Summary
Overview
Work History
Education
Skills
Timeline
Generic

Deborah Ehling

Cincinnati

Summary

Dedicated professional with extensive experience in utilization review and medical documentation. Recognized for strong attention to detail and a commitment to quality patient care, driven to support healthcare excellence through effective case management strategies.

Overview

47
47
years of professional experience

Work History

Utilization Review Nurse, Care Manager

TriHealth
Cincinnati
09.2008 - Current
  • Assessed medical necessity and cost-effectiveness of services through utilization review processes, ensuring appropriate patient care.
  • Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
  • Coordinated with insurance carriers to secure authorizations for patient services, facilitating timely access to necessary treatments.
  • Evaluated denial letters from insurance companies to confirm appropriateness and compliance with review standards.
  • Submitted cases for secondary review due to unmet criteria.
  • Documented all utilization review activities, findings, and decisions in patient records and databases.
  • Developed case management plans based on individual patient needs and eligibility criteria.

Registered Nurse

Various
Cincinnati
05.1979 - 09.2008
  • Provided direct patient care and support in various healthcare settings.
  • Collaborated with interdisciplinary teams to develop care plans.
  • Held positions as staff nurse and Care Manager for adult and pediatric patients.

Education

Registered Nurse - Registered Nursing

The Deaconess Hospital School of Nursing
Cincinnati, OH
05-1979

Bachelor of Science - Nursing

Ohio University
Athens, OH
04-2026

Skills

  • Medical documentation
  • Care coordination
  • Utilization review
  • Managing deadlines
  • Medical records management
  • Data collection
  • Insurance plan expert

Timeline

Utilization Review Nurse, Care Manager

TriHealth
09.2008 - Current

Registered Nurse

Various
05.1979 - 09.2008

Registered Nurse - Registered Nursing

The Deaconess Hospital School of Nursing

Bachelor of Science - Nursing

Ohio University
Deborah Ehling