Lisa Yarrow
Winthrop,MA
Summary
Remote ready, compassionate professional skilled in educating patients and families on health management. Proven track record in triaging immediate needs and collaborating with healthcare teams to ensure optimal care delivery.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Utilization Review RN CCM
Lahey Burlington - Hospital at Home
Burlington, MA
08.2023 - Current
- Performs utilization reviews using InterQual to determine appropriate care levels.
- Collaborates with the insurance company to manage authorizations and track review dates.
- Collaborates with interdisciplinary teams to coordinate patient services and support.
- Virtual case management for coordinating a safe discharge.
- Triages calls and managed patient immediate needs.
- Educates patients and families on health management and post-discharge care.
- Advocates for patients' needs to ensure timely access to resources and services.
Utilization Review RN
Winchester Hospital
Winchester, MA
04.2021 - 08.2023
- Enhanced reimbursement efficiency through collaboration with Case Managers on patient status classification processes.
- Conducted comprehensive case reviews of medical records, ensuring effective communication with case managers and providers.
- Triaged immediate patient related needs to improve outcomes with care team.
- Analyzed electronic medical records to investigate disputed medical claims and denials.
- Provided timely updates on claim statuses to maintain transparency and accountability.
- Ensured compliance with medical management standards utilizing InterQual expertise.
Complex Case Manager
Tufts Health Plan Insurer
Watertown, MA
10.2012 - 11.2020
- Coordinated care for patients with multiple chronic conditions, addressing functional challenges and social barriers.
- Conducted comprehensive assessments to develop individualized care plans for effective management.
- Triaged and fielded member calls with attention to immediate needs.
- Educated clients and families on available resources and self-management skills.
- Advocated for patient needs within multidisciplinary teams and community organizations.
RN - Ambulatory Care
Massachusetts General Hospital - Revere Health Center
Revere, MA
05.2010 - 10.2012
- Delivered comprehensive patient care across Pediatrics, Med/Peds, and Adult Medicine.
- Managed triage calls to prioritize patient needs effectively.
- Administered medications while monitoring responses for safety and efficacy.
- Maintained precise patient records utilizing electronic health record systems.
Elder Service Plan - PACE Program
East Boston Neighborhood Health Center
East Boston, MA
04.2001 - 05.2010
- Developed individualized care plans to enhance patient outcomes.
- Evaluated home safety and assessed patient needs for optimal care delivery.
- Triage patient calls (beeper system) to meet immediate concerns and needs.
- Collaborated with healthcare teams to coordinate treatments and services effectively.
- Educated patients and families on health management and medication administration.
Education
Bachelor of Science - Nursing
Chamberlain University, College of Nursing
07.2020
RN to BSN Program -
Lawrence Memorial Hospital School of Nursing
Medford, MA01.1991
Skills
- Remote readiness
- Effective communication
- Analytical and critical thinker
- Organizational abilities
- Problem solving, conflict resolution
- Time management
- Attention to detail
Certification
- Registered Nurse in Massachusetts
- Certified Case Manager
Timeline
Utilization Review RN CCM
Lahey Burlington - Hospital at Home
08.2023 - Current
Utilization Review RN
Winchester Hospital
04.2021 - 08.2023
Complex Case Manager
Tufts Health Plan Insurer
10.2012 - 11.2020
RN - Ambulatory Care
Massachusetts General Hospital - Revere Health Center
05.2010 - 10.2012
Elder Service Plan - PACE Program
East Boston Neighborhood Health Center
04.2001 - 05.2010
Bachelor of Science - Nursing
Chamberlain University, College of Nursing
RN to BSN Program -
Lawrence Memorial Hospital School of Nursing
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