Jennice Olan
Lebanon,PA
Summary
Experienced Nurse case manager with a proven track record in reducing hospital readmissions through effective care coordination and critical thinking. Expert in utilization review and insurance verification, I excel in managing high-acuity cases while ensuring optimal patient outcomes and satisfaction. Committed to quality improvement and empowering patients in their health journey.
Overview
8
8
years of professional experience
Work History
Nurse Care Manager
Vivo Care
2025.10 - Current
- Facilitated communication between patients and healthcare providers to ensure continuity of care.
- Coordinated care plans with multidisciplinary teams to enhance patient outcomes.
- Assessed patient needs and provided tailored resources to support health management.
- Reduced hospital readmissions for patients through proactive follow-up and continuous communication.
- Identified potential barriers to care, implementing tailored solutions to improve outcomes.
Concurrent Review Nurse
CareCentrix
2025.03 - Current
- Reduced hospital readmission rates with timely assessments and effective discharge planning.
- Conducted comprehensive chart reviews to assess medical necessity, ensuring optimal reimbursement levels for services rendered.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Managed multiple high-acuity cases simultaneously while maintaining exceptional attention to detail and accuracy in documentation.
Nurse Case Manager
Neuehealth
2024.06 - 2025.02
- Collaborated with healthcare leaders and physicians to support and offer resources in performance of duties to maintain high-quality and efficient patient care.
- Educated patients on disease management techniques, empowering them to take control of their health and reduce complications.
- Promoted continuity of care by coordinating with healthcare providers, social workers, and family members in the development of discharge plans.
- Managed caseloads efficiently, prioritizing high-risk cases while ensuring all patients received appropriate attention and support.
Managed Care Coordinator
Elevance Health
2023.07 - 2024.04
- Implemented evidence-based strategies for reducing emergency department visits among high-utilization patients through proactive outreach initiatives.
- Enhanced patient satisfaction with personalized care coordination, addressing individual needs and concerns.
- Collaborated with healthcare providers to identify gaps in care, devising targeted interventions for improvement.
- Reduced hospital readmissions by providing timely follow-up support and education to patients and their families.
- Streamlined the managed care process for better efficiency through thorough documentation and accurate recordkeeping.
- Facilitated smooth transitions of care between healthcare settings by working closely with discharge planners, case managers, nursing staff, and physicians.
Prior Authorization Nurse II
Elevance Health
2021.09 - 2023.06
- Maintained accurate records of authorization requests by organizing documentation and tracking status updates.
- Conducted follow-up calls to ensure timely processing of authorization requests, minimizing delays in patient care.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Responded to inquiries from healthcare providers regarding prior authorization requests.
- Verified eligibility and compliance with authorization requirements for service providers.
- Input all patient data regarding claims and prior authorizations into system accurately.
- Conducted thorough reviews of medical records, identifying necessary documentation to support prior authorization requests.
- Worked within care access and monitoring team to offer clerical and data entry support for members requiring hospitalization and utilization review for healthcare services.
- Maintained up-to-date knowledge of industry trends, best practices, and regulatory requirements to ensure accurate and relevant guidance during utilization review activities.
Licensed Practical Nurse
Wellspan Health
2019.06 - 2021.09
- Coordinated with insurance companies to obtain pre-authorizations for scheduled surgeries, minimizing financial barriers for patients.
- Obtained case history and gathered triage information to determine appropriate avenue for care.
- Counseled patients via telephone according to established guidelines and protocols, advising on provider-established plans of care.
- Enhanced patient satisfaction by providing timely and accurate telephone triage services.
- Scheduled appointments for patients not requiring emergency services but needing examination from provider and consulting directly with provider.
- Advised patients on pre- and post-operative instructions, medication administration and symptoms indicating emergency care.
Home Health Licensed Practical Nurse
Aveanna Healthcare
2018.10 - 2020.12
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Assisted patients with activities of daily living, promoting independence and quality of life.
- Maintained accurate documentation of patient care, facilitating communication among healthcare team members and supporting continuity of care.
- Conducted thorough assessments to identify changes in patient condition, allowing for timely intervention and treatment adjustments.
Education
Associate of Science - Nursing
Harrisburg Area Community College
Harrisburg, PA2008-12
Skills
- Critical thinking
- Care coordination
- Utilization review
- Discharge planning
- Case management
- Quality improvement
- Insurance verification
- Medicare guidelines
- Medicaid guidelines
- Milliman guidelines
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Nurse Care Manager
Vivo Care
2025.10 - Current
Concurrent Review Nurse
CareCentrix
2025.03 - Current
Nurse Case Manager
Neuehealth
2024.06 - 2025.02
Managed Care Coordinator
Elevance Health
2023.07 - 2024.04
Prior Authorization Nurse II
Elevance Health
2021.09 - 2023.06
Licensed Practical Nurse
Wellspan Health
2019.06 - 2021.09
Home Health Licensed Practical Nurse
Aveanna Healthcare
2018.10 - 2020.12
Associate of Science - Nursing
Harrisburg Area Community College
Licences
- Pennsylvania
- New York
- California