Kerry White
Fort Worth
Summary
Detail-oriented RN with over 11 years in utilization review and care management. Skilled in goal setting and emotional intelligence, ensuring compliance with HIPAA regulations while advocating for patient needs and optimizing healthcare delivery.
Overview
12
12
years of professional experience
Work History
RN Case Manager Utilization Review
Texas Health Resources
06.2014 - Current
- Coordinated patient care plans to address complex health needs and improve outcomes.
- Advocated for patients during interdisciplinary team meetings to enhance service delivery.
- Managed transitions of care, ensuring continuity and reducing readmissions effectively.
- Developed education materials to empower patients in self-management of chronic conditions.
Utilization Review
Texas Health Harris Methodist Hospital
06.2014 - Current
- Assisted in the evaluation of new technology solutions and software tools designed to streamline the utilization review process, ensuring optimal functionality and user satisfaction.
- Supported the development of standardized policies and procedures for utilization review across multiple departments within the organization.
- Provided accurate documentation of all utilization review findings, ensuring a clear audit trail for future reference or analysis.
- Enhanced utilization review efficiency by streamlining processes and implementing new software tools.
- Demonstrated strong analytical skills by interpreting complex medical records and synthesizing relevant information for utilization review purposes.
- Served as a liaison between healthcare providers, insurance companies, and patients for efficient resolution of coverage issues or denials following a utilization review assessment.
- Maintained strict adherence to HIPAA regulations, safeguarding sensitive patient information throughout all aspects of the utilization review process.
- Maintained up-to-date knowledge of industry trends, best practices, and regulatory requirements to ensure accurate and relevant guidance during utilization review activities.
- Assisted in maintaining regulatory compliance by staying up-to-date on Medicare, Medicaid, and commercial insurance requirements for utilization review activities.
- Streamlined data entry processes, ensuring timely submission of all required documentation for utilization review activities.
Education
Associate of Science - Nursing
Tarrant County Junior College
Fort Worth TX05-1996
Skills
- Direct patient care
- Goal setting
- Emotional intelligence
- Care coordination
- Case evaluation
- Discharge planning
- Patient assessments
- Care plan development
- Care management
- HIPAA compliance
- Utilization review
Timeline
RN Case Manager Utilization Review
Texas Health Resources
06.2014 - Current
Utilization Review
Texas Health Harris Methodist Hospital
06.2014 - Current
Associate of Science - Nursing
Tarrant County Junior College