Overview
Work History
Education
Skills
Timeline
Generic

Jennifer Collier

Seaford,VA

Overview

21
21
years of professional experience

Work History

Utilization Review RN

Humana
Work From Home
08.2023 - 08.2024
  • Performed medical necessity prior authorization reviews for all home care services using CMS Chapter 7 guidelines for the Medicare population.
  • Monitored pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
  • Maintained up-to-date knowledge of health plan benefits, policies, procedures, regulations, coding guidelines.

Utilization Review RN

Elevance Health
Work From Home
04.2021 - 06.2023
  • Determined medical necessity and cost-effectiveness of all outpatient services through utilization review processes using CMS NCDs, LCDs, Medicare Chapter 15 guidelines, and Elevance Health Clinical Guidelines.

Nurse Supervisor

Riverside Health System
Newport News, VA
04.2014 - 10.2021
  • Managed and supervised a team of 10-15 registered nurses, RNs, and ancillary staff.
  • Nurse triage call center : Assessed callers from the community to determine the next best course of action using Schmidt Thompson protocols.
  • Riverside Health System Transfer Center : Guided patient care with the direction of the physician. Referred patients into a Riverside facility from other hospital facilities as well as internal transfers. Offered consultations between providers and facilitated the transfer.
  • Riverside Remote Monitoring: Monitored at-risk patients' vital signs on a daily basis to implement teaching, planning, and communication with providers. This often resulted in medication management, dietary teaching, and early intervention for patients with ESRD, Diabetes 1 and 2, Cancer, COPD, and uncontrolled hypertension.
  • Post Discharge Nurse: Identified potential risks and developed and enacted procedures to address them by communicating and collaborating with physicians and the Risk Management Team.

Registered Nurse

Bon Secours Mary Immaculate Hospital
Newport News, VA
09.2007 - 12.2013
  • Charge Nurse on 14 bed Mother-Infant care unit, Newborn Nursery, and 8 bed NICU.
  • Mother and Infant care unit RN assessment, planning, teaching and implementation of patient directed care to vaginal and C-section new mothers and infants.
  • Newborn Nursery : assessment, planning, teaching and implementation of newborn infants.

Registered Nurse

Riverside Regional Medical Center
Newport News, VA
07.2003 - 09.2008
  • Change Nurse on a 22 bed Mother-Infant hospital unit with a Newborn Nursery and 7 bed Antepartum unit.
  • Mother-Infant care RN : Assessment, planning, teaching and implementation of patient directed care to vaginal and C - section mothers after delivery and infant.

Education

RN Nursing Diploma - Registered Nurse

Riverside School of Professional Nursing
Newport News, VA
07-2003

Skills

  • Current, unrestricted RN Compact State licensure in the state of Virginia
  • Proficient in standard medical practices and insurance benefit structures with the ability to use them in varied situations
  • Comprehensive knowledge of Microsoft Word, Outlook and Excel
  • Ability to work independently under general instructions and within a team
  • Effective telephonic and virtual communication skills
  • Technical savvy and ability to navigate multiple systems and screens while working cases
  • Working knowledge of CMS Medicare guidelines including CMS Manual, NCD's, LCD's, and Milliman guidelines

Timeline

Utilization Review RN

Humana
08.2023 - 08.2024

Utilization Review RN

Elevance Health
04.2021 - 06.2023

Nurse Supervisor

Riverside Health System
04.2014 - 10.2021

Registered Nurse

Bon Secours Mary Immaculate Hospital
09.2007 - 12.2013

Registered Nurse

Riverside Regional Medical Center
07.2003 - 09.2008

RN Nursing Diploma - Registered Nurse

Riverside School of Professional Nursing

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Jennifer Collier