Summary
Overview
Work History
Education
Skills
Timeline
Generic

Kathleen Burtt

Greenbackville,VA

Summary

Accomplished Utilization Review Nurse with a proven track record at Highmark Health, adept in InterQual criteria and effective communication. Expert in conducting in-depth clinical reviews and coordinating patient care plans, ensuring HIPAA compliance and enhancing healthcare quality. Demonstrated ability in problem-solving and critical thinking, significantly improving patient outcomes and care coordination efficiency.

Overview

15
15
years of professional experience

Work History

Utilization Review Nurse

Highmark Health
Wilmington, DE
07.2016 - Current

Work remotely performing inpatient clinical reviews using Interqual for par and non par hospitals to establish medical necessity. Collaboration with Medical Director for denials, length of stay and discharge planning.

Utilization Review Nurse and Discharge Planner

Florida Hospital
Palm Coast, FL
10.2014 - 06.2015

Performed clinical reviews using Interqual to establish medical necessity. Documentation and transmission of clinical data to insurance companies to ensure authorization. Discharge assessment, planning and implementation for up to 30 cases per day.

RN Case Manager

Precision Home Healthcare Inc.
Leesburg, FL
06.2013 - 10.2014

Planned, organized and directed care to the homebound patient. Monitored and educated on disease process. Provided community health education and resources to meet the needs of patients and their families.

RN Case Manager

Generations Home Care
Georgetown, De
03.2010 - 03.2013

Planned, organized and directed care to the homebound patient. Monitored and educated on disease process. Provided community health education and resources to meet the needs of the patient and their families. Direct supervision of CNAs. Preceptor for new nursing staff. Relief manager.

Staff Nurse

Beebe Medical Center
Lewes, DE
12.2009 - 01.2011

Promoted and restored patient health by completing the nursing process. Collaborated with multidisciplinary team members. Provided physical and psychological support to patients and their families. Supervision of assigned team members.

Education

Associate Of Science - Nursing

Delaware Technical Community College
Newark, DE
12.1994

Skills

  • Documentation and reporting
  • InterQual criteria
  • Records analysis
  • Physician consultations
  • Insurance verification
  • Quality improvement
  • Healthcare regulations
  • Medicaid
  • Utilization management
  • Case management

Timeline

Utilization Review Nurse

Highmark Health
07.2016 - Current

Utilization Review Nurse and Discharge Planner

Florida Hospital
10.2014 - 06.2015

RN Case Manager

Precision Home Healthcare Inc.
06.2013 - 10.2014

RN Case Manager

Generations Home Care
03.2010 - 03.2013

Staff Nurse

Beebe Medical Center
12.2009 - 01.2011

Associate Of Science - Nursing

Delaware Technical Community College
Kathleen Burtt