Elisa V. Morris

• Conducted thorough UM reviews of clinical documentation to ensure accuracy and completeness.
• Mentored junior nurses on case evaluation techniques and regulatory standards.
• Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
• Submitted cases for criteria failures and helped facilitate resolutions and approvals.
• Evaluated patient care plans for medical necessity and compliance with regulations.

Full time case manager (UR, discharge planning, daily trauma medical rounds and care coordination). Also Worked 1 year as UR Dept Manager: Management of LOS, Denials, Budget, Appeals, and Reduce Readmissions.

Utilized multiple computer platforms such as Midas, Medical Necessity Programs, Curaspan, Microsoft Office Suite, Taleo.

• Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
• Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.
• Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.

• Travel Nurse contract position working full time as a Care Coordinator- RN, covering different units as assigned. Required Milliman & Roberts for utilization review. Provided discharge planning for each patient as indicated. Utilized EPIC, Physician Order Entry, Word, Accent and Midas programs.
• (1000+ bed hospital)

• Nurse Manager for Utilization Review Department- management of nursing staff and reported directly to CMO for physician advisor and CFO for revenue cycle integrity. Implemented the Admit to Utilization Review Protocol, Direct Admit Protocol and recently opened the Admission/Discharge and Transfer Center. Was able to implement staffing 24/7 for review of medical necessity of all admissions into the facility. Reduced inappropriate admissions and reduced Length of Stay while in house. Utilized Word, Excel and Power Point on a regular basis.

• (335 bed hospital)

• Nurse Case Manager- in the Case Management Department providing discharge planning, care coordination, utilization review, and physician education. Utilized InterQual, Curaspan and Midas programs for completion of job duties.

• Working full time as a Rehab Liaison- assessing patients for admission to the hospital for inpatient rehabilitation services. Worked with CMS 13 guidelines, case management assessments and discharge planning. Worked with local hospitals, physicians and discharge planners to facilitate admission to Health South. Also provided education to community through events and health fairs.

• President and Owner of own business. Provision of medical case management services, chart review, attendant care assessments, home evaluations, life care planning, medical cost projections, care coordination and medical research. Facilitated discharges to next level of care transition. Services provided to employers, insurance companies, hospitals, and attorneys.
• (Owner)