I am a highly motivated and committed registered nurse with extensive experience across the healthcare spectrum, seeking a Utilization Management position at Molina Healthcare Services.
Overview
16
16
years of professional experience
Work History
Care Review Clinician, Inpatient Physical Health
Molina Healthcare Services
09.2024 - Current
Gather and review clinical documents, apply proper criteria/guidelines and use both clinical judgement and analytical thinking to render coverage determinations/recommendations along the continuum of care in a timely and accurate manner.
Registered Nurse Team Leader
Cayuga Medical Associates
07.2014 - 09.2024
Provided in office, telephonic and virtual nursing support, case management and staff leadership for the Internal Medicine, Rheumatology and Infectious Diseases Departments.
Registered Nurse
Tully Hill Chemical Dependency Center
08.2013 - 06.2014
Performed admissions, case management, discharge planning, weekly nursing lectures, CIWA/COWS assessments and supported clinical counselors and social workers.
Registered Nurse
Associated Medical Professionals Urology
04.2009 - 07.2013
Duties included diagnostic testing, telephonic triage, surgical center intake/OR/PACU, weekly care plans, prior authorizations, precepting nursing students.
Education
Associates in Applied Sciences - Nursing
Crouse Hospital School of Nursing
12.2008
Bachelor of Arts - Biology
State University of New York at Oswego
05.1996
Skills
Strong multitasking abilities
Skilled in PEGA, MCG, Microsoft Office Suite
Adaptability to changing priorities and evolving requirements
Productive in team settings and self-directed tasks