Donna Rollins
Tampa
Summary
To obtain a responsible position with an organization where my experience, accomplishments and proficiency will allow me the opportunity for growth.
Professional with strong background in care coordination. Skilled in patient advocacy, healthcare planning, and resource management. Known for effective team collaboration and achieving measurable results. Adaptable to changing needs with robust communication and organizational skills. Reliable and focused on delivering high-quality care outcomes.
Overview
16
16
years of professional experience
Work History
Care Coordinator
Wellcare/Centene North Carolina Healthy Opportunities Pilot
06.2024 - 01.2025
- Provided select evidence based non-medical interventions related to housing, food, transportation, and interpersonal safety and toxic stress to high needs Medicaid enrollees
Telephonic Utilization Review Nurse
WellCare/Centene Health plans of North Carolina
02.2014 - 12.2023
- Responsible for evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of the health benefits plan
- Act as a member advocate, Discharge planning, seeking and coordinating solutions to member healthcare needs
- Telephonic Utilization Review Nurse for NICU babies and Inpatient admission
- Telephonic Utilization Review Nurse for Skilled Nursing, LTAC, and Inpatient Rehab
- Clinical Appeals Nurse Reviewer
Outpatient Precert Nurse
Amerigroup Corporation
02.2012 - 02.2014
- Responsible for day-to-day telephonic medical management and pre-authorization activities
- Manages member care ensuring essential, effective, appropriate and coordinated behavioral and physical health and social services
- Acts as a member advocate, seeking and coordinating solutions to member healthcare needs
Nurse
Sun Terrace Nursing Home
08.2008 - 02.2012
- Responsible for patients in a nursing home setting taking vital signs, Preparing and administering injections, medications, enemas
- Treating bedsores, Monitoring patients and reporting changes
- Collecting samples for testing
- Provide patient hygiene
- Monitoring food and liquid input/output, applying dressings and bandages
Nurse Chart Auditor
Outcome, Inc
08.2008 - 01.2009
- Accurately and efficiently conduct medical record review services, Scan relevant components of the medical record to support reviews performed, upload scanned medical records daily
- Maintain communication lines with assigned advocate, successfully complete required training, testing and quality assessments
- Communicate effectively and professionally with care provider offices, clinics, hospitals, other clinical facilities
- Travel to medical facilities in specified area of region from home to complete review services
- Abide by all HIPAA and associated patient confidentiality requirements
Education
LPN -
Galen Health Institute
St. Petersburg, Fl05.2008
Associates Degree - Nursing
Fortis College
Tampa, Fl06.2010
Skills
- Organizational skills
- Patient education
- Documentation
- Case management
Timeline
Care Coordinator
Wellcare/Centene North Carolina Healthy Opportunities Pilot
06.2024 - 01.2025
Telephonic Utilization Review Nurse
WellCare/Centene Health plans of North Carolina
02.2014 - 12.2023
Outpatient Precert Nurse
Amerigroup Corporation
02.2012 - 02.2014
Nurse
Sun Terrace Nursing Home
08.2008 - 02.2012
Nurse Chart Auditor
Outcome, Inc
08.2008 - 01.2009
Associates Degree - Nursing
Fortis College
LPN -
Galen Health Institute
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