Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Skills Used
Timeline
Generic

Dustin Bolin

Baxter,KY

Summary

Competent Utilization Review Registered Nurse offering multi-disciplinary approach to patient care. Eager to utilize over 20 years of experience to help behavioral health members obtain the appropriate care they need to obtain optimal results. Positive and friendly people-person with organized and diligent attitude.

Overview

27
27
years of professional experience
1
1
Certification

Work History

Care Review Clinician

Molina Healthcare
01.2024 - Current
  • Participated in case reviews with multidisciplinary teams to discuss complex cases and develop collaborative solutions for members.
  • Enhanced interdisciplinary collaboration for better care of our members through effective communication and teamwork.
  • Engaged with other professionals to impart knowledge and discuss best treatment courses.
  • Work to ensure that members progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
  • Part of a 3-person team that is responsible for managing all inpatient and outpatient authorizations for the state of Nebraska.

Utilization Review Registered Nurse

Wellcare/Anthem
06.2017 - Current
  • Collecting information and using clinical knowledge and expertise to ensure members are directed to the appropriate level of care
  • Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
  • Use appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM clinical guidelines and contract.

Registered Nurse

Harlan Appalachian Regional Healthcare - Harlan, KY
04.1997 - 06.2017
  • Case Manager in the Utilization Review Department and have held this position for over 2 years
  • I was the Case Manager for the psychiatric department as well as managing medical patients with insurance as well as Medicare
  • I worked six days per week with Saturday being dedicated to managing all patients that are observation status in the hospital, both Medicare and other status insurance, to monitor the time of each patient spent in outpatient status and manage whether each patient qualifies for inpatient status
  • Prior to obtaining this position, I was a Registered Nurse in the Intensive Care Unit for 18 years and my responsibilities included the holistic care of the patients and their families, management of ventilators and various medication drips, administration of medications, admitting, discharging, and transferring of patients, transcribing orders, working as a team with fellow nurses, clerks, and physicians, and orienting new employees.

Education

Bachelor's degree in Nursing -

Grand Canyon University
Phoenix, AZ
04.2018

Associate in Science & Associate in Applied Science Nursing in Nursing -

Southeast Community College
Cumberland, KY
01.2000

Skills

  • Clinical Documentation
  • Clinical assessment
  • Multidisciplinary Approach
  • Healthcare systems navigation
  • Microsoft Office

Certification

RN

Accomplishments

Hopefully, I have had a noticeable impact on my patients, colleagues, and management personnel. I was with this company for nearly 20 years and have been in ICU the majority of the time but also served as a Case Manager for Quality Assurance. I was also occasionally pulled to other units to assist. I have worked in the Emergency Department, Telemetry, Med/Surg, Pediatrics, and Psychiatric Department as a float nurse at times as well. In addition to working as a Case Manager, I also completed coding classes and obtained my CCA certification and CPC-A certification however allowed this certification to lapse since did not pursue a coding job.

Skills Used

By working as a Case Manager, I am knowledgeable in operating HCS, Provider Portal, Star Navigator, PEGA, MS Outlook, MS Excel, OneNote, and MS Word. I also have 18 years of experience in ICU that involved patient care that consisted of ventilator management, administering and maintaining medication drips, cardiac monitoring, assisting physicians with bedside procedures including central line insertion, arterial line insertion, thoracentesis, chest tube insertion, and dialysis catheter insertion, and concise communication with other team members to provide optimal care to the patients and their families. I excel at multitasking and am a team player but can also be productive working from home.

Timeline

Care Review Clinician

Molina Healthcare
01.2024 - Current

Utilization Review Registered Nurse

Wellcare/Anthem
06.2017 - Current

Registered Nurse

Harlan Appalachian Regional Healthcare - Harlan, KY
04.1997 - 06.2017

Bachelor's degree in Nursing -

Grand Canyon University

Associate in Science & Associate in Applied Science Nursing in Nursing -

Southeast Community College
Dustin Bolin