documentation.
• Developed individualized patient care plans based on specific needs
• Discuss patient care barriers with the interdisciplinary team for better patient outcomes.
• Provide education to patients and their families with a treatment plan to prevent rehospitalizations.
• Mentor newly hired nurses in the role.