Summary
Overview
Work History
Education
Skills
Timeline
Generic

Eugenia Swearengen

Registered Nurse
Aurora,CO

Summary

Accomplished Supervisor focused on meeting customer expectations and achieving company goals. Drives success by directing high-producing teams while developing lasting employee rapport—exceptional knowledge of cost-reduction methods and streamlining production processes. Hard-working Supervisor with exceptional experience leading teams, delivering results and exceeding expectations. Creative and motivated leader adept at utilizing exceptional design and planning strengths to accomplish complex projects. Skilled in teaching new concepts and best practice strategies.

Overview

17
17
years of professional experience

Work History

Supervisor, Medicare/Medicaid Clinical Appeals

United Healthcare
04.2022 - Current
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
  • Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
  • Direct daily operations of the appeals and grievance team consisting of 20-25 employees including Staff Nurses, Subject Matter Experts, and Administrative Staff.
  • Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
  • Responsible for monitoring, oversight, and compliance with the Centers of Medicare and Medicaid Services (CMS)
  • Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.

Clinical Appeals Nurse Subject Matter Expert

United Healthcare
05.2013 - 04.2022
  • Mentored new nursing staff members, fostering teamwork and improving unit efficiency.
  • Contacted each new employee to welcome them and introduce them to team and department courses.
  • Increased quality of care by participating in ongoing professional development opportunities such as workshops, conferences, and online courses.
  • Managed approximately 10 clinical reviews from mentees each day.

Nurse Educator Utilization Management, Remote

Humana
08.2007 - 05.2013
  • Directly completed utilization reviews for members at least 20 each day to maintain Medicare and Medicaid guidelines.
  • Promoted professional growth among nursing staff through continuous education opportunities, conferences, and workshops.
  • Established a supportive learning environment by providing guidance and mentorship to nursing staff.
  • Collaborate with other healthcare givers in reviewing actual and proposed medical care and services against established Medicare and Medicaid, Coverage Guidelines review criteria.

Education

Master of Science - Nursing Leadership/Management

Capella University
Minnesota City, MN
12.2016

Bachelor of Science - Nursing

Our Lady of The Lake College
Baton Rouge, LA
12.2006

Associate of Science - Nursing

Northwest Mississippi Community College
Senatobia, MS
12.2002

Skills

  • Year Performance evaluation
  • Interviewing and hiring
  • Organizing and Leading Staff Meetings
  • Employee Motivation

Timeline

Supervisor, Medicare/Medicaid Clinical Appeals

United Healthcare
04.2022 - Current

Clinical Appeals Nurse Subject Matter Expert

United Healthcare
05.2013 - 04.2022

Nurse Educator Utilization Management, Remote

Humana
08.2007 - 05.2013

Master of Science - Nursing Leadership/Management

Capella University

Bachelor of Science - Nursing

Our Lady of The Lake College

Associate of Science - Nursing

Northwest Mississippi Community College

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Eugenia SwearengenRegistered Nurse