Emem Nnah
Garner,NC
Summary
Compassionate and detail-oriented Registered Nurse with over 17 years of clinical experience and 5 years in utilization review. Experienced in caring for individuals with mental health and behavioral health conditions, utilizing strong assessment, therapeutic communication, and patient-centered care to support emotional and physical well-being. Skilled in evaluating medical necessity, applying InterQual/MCG criteria, and conducting concurrent and retrospective reviews while ensuring regulatory compliance. Proven ability to collaborate with healthcare providers, insurers, and interdisciplinary teams to support safe, effective, and recovery-oriented care. Committed to improving patient outcomes, promoting mental wellness, and supporting quality healthcare delivery.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse
AmeriHealth Caritas PA
10.2019 - Current
- Performed utilization reviews in accordance with CMS, Joint Commission, and HIPPA regulations
- Attended meetings with medical staff to finalize patient discharge plans
- Adheres to accreditation, contractual and regulatory timeframes in performing all utilization management review processes
- Refers to the Utilization Review Physician Advisor all cases that do not meet established guidelines for admission or continued stay consistent with the arrangement with the Physician Advisor
- Performs concurrent review of acute and sub-acute services, as well as precertification review for all services following the plans authorization guidelines
- Completes quality monitoring of the case management professional documentation to the department standards on every case processed using a tool designated to measure compliance to standards of practice.
REGISTERED NURSE (Med/Surg)
UNC REX HOSPITAL - NC
10.2017 - Current
- Obtains accurate nursing history and documents on appropriate patient records
- Formulates an effective, individualized nursing plan of care
- Monitor and report any changes in patients admitted for stroke work up in a timely manner
- Implement hospital and nursing guidelines and procedures in clinical practice
- Initiates discharge planning upon admission and coordinates movements towards these plans and goals throughout the admission
- Provides information on health maintenance
- Per diem
REGISTERED NURSE (Surgical Step-down Unit)
FOXCHASECANCER CENTER- PA
12.2016 - 10.2017
- Educate patients and caregivers on diagnosis, treatment options, and disease process and self-management
- Frequent monitoring of flap for patients with breast reconstructive surgery as well as other kinds of surgery requiring flap check
- Post-surgical care for patients with various kinds of lung surgeries diagnosed with lung cancer
- Closely monitor patients with adverse reaction to chemo treatment to identify signs life threatening complications.
- Provide comprehensive instruction on discharge plans to sustain continuity of care upon discharge and drive recovery goals.
- Precept student nurses and new hires on unit and hospital policies, clinical skills, and direct patient care
REGISTERED NURSE (TELE UNIT)
ADVOCATE CHRIST MEDICAL CENTER- OAKLAWN
07.2015 - 09.2016
- Closely monitor patients to identify signs of arrhythmias and other life-threatening complications.
- Provide pre/ post care for patients undergoing cardiac-catheterization, TEE, stress test, pacemaker and AICD implantations, Electrophysiological studies, and anticoagulant therapy.
- Work collaboratively with cardiologist and other disciplines to discuss patients’ condition and medical needs.
- Educate the patient and family on pre and post-operative procedure, prevention, medication, and pain management.
- Perform total patient assessments on diverse patient populations and establish a plan of care for all patients at point of admission.
WARREN BARR NORTH SHORE HEALTHCARE AND REHAB CENTER
03.2014 - 07.2015
- Evaluates assigned patients within a nursing home environment and plans
- Performs various patient tests and administers medications within the scope of practice of the registered nurse.
- Promotes patients’ independence by establishing patients’ care goals, and teaching patient and families to understand conditions, medications, and self-care skills
- Establishing trust and rapport with patients and their family
- Communicate with physician, patient, and family regarding patient status and care
- Educate patients on conditions, medication, and disease processes
- Monitor physical and mental status of patient including vital signs, physical assessment, and skin assessment
- Evaluate patient and develop appropriate care plan
Registered Nurse
WESTWOOD VILLAGE (Long-Term Care / Behavioral Health Facility)
2444 W Touhy Ave, Chicago, IL 60645
11.2013 - 07.2014
- Provided nursing care to residents with mental health and behavioral disorders.
- Monitored behavioral changes and psychiatric symptoms, reporting concerns to providers.
- Administered psychotropic and other medications and monitored for side effects.
- Supervised CNAs and delegated resident care tasks.
- Implemented individualized care and behavioral management plans.
- Assisted with crisis intervention and de-escalation when needed.
- Collaborated with the interdisciplinary team to support resident care.
- Ensured compliance with safety and infection control standards.
St. POLYCARP MEDICAL CENTER. NIGERIA
12.2008 - 10.2011
- Closely monitor patients who came in with stroke like symptoms, perform neuro-checks and report any neurological deficit noted
- Educate both patient and family on the signs and symptoms of stroke and the necessary quick action they need to take
- Closely monitor patients with adverse reaction to chemo treatment to identify signs life threatening complications
- Recorded patients’ medical history, vital statistics and test results in medical records
- Assess, plan, implement, and evaluate care for patients
Education
Associate Degree in Nursing (ADN) -
School of Nursing St Lukes’ Hospital Anua
Uyo, Nigeria05-2008
Bachelor of Science in Nursing (BSN) - undefined
Grand Canyon University
Phoenix, AZ06-2015
Master of Science - PMHNP
Purdue Global University
2550 Northwestern Ave Suite 1100, West Lafayette, 01-2027
Skills
- Knowledgeable in Utilization review and medical necessity determinations
- Experience assessing patients in acute, behavioral health, post-acute, and long-term care settings
- Ability to interpret clinical documentation, lab results, imaging, and provider notes
- Expertise in acute, post-acute, and long-term care assessment
- Therapeutic communication and behavioral health assessment with knowledge of mental health and psychiatric disorders
- InterQual and MCG (Milliman) criteria proficiency
Certification
- State of North Carolina License
- State of California License
- State of Indiana License
- Certified Medical and surgical Registered Nurse (CMSRN)
- Basic Life Support Certification (BLS)
Timeline
Utilization Review Nurse
AmeriHealth Caritas PA
10.2019 - Current
REGISTERED NURSE (Med/Surg)
UNC REX HOSPITAL - NC
10.2017 - Current
REGISTERED NURSE (Surgical Step-down Unit)
FOXCHASECANCER CENTER- PA
12.2016 - 10.2017
REGISTERED NURSE (TELE UNIT)
ADVOCATE CHRIST MEDICAL CENTER- OAKLAWN
07.2015 - 09.2016
WARREN BARR NORTH SHORE HEALTHCARE AND REHAB CENTER
03.2014 - 07.2015
Registered Nurse
WESTWOOD VILLAGE (Long-Term Care / Behavioral Health Facility)
11.2013 - 07.2014
St. POLYCARP MEDICAL CENTER. NIGERIA
12.2008 - 10.2011
Bachelor of Science in Nursing (BSN) - undefined
Grand Canyon University
Associate Degree in Nursing (ADN) -
School of Nursing St Lukes’ Hospital Anua
Master of Science - PMHNP
Purdue Global University