Falan Williams
Windsor Locks,CT
Summary
Experienced Registered Nurse with 15 years in acute care, specializing in utilization review and virtual nursing. Evaluates medical necessity and manages resource allocation to ensure safe patient care transitions. Applies MCG/InterQual criteria to minimize clinical denials and uphold regulatory compliance in remote and high-acuity settings.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Utilization Review Nurse
UConn John Dempsey Hospital
Farmington, CT
05.2025 - Current
- SPECIALTIES: Utilization Review, Case Management
- Monitored bed count for 234-bed facility, ensuring optimal patient placement and resource allocation.
- TECH CHARTING: Epic, Microsoft outlook, Microsoft teams, Kronos and Voalte secure chat messaging
- ADDITIONAL SKILLS: Daily evaluation of patient medical records and care plans to ensure that healthcare services are medically necessary, cost-effective, and aligned with insurance and regulatory standards
- Clinical Evaluation and Timing
- Prospective Review (Prior Authorization): Evaluating proposed treatments, diagnostics, or surgeries before care is delivered to confirm necessity and policy coverage.
- Concurrent Review: Monitoring active inpatient stays day-by-day to ensure the level of care remains medically justified.
- Retrospective Review:
- Auditing medical records after services are rendered to verify proper billing, compliance, and quality.
- Communication and Coordination:
- Acting as a bridge between healthcare providers (hospitals, physicians) and insurance/managed care organizations (MCOs).
- Communicating clinical updates and coordinating discharge planning or alternative care settings.
- Compliance and Documentation:
- Maintaining accurate, real-time records in clinical and claims management systems to prevent claim denials and maximize reimbursement.
Medical Surgical Unit Registered Nurse (Per Diem: 12 hrs/month)
Saint Francis Hospital and Medical Center
Hartford, CT
07.2023 - Current
- Specialized in medical-surgical, telemetry, and neurological nursing
- BED COUNT: 871 Facility
- Managed patient care for a nurse-to-patient ratio of 1:32
- TRAUMA LEVEL: Level 1 Trauma Center
- Utilized Epic software for electronic charting and documentation
- Served as charge nurse overseeing daily unit operations
- ADDITIONAL SKILLS: VIRTUAL REGISTERED NURSE - Collaborated with patient care team to ensure effective communication and continuity of care, admissions, discharges, post-discharge teaching, in-patient education, safety rounding, clinical support, data analysis, best practices, medical policy review, chart audits and report/investigate findings, patient advocacy and nurse mentoring and preceptorship.
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 36 hrs/wk)
MidState Medical Center
Meriden, CT
01.2023 - 07.2023
- Provided specialized care in Med-Surg unit
- Managed patient care in an 80-bed facility
- Maintained nurse-to-patient ratio of 1:6
- Utilized Epic, Kangaroo, and Vocera for technical charting
- Worked as a staff member at Maxim Healthcare
Medical Surgical / Telemetry Unit Registered Nurse (Per Diem: 12 hrs/month)
Baystate Medical Center
Springfield, MA
11.2021 - 04.2023
- Specialized in medical-surgical nursing
- Managed operations in a 713-bed facility with 40 patient units
- Ensured optimal care by adhering to a 1:7 nurse-to-patient ratio
- Utilized Cerner and Vocera for electronic health record charting
- Participated in Magnet Recognition program initiatives
- Conducted educational sessions for nursing staff
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 48 hrs/wk)
Sturdy Memorial Hospital
Attleboro, MA
08.2022 - 11.2022
- Specialized in medical-surgical nursing practices
- Managed operations in a facility with 128 beds
- Maintained a nurse-to-patient ratio of 1 nurse for every 5 patients
- Utilized Cerner for electronic health record documentation
- Worked as a contracted healthcare professional with Aya Healthcare
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 40 hrs/wk)
Baystate Wing Hospital
Palmer, MA
09.2019 - 10.2021
- Specialized in telemedicine and medical-surgical nursing
- Managed patient care in a facility with 68 beds and 50 in the unit
- Maintained a nurse-to-patient ratio of 1 nurse for every 8 patients
- Utilized Cerner and Vocera for electronic charting and communication
- Served as charge nurse supervising staff and patient care
- Worked at O'Grady Peyton in a nursing capacity
Medical Surgical Unit Registered Nurse (Staff: 40 hrs/wk)
University Hospital
Kingston, St. Andrew Parish
01.2011 - 08.2019
- SPECIALTIES: Obstetrics, Step Down, Med-Surg
- BED COUNT: 493 Facility
- Managed patient ratio of 1 nurse to 6 patients
- TRAUMA LEVEL: Level 1 Trauma Center
- TECH CHARTING: Paper/Non-electronic
- SUPERVISOR EXPERIENCE: Charge
- Achieved Magnet designation for nursing excellence
- Teaching
Education
MSN -
Walden University
Minneapolis, MNBSN -
University of the West Indies
JamaicaSkills
- Utilization review
- Case management
- Discharge planning
- Patient health education
- Clinical documentation
- Epic documentation
- Quality assurance
- Patient education
- Patient health education
- Care coordination
- Clinical quality improvement
- Care quality assessments
- Progress monitoring
- Clinical supervision
- Compliance with regulatory guidelines
- Policy review
- Chart audits
- Clinical data collection
- Healthcare system resources
- Computerized charting
- Team leadership
- Unit leadership
- Staff development
- Multidisciplinary team collaboration
- Effective communication
- Conflict resolution
- Critical thinking
- Clinical judgment
- HIPAA compliance
- Informed consent
- Process improvements
- Research coordination
- Care coordination
- Clinical assessment
Certification
- Connecticut - RN
- #204296
- Exp: 2027-10
Languages
English (Native / bilingual)
Timeline
Utilization Review Nurse
UConn John Dempsey Hospital
05.2025 - Current
Medical Surgical Unit Registered Nurse (Per Diem: 12 hrs/month)
Saint Francis Hospital and Medical Center
07.2023 - Current
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 36 hrs/wk)
MidState Medical Center
01.2023 - 07.2023
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 48 hrs/wk)
Sturdy Memorial Hospital
08.2022 - 11.2022
Medical Surgical / Telemetry Unit Registered Nurse (Per Diem: 12 hrs/month)
Baystate Medical Center
11.2021 - 04.2023
Medical Surgical / Telemetry Unit Registered Nurse (Travel: 40 hrs/wk)
Baystate Wing Hospital
09.2019 - 10.2021
Medical Surgical Unit Registered Nurse (Staff: 40 hrs/wk)
University Hospital
01.2011 - 08.2019
MSN -
Walden University
BSN -
University of the West Indies