Highly adaptable adult BH Care Manager dedicated to providing exceptional skills in the hospital case environment. Smart and bilingual with developed interpersonal and time management skills. Seeking challenging role in new setting devoted to quality patient care. Self-motivated professional promoting attention to detail and the drive to resolve issues effectively. Calm and poised in the most stressful environments. Seeking the opportunity to join Partners Health Management in the role of BH Utilization Review Nurse.
Overview
18
18
years of professional experience
1
1
Certification
Work History
BH RN Care Manager
Advent Health
Hendersonville, NC
10.2021 - Current
Coordinated support services and optimized communication between healthcare workers and patients.
Reviewed treatment plans against individual goals and healthcare standards.
Provided direct service and support by handling referrals for advocacy issues or resolving complaints.
Collaborated with medical professionals to coordinate treatment plans for clients.
Acted as an advocate for vulnerable populations by advocating for policy changes at the state level.
Advocated for clients by obtaining information regarding treatment options and clinical status.
Monitored utilization of health care services to ensure appropriate utilization and cost effectiveness.
Assessed medical necessity of inpatient admissions and continued stays.
Provided consultation regarding the most appropriate site of service for outpatient services.
Ensured compliance with applicable state and federal guidelines related to utilization review activities.
Identified opportunities for improvement in processes related to utilization management functions.
Conducted concurrent reviews to identify any inappropriate use of resources as well as duplication of services.
NA at Fundamentals of Nursing Advent Health, Advent Health, Mental Health. Advent HealthNA at Fundamentals of Nursing Advent Health, Advent Health, Mental Health. Advent Health