Julia Fanua
Perris,CA
Summary
Dependable Utilization Review Nurse promoting over 4 years of expertise in healthcare industry. Knowledgeable in admissions and stay reviews. Considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers.
Overview
1
1
year of professional experience
Work History
Utilization Management Nurse
Kern Health Systems
05.2023 - Current
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Improved patient care quality by conducting thorough utilization reviews and making recommendations for optimal treatment plans.
- Supervised and maintained all utilization review documentation through JIVA.
- Evaluated patient histories, complaints, and current symptoms.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
Licensed Vocational Nurse Lead
Mental Health Urgent Care
01.2023 - Current
- Responded to patient requests with appropriate clinical and personal assistance.
- Assessed patients' temperature, pulse, and blood pressure and recorded in electronic medical records.
- Assisted with admissions, appointments, transfers, and discharges.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Safeguarded patient confidentiality by adhering to HIPAA regulations and maintaining secure medical records.
- Provided patient education on health care issues and prescribed medications.
Education
Bachelor of Science - Registered Nursing
West Coast University
Ontario, United States04.2024
No Degree - Nursing
Northwest College
Riverside, United States09.2019
Skills
- Outpatient Care
- Medical Coding
- Utilization Management
- Milliman Guidelines
- Microsoft Office
- Training staff
- Certified in CPR/AED
- Effective Communication
Timeline
Utilization Management Nurse
Kern Health Systems
05.2023 - Current
Licensed Vocational Nurse Lead
Mental Health Urgent Care
01.2023 - Current
Bachelor of Science - Registered Nursing
West Coast University
No Degree - Nursing
Northwest College
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