DEBORAH VIRGINIA HANEY
Summary
Healthcare professional with substantial experience in utilization review and patient care management. Known for precision in evaluating patient treatment plans and making critical decisions to optimize resource use. Valued team collaborator with focus on achieving impactful results and adapting to dynamic healthcare environments.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse Specialist
Community Health Systems (CHS)
01.2026 - Current
- Conduct concurrent and retrospective utilization reviews using evidence-based criteria and Medical Policy (MCG).
- Evaluate inpatient services for medical necessity and coverage determination.
- Collaborate with physicians, care management teams, and medical directors.
- Support discharge planning and smooth transitions of care.
- Monitor cases for compliance with regulatory and contractual requirements.
- Identify delays in care and escalate complex cases appropriately.
- Remote
Continuum of Care Coordinator
Community Health Systems (CHS)
11.2024 - 01.2026
- Manage the Accountable Care Organizations (ACOs) for Woodland Heights Medical Center, Longview Regional Medical Center, and Navarro Regional Hospital.
- Work closely within leadership and multiple departments (Quality, Case Management, and Post-Acute Care providers) to improve the lives of ACO Medicare patients after discharge.
- Monitor the ACO Care Continuum for patients discharged from CHS hospitals; this includes managing the local partners in the post-acute network (ACO Skilled Nursing Facilities, Home Health Agencies, Hospice, and Inpatient Rehab Facilities).
- Collaborate with Hospital Leadership and Case Managers to review trends in resource utilization and serve as a local subject-matter expert on all things ACO for the supported markets.
- Hybrid
Case Manager
Professional Case Management: New Mexico/Texas
09.2022 - 11.2024
- Worked with 12-18 clients in the northern New Mexico area and transferred to Texas in 2024. Ensured that medical care is well-rounded and collaborated amongst pharmacy, nurses, aides, and doctors.
- Developed care plans to achieve optimal health outcomes and to the desire of clients and family. Assisted and educated client and family on health status, care, and needs.
- Ensured proper documentation for DOL coverage.
- Remote
Float Registered Nurse (PRN)
Los Alamos Medical Center
Los Alamos, New Mexico
05.2021 - 10.2022
- Worked within various hospital departments: Endoscopy, Med-Surg, Tele, and as House Supervisor.
- Oversaw healthcare monitoring, blood collection, EKGs, Scans, IVs, and medication administration.
- Worked as House Supervisor: case management responsibilities on weekends, patient transfers and discharges, scheduling and delegation of nurses and technicians in hospital departments.
- Documentation with Electronic Medical Records (EMR) of MedHost, gGastro, and CQI. Ensured patient confidentiality and maintenance of HIPAA regulations.
Director of Surgical Services
Los Alamos Medical Center
Los Alamos, New Mexico
11.2020 - 04.2020
- Departmental administrator for ATU, perioperative surgical services, and off-site Endoscopy Center.
- In charge of hiring, placement, payroll, scheduling, quality control, and delegation of tasks for employees.
- Experienced with daily usage of Microsoft Office and Oracle.
- Ensured proper education, licensure, and certification of all supervisors, nurses, and technicians.
- Helped with development and overseeing of case management, workplace OSHA guidelines, Performance Improvement (PI) plans, HIPAA regulation, and FMLA paperwork.
Clinical Office Manager and Technician Supervisor
Total Eye Care
Duncanville, Texas
01.2020 - 12.2020
- Managed interviewing, hiring, scheduling, training, and delegation of jobs for scribes and technicians. Managed employee and workplace OSHA requirements and HIPAA regulations.
- Trained ophthalmic technicians in AR/MR, Goldman Tonometry, proper documentation (EMR), diagnostic testing (OCT, 3Dx, HVF) and patient work-up.
- Trained ophthalmic scribes in documentation of CC, HPI, ROS, exam findings, diagnostics, billing, and coding, as well as insurance verification, modifiers, and submission.
- Director of Medical Records request management, verification, and fulfillment.
Lead Clinical Research Coordinator
Total Eye Care
Duncanville, Texas
10.2018 - 09.2020
- Initiated and managed in constructing new research department within an Ophthalmology clinic.
- Trained in federal research guidelines and maintained quality control and research compliance for the research site according to research protocol and FDA regulations.
- Coordinated enrollment of over 50 patients in a 3-year study and managed technicians regarding case management and delegation of patient follow-up and care for patient visits.
