Dolly Oliver
League City
Summary
Highly skilled registered nurse with over 15 years of multifaceted clinical experience, my professional focus has predominantly revolved around Case Management and Utilization Review. My practice is characterized by attention to detail, innate problem-solving abilities, and adept communication skills, all essential attributes in navigating complex medical scenarios and facilitating optimal patient care delivery.
Overview
8
8
years of professional experience
Work History
Travel RN Case Manager
AMN Healthcare
Atlanta, GA
02.2026 - Current
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Optimized resource utilization by identifying opportunities for cost containment while maintaining quality of care.
- Conducted comprehensive assessments of patient needs to inform effective care planning.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
RN Case Manager
HCA Healthcare Houston Medical Center
Houston, TX
10.2024 - 02.2026
- Coordinated multidisciplinary team meetings to enhance communication and streamline patient care processes.
- Assessed patients' needs through detailed evaluations, ensuring appropriate resource allocation and support services.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
- Educated patients and caregivers on healthcare protocols and processes.
- Advocated for patients with insurance companies, securing coverage for necessary treatments and medications.
RN Case Manager/Utilization Review
ALPS Services, Inc.
Cincinnati, OH
01.2023 - 03.2024
- Analyzed patient records to determine whether requested services met established criteria for medical necessity.
- Maintained detailed documentation related to all reviews.
- Reviewed provider documentation to ensure billed services align with national and local policies, adhere to accepted billing and coding standards, and meet Medicare requirements.
- Managed daily workload efficiently by prioritizing tasks based on urgency and importance.
- Conducted an educational session with providers to address denial reasons and provide education on proper billing and documentation to reduce denials.
- CONTRACT POSITION at Noridian Healthcare Solutions
RN Clinical Review Nurse
ALPS Services, Inc.
Cincinnati, OH
01.2022 - 08.2022
- Focused on post-payment claims.
- Utilized critical thinking skills to make sound clinical judgments in complex situations.
- Examined documentation submitted by providers under review and made clinical determinations for payment.
- Reviewed documentation to determine that services billed were reasonable and necessary, supported by national and local policies, under accepted billing and coding practices, and met standards of medical care. Reviewed part B and BA claims.
- CONTRACT POSITION at Noridian Healthcare Solutions
RN Concurrent Review Case Manager
KelseyCare Advantage
Pearland, TX
08.2019 - 06.2021
- Responsible for conducting concurrent and retrospective reviews for members within assigned facilities.
- Responsible for processing referrals based on priority and turnaround time.
- Performed bi-weekly reviews of inpatient members and weekly reviews of members in skilled nursing facilities, utilizing Interqual criteria to ascertain medical necessity and determine the optimal level of care.
- Collaborated closely with the medical director and hospitalist team to facilitate discharge planning through weekly caseload conferences.
- Demonstrated excellent communication skills when interacting with colleagues, supervisors, and patients.
RN Care Coordinator
Altus ACE
Houston, TX
08.2018 - 08.2019
- Oversaw diverse managed care memberships and conducted post-hospital discharge follow-ups with discharged individuals.
- Maintained regular communication with high-utilization individuals, providing support through tailored programs and resources to mitigate unnecessary hospital or emergency room visits, thereby contributing to cost-reduction initiatives.
- Liaised with multidisciplinary teams to organize and coordinate health and care services to meet patients' complex care needs.
- Engaged in targeted disease management initiatives to educate members on disease processes. Contributed to weekly rounds with the medical director to deliberate on high-risk member cases.
Education
Bachelor of Science - Nursing
Lamar University
Beaumont, TX12.2003
Skills
- Time Management
- Multidisciplinary approach
- Case Management
- Discharge Planning
- Patient Assessment
- Medical Necessity
- Critical Thinking
- Utilization review
Licensures
Registered Nurse
Texas- Compact
2/24/2004- Current
Additional Experience
- RN Case Manager Memorial Hermann SE (2015-2019)
- RN Case Manager Clear Lake Regional Medical Center (2014-2015)
- RN Case Manager Memorial Hermann Home Health (2010-2013)
- RN Field Nurse/Nurse-Family Partnership Program (2008-2010)
- RN 3 RMCHP Clinic UTMB (2005-2008)
- RN2 Labor and Delivery UTMB (2004-2005)
Timeline
Travel RN Case Manager
AMN Healthcare
02.2026 - Current
RN Case Manager
HCA Healthcare Houston Medical Center
10.2024 - 02.2026
RN Case Manager/Utilization Review
ALPS Services, Inc.
01.2023 - 03.2024
RN Clinical Review Nurse
ALPS Services, Inc.
01.2022 - 08.2022
RN Concurrent Review Case Manager
KelseyCare Advantage
08.2019 - 06.2021
RN Care Coordinator
Altus ACE
08.2018 - 08.2019
Bachelor of Science - Nursing
Lamar University