Dependable Utilization Review Nurse promoting over 4 years of expertise in healthcare industry. Knowledgeable in admissions and stay reviews.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse
Community Home Health Of Maryland
12.2021 - Current
Performed prior authorization review of services requiring notification.
Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Obtained authorizations from multiple insurance carriers for various levels of care.
Supervised and maintained all documentation through InterQual Software
Facilitated work group meetings with Interdisciplinary teams to find effective solutions to issues
Registered Nurse, Home Health Care
Victory Home Health Care
09.2020 - 11.2021
Provided direct patient care, stabilized patients, and determined next course of action.
Managed care from admission to discharge.
Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
Coordinate patient appointments and assisted with obtaining durable medical equipment to reduce stress and wait time for patients
Critical Care Registered Nurse
Medstar Washington Hospital Center
07.2019 - 08.2020
Oversaw various aspects of telemetry by administering pa catheters and arterials, vasoactive drugs, titration, thrombolytic therapy, dysrhythmia interpretation, and chest tubes.
Coordinated with healthcare staff from various disciplines to devise, carry out, and manage personalized care plans to benefit patient health and recovery.
Conducted patient assessments, recorded vitals, and analyzed records and charts to define care requirements.
Assessed and managed various patient treatments for numerous patient diagnoses from sepsis to acute respiratory distress.
Intake Supervisor, QA Manager, Field Clinician at Community Home Health Of MarylandIntake Supervisor, QA Manager, Field Clinician at Community Home Health Of Maryland