- Nationally recognized as top-enrolling site and Clinical Research Coordinator.
- Gave educational presentations regarding enrollment and patient care at Glaukos conferences in Canada and Florida (2019).
- Awards: Top Glaukos clinical research enrollment coordinator of second quarter (2019); Highest enrolling Glaukos clinical research coordinator internationally (2019); In Top 5 enrolling sites for Glaukos iDose study (2019 & 2020).
Operating Room Circulating Nurse
North Texas Surgery Center
Dallas, Texas
09.2018 - 08.2020
- Ensured HIPAA regulations followed and patient confidentiality maintained.
- Prepared patients prior to surgery with surgical site sterilization, patient transport and positioning, vital signs monitoring, documentation and OR discharge.
- Prepared medications, surgical devices, and sterilization for ophthalmic procedures.
- Pre-op/PACU Nurse.
- Collaboration and patient care with various surgeons in gastroenterology, gynecology, ophthalmology, podiatry, orthopedics, ENT and general surgery.
- Direct patient care. Skills with IVs, catheters, medication administration, vitals and symptom monitoring, follow-up, and documentation. Involved in emergent code response team.
Ophthalmologist Scribe & Technician
Total Eye Care
Duncanville, Texas
11.2015 - 09.2018
- Various roles of diagnostic testing, clinical documentation (paper records and NextGen EMR), and patient care.
Education
Doctorate of Nursing, PhD -
The University of Texas at Tyler
Tyler, Texas04-2023
Bachelor of Science in Nursing, BSN - undefined
The University of Texas at Tyler
Tyler, Texas08-2018
Bachelor of Arts in Psychology - undefined
The University of Texas at Tyler
Tyler, Texas08-2012
Skills
- Leadership experience with skills in case management, research, and education
- Proficient in employee onboarding and training, policy making, quality control, and accomplishing tasks and goals on tight schedules
- Skilled in Microsoft Office and Electronic Medical Records utilization
- Experience with FMLA, worker's compensation, Medicare Insurance, and Accountable Care Organizations
- HIPAA training and experience in administration, research, and educational disciplines
Certification
- Texas Board of Nursing – Registered Nurse | Exp. 10/2027
- BLS for Healthcare Providers (CPR & AED) – American Heart Association | Exp. 06/2026
- ACLS Certification – American Heart Association | Exp. 03/2025
- PALS Certification – American Heart Association | Exp. 04/2025
- American Academy of Ophthalmology (AAO) Member (OSC & COA) | 2015-Present
- COA Certified – AAO | 2018
- Glaukos Excellence in Research: Stage I & II Certificate | 2019
- HIPAA trained and certified – LifePoint Hospital System | 2020
Accomplishments
University of Texas Honors Program Graduate | 08/2012
Volunteer Women's Refugee Center: San Salvador, El Salvador | 2014-2015
Magna Cum Laude Graduate | 08/2018
Top Glaukos clinical research enrollment coordinator of second quarter | 2019
Highest enrolling Glaukos Clinical Research Coordinator internationally | 2019
Top 5 enrollment site for Glaukos iDose study | 2019 & 2020
Sigma Theta Tau International Honor Society of Nursing Inductee | 2018, 2022
National Society of Leadership and Success Member | 2022
Timeline
Utilization Review Nurse Specialist
Community Health Systems (CHS)
01.2026 - Current
Continuum of Care Coordinator
Community Health Systems (CHS)
11.2024 - 01.2026
Case Manager
Professional Case Management: New Mexico/Texas
09.2022 - 11.2024
Float Registered Nurse (PRN)
Los Alamos Medical Center
05.2021 - 10.2022
Director of Surgical Services
Los Alamos Medical Center
11.2020 - 04.2020
Clinical Office Manager and Technician Supervisor
Total Eye Care
01.2020 - 12.2020
Lead Clinical Research Coordinator
Total Eye Care
10.2018 - 09.2020
Operating Room Circulating Nurse
North Texas Surgery Center
09.2018 - 08.2020
Ophthalmologist Scribe & Technician
Total Eye Care
11.2015 - 09.2018
Bachelor of Science in Nursing, BSN - undefined
The University of Texas at Tyler
Bachelor of Arts in Psychology - undefined
The University of Texas at Tyler
Doctorate of Nursing, PhD -
The University of Texas at Tyler