Jennifer Helch
Butler,PA
Summary
Dynamic healthcare professional with extensive experience in utilization review and case management. Known for strong collaboration and effective communication, enhancing patient care through meticulous documentation and discharge planning. Aiming to drive improvements in patient outcomes and operational efficiency.
Overview
27
27
years of professional experience
Work History
Utilization Review Nurse/Case Manager
Independence Health System
Butler, PA
05.2013 - Current
- Analyzed patient care plans to verify alignment with established clinical guidelines and insurance protocols.
- Conducted comprehensive reviews of medical records to ensure appropriate resource utilization.
- Served as a vital liaison between patients, healthcare providers, and insurance companies, fostering effective communication and coordination among all parties involved in the care process.
- Assisted discharge planning efforts through prompt identification of medically stable patients who were ready for transition to alternate levels of care.
- Conducted thorough reviews of prior authorizations to ensure compliance with service requirements.
Critical Care Registered Nurse
Independence Health System
Butler, PA
06.1999 - 05.2013
- Administered critical care interventions to stabilize patient conditions in high-pressure environments.
- Collaborated with interdisciplinary teams to develop individualized care plans for critically ill patients.
- Monitored vital signs and clinical data, ensuring timely adjustments to treatment protocols.
- Educated families on critical care processes, enhancing understanding and emotional support during difficult times.
- Conducted comprehensive assessments to identify changes in patient status, facilitating prompt medical response.
Education
Bachelor of Science - Nursing
Slippery Rock University of Pennsylvania
Slippery Rock, PASkills
- Documentation and reporting
- InterQual criteria
- Utilization review
- Prior authorization
- Discharge planning coordination
- Insurance verification
- Medicaid
- Managed care
- Medicare
- Case management
- Milliman guidelines
Timeline
Utilization Review Nurse/Case Manager
Independence Health System
05.2013 - Current
Critical Care Registered Nurse
Independence Health System
06.1999 - 05.2013
Bachelor of Science - Nursing
Slippery Rock University of Pennsylvania