Hi, I’m
Corinda Reall-Ockerman
Winchester,VA
Summary
Smart Utilization Review Nurse considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers.
Overview
19
years of professional experience
Work History
Conifer Healthcare Solutions
RN Utilization Management
01.2011 - Current
Job overview
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Performed admission reviews based for medical necessity based upon MCG specification.
- Supervised and maintained all utilization review documentation
- Served as subject matter resource, providing information related to UM situations.
Valley Health-Winchester Medical Center
RN Utilization Manager
01.2008 - 01.2011
Job overview
- Provided direct patient care, stabilized patients, and determined next course of action.
- Fostered improvement in staff development, personnel training, and standards of patient care.
- Prioritized and distributed assignments and workload based on individual staff strengths and experience.
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Aurora Medical Center
Cath Lab RN
06.2004 - 12.2007
Job overview
- Administered nursing care to cardiac patients undergoing diagnostic, therapeutic or emergency services.
- Supported healthcare team by maintaining responsibility for electrocardiogram monitoring, defibrillation and cardio rehabilitation training.
- Utilized stethoscopes, thermometers and sphygmomanometers to meet patient needs and prescribed medical therapies.
- Performed fractional flow reserve tests to measure blood pressure and diagnose severity of restriction at blocked areas within arteries.
- Supported physicians throughout introduction of medical devices and vascular closure with collagen plugs and stitches.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Evaluated patient histories, complaints, and current symptoms.
- Educated family members and caregivers on patient care instructions.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Education
Old Dominion UniversityNorfolk, VA
MSN from Nursing Education
04.1993
WVUMorgantown, WV
BSN from Nursing
05.1986
Skills
- Profitability Strategies
- Interpersonal and Written Communication
- Physical Assessment
- Quality Patient Care
- Operational Procedures
- Clinical Staff Management
- Leadership
- Case Evaluations
- Needs Assessment
- Patient Care Assessment
- Resource Utilization
- Creative Thinking
- Utilization Review
- Invasive Procedures
Accomplishments
1986-1994 Staff RN: Medical/Surgical/telemetry
1994-1995
Manager Medical/telemetry
1995-2007
Cath Lab RN
2008-present
Utilization Management RN
Timeline
RN Utilization Management
Conifer Healthcare Solutions
01.2011 - Current
RN Utilization Manager
Valley Health-Winchester Medical Center
01.2008 - 01.2011
Cath Lab RN
Aurora Medical Center
06.2004 - 12.2007
Old Dominion University
MSN from Nursing Education
WVU
BSN from Nursing
Similar Profiles
Electa WoodElecta Wood
Patient Access Representative at Conifer Healthcare SolutionsPatient Access Representative at Conifer Healthcare Solutions
JENNIFER WILBONJENNIFER WILBON
Insurance Verification Specialist at Conifer Healthcare SolutionsInsurance Verification Specialist at Conifer Healthcare Solutions
Nicole PrasadNicole Prasad
Patient Access Supervisor at Conifer Healthcare SolutionsPatient Access Supervisor at Conifer Healthcare Solutions
Sandra GroomSandra Groom
Third Party Billing Specialist at Conifer Healthcare SolutionsThird Party Billing Specialist at Conifer Healthcare Solutions
Juan NunezJuan Nunez
Sales Associate at CostcoSales Associate at Costco