Cierra Warren
Summary
Professional nurse with extensive experience in utilization review. Skilled in analyzing patient care and ensuring compliance with healthcare regulations. Strong focus on team collaboration and achieving optimal patient outcomes. Adaptable and reliable, excelling in dynamic environments requiring precise decision-making and effective communication.
Overview
8
8
years of professional experience
Work History
Registered Nurse
Aya Healthcare
07.2024 - Current
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
Utilization Review Nurse
Holmes Regional Medical Center
03.2018 - 07.2024
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Mitigated potential legal issues related to improper admission or discharge decisions by consulting with physicians regarding complex cases that required further clarification.
- Facilitated workgroup meetings with medical personnel to find effective solutions to issues.
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
Medical Record Reviewer
Medical Associates of Brevard
05.2017 - 03.2021
- Identified trends in documentation errors through careful analysis of multiple records, allowing for targeted training initiatives among healthcare professionals.
- Conducted detailed audits on medical records to identify errors, leading to improved accuracy and quality assurance.
- Participated in ongoing professional development opportunities, elevating my expertise as a Medical Record Reviewer over time.
- Liaised with insurance companies to provide thorough assessments of claims based on accurate medical record analysis.
Education
Associate of Science - Nursing
Keiser University
Fort Lauderdale, FL12-2020
High School Diploma -
Bradwell Institute
Hinesville, GA05-2014
Skills
- InterQual criteria
- Documentation and reporting
- Discharge planning coordination
- Utilization review
- Insurance verification
- Records analysis
- Quality improvement
- Clinical assessment
- Healthcare regulations
- Interpersonal and written communication
- Utilization management
- Medical coding
- Outpatient care
- Physician consultations
- Patient care plans
- Prior authorization
- HIPAA compliance
Timeline
Registered Nurse
Aya Healthcare
07.2024 - Current
Utilization Review Nurse
Holmes Regional Medical Center
03.2018 - 07.2024
Medical Record Reviewer
Medical Associates of Brevard
05.2017 - 03.2021
Associate of Science - Nursing
Keiser University
High School Diploma -
Bradwell Institute
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