Dependable Utilization Review Nurse promoting over 30 years of expertise in healthcare industry. Knowledgeable in admissions and stay reviews.
Overview
30
30
years of professional experience
1
1
Certification
Work History
RN Case Manager
Advocate Aurora Health Care
06.2005 - Current
Effectively communicated with physicians regarding patient needs, performance, medications and changes.
Responded promptly and professionally to patient questions and concerns.
Participated in patient and family planning process, as well as provided instructions and addressed question and concerns.
Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
Nursing House Supervisor
Aurora Medical Center
01.2021 - 01.2023
Assisted with patient flow throughout the hospital by communicating with team members and providers
Assured adequate staffing to accommodate patient needs based on acuity
Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
Registered Nurse, Medical-Surgical Unit
Aurora Health Care
06.1993 - 01.2021
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Administered medications via oral, IV, and intramuscular injections and monitored responses.
Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
Registered Nurse
St Catherine's Hospital
01.1997 - 01.1999
Provided nursing care on a pediatric unit for 6 months
Provided nursing care in the outpatient department for 18 months
Administered Chemotherapy and performed therapeutic phlebotomies in the hospital outpatient oncology department
Coordinated with patients to prepare for upcoming for surgeries and procedures in the Preadmission Department
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Education
Associate of Applied Science - Nursing
Excelsior College
Albany, NY
11.2002
Associate of Applied Science - Nursing
Gateway Technical College
Kenosha, WI
05.1993
Skills
Utilization Review Experience with Inter-Qual and MCG Initial education received on IA use with the MCG product
Denial Management Collaboration with our physician advisor on clinical review and management Prior support with preparation of appeal letters prior to systemization of the denial process via Revenue Recovery
Second level reviews Familiarity with the communication process with the physician advisors to perform concurrent and retro clinical reviews
Accomplishments
Aurora Star Award 2002
Nurse Excellence Award Recipient
Nominated for/ participated in the Aurora Leadership Academy
Certification
Certified Case Manager. CCCM Certified CM. Certification: 1/23 to 11/27. Prior ANCC Medical Surgical RN and CM Certification
Timeline
Nursing House Supervisor
Aurora Medical Center
01.2021 - 01.2023
RN Case Manager
Advocate Aurora Health Care
06.2005 - Current
Registered Nurse
St Catherine's Hospital
01.1997 - 01.1999
Registered Nurse, Medical-Surgical Unit
Aurora Health Care
06.1993 - 01.2021
Associate of Applied Science - Nursing
Excelsior College
Associate of Applied Science - Nursing
Gateway Technical College
Certified Case Manager. CCCM Certified CM. Certification: 1/23 to 11/27. Prior ANCC Medical Surgical RN and CM Certification
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