Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Heather Yoder

Fredericktown,OH

Summary

Dedicated Registered Nurse with a strong background in acute care, care coordination, and utilization management. Demonstrated expertise in prior authorization reviews and clinical documentation analysis, ensuring compliance with medical necessity standards. Committed to enhancing patient outcomes through effective communication and collaboration.

Overview

1
1
Certification
6
6
years of professional experience

Work History

Pre-Certification Review Nurse

Quantum Health
11.2025 - Current
  • Analyzed clinical documentation to determine medical necessity, supporting informed decision-making.
  • Reviewed prior authorization requests to ensure compliance with InterQual and payer-specific criteria, enhancing approval accuracy.
  • Collaborated with providers to gather clinical information, facilitating timely review processes.

Nurse Care Coordinator

Quantum Health
06.2024 - 11.2025
  • Facilitated patient education on treatment options and health management, empowering patients to make informed health decisions.
  • Coordinated care management, prior authorizations, pharmacy benefits, and financial assistance to streamline patient access to necessary services.
  • Reviewed documentation to identify members eligible for targeted care management programs.

Travel Registered Nurse

Pluto Healthcare
10.2021 - 06.2024
  • Led patient care and staff management in the role of Charge Nurse.
  • Delivered patient care in cardiac, neuro, med-surg, and observation units.

Registered Nurse

OhioHealth Riverside Methodist Hospital
07.2020 - 10.2021
  • Delivered comprehensive stroke and neurology nursing care, ensuring optimal patient outcomes and support during critical treatment phases.

Education

Bachelor of Science - Nursing

Mount Vernon Nazarene University
Mount Vernon, OH
05-2020

Skills

  • Prior Authorization
  • InterQual
  • Utilization Management
  • Acute Care Nursing
  • Case Management
  • Patient Advocacy

Certification

  • Registered Nurse - Compact Multistate License (NLC), Active

Timeline

Pre-Certification Review Nurse

Quantum Health
11.2025 - Current

Nurse Care Coordinator

Quantum Health
06.2024 - 11.2025

Travel Registered Nurse

Pluto Healthcare
10.2021 - 06.2024

Registered Nurse

OhioHealth Riverside Methodist Hospital
07.2020 - 10.2021

Bachelor of Science - Nursing

Mount Vernon Nazarene University
Heather Yoder