Dana L Cannady
Hamden,CT
Summary
Expert in utilization management and healthcare authorization, driving operational efficiency and patient access to critical services. Strong communication skills and analytical capabilities support collaboration with clinical teams and insurance providers. Dedicated to maintaining high standards of accuracy and compliance using Epic systems.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Utilization Management Coordinator
Aware Recovery Care
Wallingford, CT
05.2022 - 05.2026
- Assessed member eligibility status before authorizing services using available resources.
- Documented interactions and outcomes in the authorization database accurately.
- Coordinated follow-ups on pending authorizations, enhancing communication with insurance companies.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Developed relationships with external vendors providing pre-authorization services.
- Conducted quality assurance audits of prior authorization processes according to established standards.
- Communicated authorization decisions, including approvals and denials, to healthcare providers and patients to ensure clarity and understanding.
- Conducted utilization reviews for members to ensure services are medically necessary, appropriate and cost effective.
- Utilized computer systems such as EMRs, UM software programs and databases to access information relevant to the review process.
Managed Care Reviewer
Rushford Center Hartford Healthcare
Meriden, CT
07.2018 - 04.2022
- Managed higher levels of care and outpatient mental and substance abuse authorizations to ensure timely access to necessary services.
- Coordinate closely with Utilization Care Managers and clinical staff to ensure authorizations do not expire or overlap.
- Resolved payment denial issues by collaborating with clinicians, insurance companies, and the billing department.
- Reviewed denial reports to identify and address outstanding authorizations promptly.
- Analyze and input behavioral health data in the Epic system.
Eligibility Verification/Financial Counselor
Stamford Health Medical Group
Stamford, CT
01.2017 - 04.2017
- Managed insurance pre-authorizations and pre-certifications, conducting quality assurance audits to enhance staff performance and operational efficiency.
- Coordinated with patients for financial clearance, developed financial assistance plans, and assessed need-based assistance eligibility.
- Developed patient payment plans for applicants and assisted with financial arrangements for patient care encounters.
- Answered telephones following customer service protocol, integrated resources for patients, and collaborated with nursing and clinical staff to enhance patient experience.
Legal/Financial Specialist
Lifecare/Care.com
Shelton, CT
01.2008 - 01.2017
- Coordinated assistance for families in obtaining legal and financial services, scheduling both phone and in-person consultations to enhance client access.
- Answered all incoming and outbound calls for corporate clients, serving as the first point of contact for support with EAP, legal, and financial matters.
- Verified client eligibility and achieved high client satisfaction by providing attentive listening around the client's specific needs and educating clients on his/her benefits options in a call center environment.
- Delivered efficient and courteous service to customers, consistently addressing their needs and enhancing overall client experience.
- Committed to delivering excellent customer service while working in a fast-paced environment.
Education
Psychology Candidate -
Southern New Hampshire University
Manchester, NH, USHigh School Diploma -
Cooperative Arts & Humanities Magnet High School
New Haven, CTSkills
- Utilization review
- Epic systems knowledge
- Insurance verification
- Documentation accuracy
- HIPAA compliance awareness
- Medical terminology
- Analytical skills
- Customer Relationship management
- Effective communication
- Patient advocacy
- Call center environment
Certification
Mental Health First Aid Certificate USA
References
References available upon request
Volunteer Experience
- Human Service Commission, Town of Hamden, Hamden, CT, 05/01/24, 04/01/26, Provide advisement and to formulate human service needs for the departments of elderly, youth, and community services in the town of Hamden, CT.
- Behavioral Health Patient & Family Advisory, Yale New Haven Hospital, New Haven, CT, 04/01/17, 04/01/23, Developed and implemented patient-centered care plans to ensure optimal outcomes for patients and families., Participated in interdisciplinary meetings to discuss ongoing issues related to quality improvement initiatives., Demonstrated strong interpersonal skills to effectively engage with patients, families, and healthcare professionals.
Timeline
Utilization Management Coordinator
Aware Recovery Care
05.2022 - 05.2026
Managed Care Reviewer
Rushford Center Hartford Healthcare
07.2018 - 04.2022
Eligibility Verification/Financial Counselor
Stamford Health Medical Group
01.2017 - 04.2017
Legal/Financial Specialist
Lifecare/Care.com
01.2008 - 01.2017
Psychology Candidate -
Southern New Hampshire University
High School Diploma -
Cooperative Arts & Humanities Magnet High School