CHIANTI L. LAWYER
Registered Nurse
Bradenton,FL
Summary
Registered nurse with 15+ years of experience, focusing on utilization management and discharge planning in a leading healthcare organization. Proficient in patient advocacy, clinical leadership, and interdisciplinary collaboration. Proven track record in managing care transitions and authorizations, making qualifications suitable for pharmaceutical roles including clinical sales representative.
Overview
17
17
years of professional experience
2
2
Certifications
Work History
Utilization Management / Discharge Planner
Elevance Health
11.2019 - Current
- Perform utilization reviews to assess medical necessity, ensure alignment with clinical guidelines, and support accurate level-of-care decisions.
- Coordinate patient discharges by collaborating with hospitals, providers, and care managers to facilitate smooth transitions and continuity of care.
- Utilize ACMP system, Facets, and LTSS platforms for case management, authorization tracking, and documentation of long-term services and supports.
- Obtain prior authorizations, communicate with insurance carriers, and handle peer-to-peer reviews to streamline care delivery and minimize denials.
- Educate patients and families on discharge plans, medication adherence, and post-care instructions to promote long-term health outcomes.
- Maintain thorough documentation in EMR systems and ensure full compliance with federal and organizational standards.
Charge Nurse
MCR Health Services
01.2009 - 11.2019
- Led clinical operations and supervised nursing staff across multiple departments.
- Performed monthly chart audits to ensure accurate documentation for quality assurance and reimbursement.
- Managed prior authorizations and provided direct clinical care including triage, medication administration, and diagnostic testing.
- Coordinated case reviews for high-cost patients and led team meetings to optimize care strategies.
- Served as a mentor and trainer for nursing staff, promoting best practices and clinical excellence.
- Specialties: Infectious Disease, Behavioral Health, Acute Care, Internal Medicine, Cardiology, Dermatology, General Surgery
Education
Bachelor of Science - Nursing
University of Tampa
Tampa, FL01.2009
Skills
Utilization management
Insurance authorization
Clinical documentation
Patient education
Cross-functional teamwork
Strategic analysis
process efficiency
EMR systems Microsoft Office suite
HIPAA compliance
Leadership development
Certification
Basic Life Support (BLS)
AWARDS & RECOGNITION
Excellence Award – 2018, 2019, Exceptional Experience Spotlight Recipient – 2018, Dean’s List, University of Tampa
Timeline
Utilization Management / Discharge Planner
Elevance Health
11.2019 - Current
Charge Nurse
MCR Health Services
01.2009 - 11.2019
Bachelor of Science - Nursing
University of Tampa