Lindsey Mullins
2670 Aventura Blvd Apt 307,FL
Overview
19
19
years of professional experience
Work History
Utilization Review Nurse Medicare
Aetna/CVS
Remote
10.2019 - Current
- Evaluate patient records and conduct through reviews to determine medical necessity and appropriateness of care following CMS guidelines
- Reduce healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensure compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities
- Submitted cases for criteria failures and helped facilitate denials of care
- Enhanced team knowledge and skills by participating in departmental meetings, training programs, and continuing education opportunities related to utilization review.
Case Manager
Aetna/CVS
Remote
07.2018 - 10.2019
- Coordinated patient care plans to enhance service delivery and improve health outcomes.
- Conducted comprehensive assessments to determine individual needs and appropriate resources.
RN, ED Charge/Staff RN
Fairfield Medical Center
Lancaster, OH
08.2013 - 07.2018
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
- Managed patient flow to optimize department efficiency and reduce wait times.
- Facilitated communication between patients, families, and healthcare providers during critical care scenarios.
- Reduced waiting times for patients by effectively prioritizing urgent cases and managing resources within the ED team.
- Assisted in staff development by mentoring new ED Registered Nurses, sharing knowledge, skills, and expertise to support professional growth.
- Worked closely with physicians and nurse practitioners to coordinate care, ensuring seamless transitions from the ED to other inpatient units or outpatient services.
RN, ED
Mount Carmel East Hospital
Columbus, OH
03.2009 - 08.2013
- Assessed and prioritized patient care needs in fast-paced emergency department environment.
- Administered medications and treatments according to established protocols and physician orders.
- Collaborated with interdisciplinary teams to develop patient-centered care
Registered Nurse, Step Down Unit
Mount Carmel East Hospital
Columbus, OH
08.2007 - 03.2009
- Monitored patient vital signs and managed post-operative care in Step Down Unit.
- Collaborated with multidisciplinary teams to develop individualized patient care
- Educated patients and families on recovery processes and discharge planning.
Education
Bachelor of Science - Nursing Administration
Mount Carmel College Nursing
Columbus, OH07.2007
Skills
- Florida RN licensed
- Medicare and Medicare Advantage
- Med Compass, Quickbase, ATV and AI systems
- Teamwork
- Multitasking
- Excellent communication
- Organizational skills
Timeline
Utilization Review Nurse Medicare
Aetna/CVS
10.2019 - Current
Case Manager
Aetna/CVS
07.2018 - 10.2019
RN, ED Charge/Staff RN
Fairfield Medical Center
08.2013 - 07.2018
RN, ED
Mount Carmel East Hospital
03.2009 - 08.2013
Registered Nurse, Step Down Unit
Mount Carmel East Hospital
08.2007 - 03.2009
Bachelor of Science - Nursing Administration
Mount Carmel College Nursing