Holly Gilliam
Pelham,TN
Summary
Dedicated and detail-oriented Registered Nurse with 12 years of diverse healthcare experience, encompassing ICU, urgent care, long-term care, and utilization review across commercial, Medicare, and Medicaid insurance plans. Adept at evaluating clinical information, ensuring compliance with protocols, and delivering exceptional patient care. Possessing expertise in eviCore's clinical platforms CDP and Isaac, with a proven track record of maintaining professionalism and fostering effective communication among healthcare providers and health plan representatives. Skilled in critical thinking, conflict resolution, and multitasking within fast-paced environments. Seeking to leverage expertise as a Clinical Service Delivery Nurse Liaison to drive excellence in healthcare delivery.
Overview
9
9
years of professional experience
Work History
Registered Nurse, Utilization Review Analyst
Evicore
04.2019 - Current
- Evaluate clinical information to determine medical necessity, ensuring adherence to established protocols.
- Utilize expertise in medical terminology and ICD-10 coding for accurate reviews across various health plans.
- Maintain 100% accuracy in case decision audits, exceeding departmental standards for productivity.
- Collaborate with team members and supervisors to provide excellent customer service and ensure compliance with HIPAA and state regulations.
- Served as trusted mentor to new and tenured utilization review analysts for CDP MSK and ISAAC MSK, contributing to team development and success.
- Promoted to Isaac MSK written team, started position 01/02/2022.
Registered Nurse Clinical Liaison
Wellness Solutions Geriatrics
11.2017 - 09.2018
- Assisted healthcare providers in long-term care facilities, facilitating patient care and documentation.
- Communicated effectively with nursing staff and physicians to address patient needs and concerns.
- Demonstrated attention to detail in reviewing medical records and ensuring accurate medication administration.
Staff Nurse/Charge Nurse, ICU
Tennova Healthcare
05.2015 - 12.2017
- Provided comprehensive care to 2-3 critically ill patients per shift, including assessment, monitoring, and medication management.
- Educated patients and families on treatment plans and discharge procedures, promoting optimal health outcomes.
- Collaborated with interdisciplinary teams to coordinate patient care and ensure quality standards were met.
- Developed strong rapport with patients and families, fostering trust and open communication during challenging times.
- Demonstrated excellent time management skills while juggling multiple priorities in fast-paced environment.
Education
Bachelor of Science - Nursing
Capella University
Minneapolis, MN12.2024
Associate of Applied Science - Nursing
Motlow State Community College
Tullahoma, TN05.2015
Associate of Applied Science - Radiologic Technology
Chattanooga State Community College
Chattanooga, TN08.2011
Skills
- Organizational Skills
- Critical Thinking
- Flexibility
- Teamwork and Collaboration
- Professionalism and Strong Work Ethic
- Patient Privacy
- Problem-Solving
- Interpersonal and Written Communication
- Proficient in Microsoft Office Suite (Outlook, Excel, and PowerPoint), WebEx Teams
License
2025-08 Registered Nurse (RN): 207491- Nurse License Compact (NLC), Tennessee State Board Licensing
Timeline
Registered Nurse, Utilization Review Analyst
Evicore
04.2019 - Current
Registered Nurse Clinical Liaison
Wellness Solutions Geriatrics
11.2017 - 09.2018
Staff Nurse/Charge Nurse, ICU
Tennova Healthcare
05.2015 - 12.2017
Bachelor of Science - Nursing
Capella University
Associate of Applied Science - Nursing
Motlow State Community College
Associate of Applied Science - Radiologic Technology
Chattanooga State Community College
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