Kari Blevins
Archbold ,OH
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Manager Clinical Health Services
Aetna, A CVS Health Company
11.2021 - Current
- Leadership and oversight of large team of direct reports, managing all daily operations, staffing metrics, overtime usage, HR functions, and performance management.
- Oversight and leadership of centralized letters team for Aetna Better Health of TX/IL/NJ/FL/MD/KS/OHRISE, and OK.
- Oversight and leadership of centralized peer-to-peer team through
- Drive strategic thinking for creative staffing plan, to mitigate overtime use and increase overall TAT compliance for centralized Medicaid letters team.
- Drive strategic restructure for Aetna Better Health TX/IL/NJ/FL/MD/KS/OHRISE letters team to cross-train and move to true centralization, with writer team, and specialized audit team.
- Initiated and continue to drive cost-saving initiatives with support from executive leadership including system improvements and translation projects.
- Initiated planning for cross-plan translation workflow in preparation for future translation needs in all plans.
- Investigation and planning for master crosswalk to drive approval letter automation
- Drive standardization amongst centralized teams by working collaboratively among different departments including regulatory, compliance, and health plan leadership to improve processes.
- Initiated and assisted in creating a department-wide weekend/overtime calendar to alleviate individual emails from each plan.
- Use of PDSA processes to collaborate with multi-functional teams to improve processes, implement change, evaluate outcomes, and adjust to meet objectives.
- Built the centralized letters teams for TX/IL/NJ/FL/MD/KS/OHRISE and OK from the ground up by acknowledging the talent within the team, hiring based on fit vs. experience, instilling trust in employees, mentoring, creating internal leaders, and promoting a positive, inclusive, and caring team environment.
UM Coordinator
Paramount
09.2021 - 11.2021
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
- Gathered and organized materials to support operations.
- Evaluated operational practices and identified improvement opportunities to develop revisions for systems and procedures.
- Evaluated processes and reported compliance risk to leadership for resolution
- Reviewing of post-acute stays
- Training on proper write ups for post-acute stays to other UM coordinators and Medical directors
Clinical Team Lead
Aetna, A CVS Health Company
03.2021 - 09.2021
- Fostered staff development and competency through coaching, trainings and team meetings.
- Contributed to interdisciplinary team meetings to review client caseload, treatment, concerns and recommendations.
- Built and updated a team Sharepoint for current resources in order to ensure the teams success
- Continuously kept up-to-date on the department workflows, job aids, policies, and procedures to mentor and lead the team by example
- Coordinated daily staffing assignments
- Exceeded quality and performance metrics for the department
- Designed, initiated, and implemented training of the SME team to transition to the national AR and LTACH review team.
UM Post-Acute SME
Aetna, A CVS Health Company
09.2019 - 09.2021
- Daily collaboration between the clinical review staff and medical directors in the different markets.
- Provided education to on criteria, documentation, and proper write-up of rationales for post-acute clinical decisions for Medicare and Commercial LOBs.
- Driving decreased length of stay and avoidance of inappropriate post-acute admissions.
- Assisted on special project teams for the director of post-acute including report scrubbing and deliverables, market clinician education, and cross-coverage based on business needs.
- Assisted in post-acute template upgrade initiative to provide insight into the set-up and functionality of the template, time studies pre-implementation, and performing audits post-implementation for ease and accuracy of use studies.
- Before taking the team lead position, chosen to join the PPM team under the director of post-acute for monitoring of SMART training effectiveness.
Utilization Management Nurse Consultant
Aetna, A CVS Health Company
07.2017 - 09.2019
- Reviewed post-acute cases for national UAW trust team.
- Reviewed post-acute cases for Capitol Market team (MD and DC).
- Maintained 100% on quality audits, highest level productivity, and 100% on TATs each quarter for both Medicare and Commercial reviews.
- Primary DENC and NOMNC letter reviewer for Capitol market and trained the supervisor and team lead on how to write/audit these letters and collaborated with other markets to create a universal best practice process.
- Assisted in setting up market level workflows.
- Provided guidance and information to the supervisor and team lead for market processes that were later added to the national post-acute job aid as best practice process.
ICU (Critical Care) Nurse
CHWC
11.2016 - 02.2018
- Provided patient-centered care to critical care patients with a range of complex care needs.
- Assessment, evaluation, and monitoring of needs.
- Oral, IM, IV, Subcutaneous medication administrations.
- Ventilator management
- Family and patient education
- Received honors from lead cardiologist for gold standard care
- 100% on all performance reviews
BSN, RN Nurse Manager
Fairlawn Haven
09.2015 - 11.2016
- Leadership and oversight of large team of over 100 direct reports, managing all daily operations, staffing metrics, overtime usage, HR functions, and performance management.
- Oversight of patient care for multiple units and varying levels of complexity
- Oversight of compliance and quality standards.
- Drive quality improvement initiatives making various changes throughout the facility by cutting down medication pass times, implementing like level skills in cluster units, and pushing for upgraded equipment for better quality of care.
- Writing and updating policies and procedures based on evidence based practice standards.
- Lead the restorative nursing team
- Increased the case mix index
RN House Supervisor
Genesis Healthcare System
10.2014 - 10.2015
- 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.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
RN Case Manager
Aspire Home Health Care
01.2015 - 06.2015
- Admissions, recertification, and discharges
- Collaborating care with providers, insurance payors, waiver services, DODD to ensure the patient's had the best care possible.
- Managed medications and treatments in the home setting.
Behavioral Health Charge RN
Ridgeview Behavioral Hospital
03.2014 - 10.2014
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Managed care from admission to discharge.
- Collected blood, tissue, and other laboratory specimens and prepared for lab testing.
- Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Education
DNP (Doctor of Nursing Practice) - Nursing Practice
University of Toledo
Toledo, OH12.2025
Bachelor of Science - Nursing
Hondros College
Westerville, OH2016
Associate of Science - Nursing
James A. Rhodes State College
Lima, OH2013
Skills
- Workforce Management
- Business Administration
- Strategic Planning
- Staff Development
- Complex Problem-Solving
- Business Planning
- Team Leadership
- Cross-functional Teamwork
Certification
- Basic Life Support (BLS)
Licenses
- Ohio (Multi-State/Compact) Nursing license #RN.400737
- MI Nursing License #4704380175
Timeline
Manager Clinical Health Services
Aetna, A CVS Health Company
11.2021 - Current
UM Coordinator
Paramount
09.2021 - 11.2021
Clinical Team Lead
Aetna, A CVS Health Company
03.2021 - 09.2021
UM Post-Acute SME
Aetna, A CVS Health Company
09.2019 - 09.2021
Utilization Management Nurse Consultant
Aetna, A CVS Health Company
07.2017 - 09.2019
ICU (Critical Care) Nurse
CHWC
11.2016 - 02.2018
BSN, RN Nurse Manager
Fairlawn Haven
09.2015 - 11.2016
RN Case Manager
Aspire Home Health Care
01.2015 - 06.2015
RN House Supervisor
Genesis Healthcare System
10.2014 - 10.2015
Behavioral Health Charge RN
Ridgeview Behavioral Hospital
03.2014 - 10.2014
DNP (Doctor of Nursing Practice) - Nursing Practice
University of Toledo
Bachelor of Science - Nursing
Hondros College
Associate of Science - Nursing
James A. Rhodes State College
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