Divina Meng
Summary
Experienced professional with a wealth of knowledge and skills in expertise. Exceptional time management abilities for effective task prioritization and consistent meeting of deadlines. Highly organized with a strong focus on executing projects efficiently and with attention to detail. Thrives in both independent and collaborative environments, always ready to support and contribute to team success.
Overview
20
20
years of professional experience
Work History
Utilization Review Nurse
Elevance Health
06.2021 - Current
- Conducts initial medical necessity clinical screening
- Determines if presented clinical information meets medical necessity criteria
- Follows up to obtain additional clinical information
- Ensures proper documentation, provider communication, and telephone service
- Adheres to department standards and performance metrics
- Work in collaboration with medical directors, colleges, discharge planners
Clinical Nurse
Sharp Healthcare
08.2004 - 06.2021
- Uses systematic planning for coordinated care with multidisciplinary teams and patients
- Manages multiple patient needs and aspects of care effectively
- Identifies actual/potential problems and continuously evaluates interventions
- Collaborates with patients, families, and the team for a comprehensive plan of care
- Analyzes situations for appropriate delegation, supervision levels, and follows through
- Establishes a therapeutic relationship and anticipates and addresses potential barriers
Education
Bachelor's degree - Registered Nurse
Newman University
Skills
- Adaptability in Dynamic Environments
- InterQual criteria
- Clinical assessment
- Utilization review
- Documentation and reporting
Timeline
Utilization Review Nurse
Elevance Health
06.2021 - Current
Clinical Nurse
Sharp Healthcare
08.2004 - 06.2021
Bachelor's degree - Registered Nurse
Newman University
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