
Dynamic RN Care Coordinator at Network Health with expertise in care management and utilization review. Proven ability to navigate healthcare regulations and enhance patient outcomes through ethical practice. Skilled in data collection and decision-making, demonstrating high autonomy in authorization determinations. Committed to delivering exceptional patient care and optimizing healthcare processes.
Reviews authorization requests for medical necessity, appropriateness of care and benefit eligibility. Reviews applicable guidelines regarding payment and coverage, and makes determinations for authorization/payment.
Care planning
Quality improvement
Ethical practice
Healthcare regulations
Data collection
High level of autonomy