Jillian Blair, MSN RN
Registered Nurse
East Brunswick,NJ
Summary
Experienced registered nurse with a background in public health and managed care. Skilled in ensuring patient safety, compliance, and risk management. Proven ability to enhance processes and meet regulatory standards. Seeking opportunities to utilize expertise in risk management, compliance, and safety to drive organizational excellence and maintain regulatory adherence.
Overview
12
12
years of professional experience
3
3
Certifications
1
1
Language
Work History
Associate Director of Risk Management
NYC Health & Hospitals Gotham Health
04.2023 - Current
- Experience working with 29 federally qualified health centers (FQHC), including community health centers, diagnostic treatment centers, and school-based centers within the largest public healthcare system in the metro area.
- Identified and mitigated healthcare risks to ensure patient safety and regulatory compliance, improving care quality and reducing liabilities.
Visiting Professor
Chamberlain University
04.2022 - 02.2023
- Designed and delivered lectures, facilitated class discussions, and created assignments to enhance student learning.
- Assessed student performance accurately using departmental guidelines and rubrics.
Clinical Performance Manager Utilization Review
Bright Health
06.2022 - 01.2023
- Managed daily clinical and operational activities for offshore outpatient vendor partnerships.
- Worked closely with medical directors to develop and implement policy changes.
- Assisted with audit development, driving process improvements and operational efficiency.
Utilization Review Nurse
Healthfirst
11.2020 - 06.2022
- Reviewed patient records and treatment plans to ensure medical necessity and compliance with insurance policies and clinical guidelines.
- Collaborated with healthcare providers to facilitate prior authorizations and improve patient care.
- Documented utilization review findings and provided recommendations to optimize care delivery.
Clinical Quality Assurance Auditor
Healthfirst
11.2015 - 11.2020
- Performed clinical quality audits and evaluations for intake assessment and utilization review nurses to ensure compliance with standards and improve operational efficiency.
Assessment Nurse
Healthfirst
12.2012 - 11.2015
- Conducted home visits to assess member enrollment, service needs, and contributed eligibility for long-term care plans, ensuring compliance with Department of Health (DOH) requirements.
Education
Bachelor of Science - Nursing
Drexel University
Bachelor of Arts - Communications
Temple University
Master of Science - Nursing Informatics
Walden University
Skills
Decision-making
Team collaboration and leadership
Strategic leadership
Organizational development
Certification
Certified Registered Nurse, State of New York Board of Nursing
Affiliations
- American Society for Health Care Risk Management
- Autism Speaks, Volunteer
Additional Employment History
Village Point Rehabilitation and Healthcare
Per Diem RN Charge Nurse
2019-2020
Sunrise Assisted Living
Per Diem RN Charge Nurse
2018-2019
Trinity Health
RN Coordinator of Care
2011-2012
Genesis Healthcare The Belvedere
Charge Nurse
2010-2011
Timeline
Associate Director of Risk Management
NYC Health & Hospitals Gotham Health
04.2023 - Current
Clinical Performance Manager Utilization Review
Bright Health
06.2022 - 01.2023
Visiting Professor
Chamberlain University
04.2022 - 02.2023
Utilization Review Nurse
Healthfirst
11.2020 - 06.2022
Clinical Quality Assurance Auditor
Healthfirst
11.2015 - 11.2020
Assessment Nurse
Healthfirst
12.2012 - 11.2015
Bachelor of Arts - Communications
Temple University
Certified Registered Nurse, State of New York Board of Nursing
Certified Registered Nurse, State of New Jersey Board of Nursing
Certified Registered Nurse, State of Maryland Board of Nursing
Bachelor of Science - Nursing
Drexel University
Master of Science - Nursing Informatics
Walden University
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