Geri Albright
Tucson,AZ
Summary
Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
15
15
years of professional experience
Work History
Concurrent Review Nurse, Utilization Management
Centene Management Services LLC
12.2015 - 10.2023
- Reduced hospital readmission rates with timely assessments and effective discharge planning.
- Reviewed Medical Inpatient and Outpatient prior authorizations for necessity and appropriateness of level of care following InterQual and Centene policies.
- Used InterQual criteria for Medicare, Marketplace and Medicaid to assist with preadmission, admission and continued stay.
- Weekly rounds for discharge planning with Medical Director input and guidance.
- Worked closely with facility Case Management and staff to promote safe discharge planning
Nurse Case Management
Carondelet Health Network, St. Joseph Hospital
10.2012 - 12.2015
- Facilitated smooth transitions between healthcare settings by effectively communicating pertinent information to receiving facilities or home health agencies.
- Educated patients and caregivers on healthcare protocols and processes.
- Using InterQual, reviewed appropriateness of patient's admission to hospital from Emergency department, continued stay and coordination of needs for discharge.
- Facilitated admissions to Skilled Nursing Facilities, Assisted Living or Hospice directly from Emergency Department.
Primary Care Nurse, Neonatal Intensive Care Unit
Banner University Medical Center Tucson
07.2008 - 10.2011
- Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
- Utilized evidence-based practices to develop individualized treatment plans tailored specifically for each patient''s unique needs.
- Monitored patient reactions after administering medications and IV therapies.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
Education
Nursing Diploma - Nursing
Good Samaritan School of Nursing
Portland, OR06.1984
Skills
- Interdisciplinary Collaboration
- Patient Care Assessment
- Attention to Detail
- Patient and family advocacy
- Intake and discharge
- Utilization review
- Direct Patient Care
- Nursing Documentation
- HIPAA Compliance
Timeline
Concurrent Review Nurse, Utilization Management
Centene Management Services LLC
12.2015 - 10.2023
Nurse Case Management
Carondelet Health Network, St. Joseph Hospital
10.2012 - 12.2015
Primary Care Nurse, Neonatal Intensive Care Unit
Banner University Medical Center Tucson
07.2008 - 10.2011
Nursing Diploma - Nursing
Good Samaritan School of Nursing
Similar Profiles
Rona WilsonRona Wilson
Care Management Support Coordinator II at Centene Management Company LlcCare Management Support Coordinator II at Centene Management Company Llc
Melissa JohnsonMelissa Johnson
NICU/Pediatric Concurrent Review Nurse at Centene Management Company LLCNICU/Pediatric Concurrent Review Nurse at Centene Management Company LLC
Mikael SpencerMikael Spencer
Grievance & Appeals Coordinator at Centene Health ManagementGrievance & Appeals Coordinator at Centene Health Management