Louisa Menard
San Antonio,Texas
Summary
Prior Authorization Nurse Prior Authorization Nurse with over 15 years of extensive expertise in healthcare administration and patient care. Demonstrates advanced skills in clinical documentation, utilization management, and interdisciplinary collaboration to enhance patient outcomes and team efficiency. Committed to fostering a supportive work environment and streamlining processes to ensure compliance and improve quality control.
Overview
8
8
years of professional experience
Work History
Patient Care Floor Nurse
Mystic Park Nursing and Rehabilitation Center
02.2024 - Current
- Provided compassionate care to patients, fostering trust and enhancing their overall experience in a rehabilitation setting. Work closely with interdisciplinary teams to develop tailored care plans, optimizing patient outcomes through a holistic approach.
Prior Authorization Nurse
WellMed Medical Management
09.2017 - 12.2025
- Reviews and approves medical services, ensuring necessary coverage and following insurance guidelines, verifying patient insurance and obtaining prior authorization for treatments, checks patient insurance eligibility and benefits, including plan updates and changes. Obtains prior authorization: Secures approval for medical services, procedures, and referrals required by insurance companies. Reviews medical necessity: Evaluates requests to ensure services meet the criteria for coverage. Collaborates with providers: Works with healthcare providers to gather necessary information and ensure efficient processing. Coordinate prior authorizations, enhancing patient care efficiency. Train global teams in UM processes, boosting compliance. Lead weekend teams, ensuring seamless operations. Audit staff performance, improving quality control. Collaborated with management to streamline workload sharing, enhance team efficiency and foster a supportive work environment, Developed detailed job aids and training materials, resulting in measurable improvements in team performance and knowledge retention.
Patient Care Home Health Nurse
Guardian Home Health
08.2023 - 02.2024
- Provided comprehensive care to homebound patients, enhancing recovery rates and patient satisfaction. Coordinated with multidisciplinary teams to improve care plans, resulting in better health outcomes.
Patient Care Home Health Nurse
Adventia -Home Health
05.2022 - 12.2022
- Provided comprehensive care to homebound patients, enhancing recovery rates and patient satisfaction. Coordinated with multidisciplinary teams to improve care plans, resulting in better health outcomes.
Education
Licensed Vocational Nurse - Nursing
Galen School of Nursing
San Antonio, TX12.2021
Master of Science - Health Law Legal Regulatory Compliance
NSU Shepard Broad College of Law
Davie, FL12.2020
Bachelor of Science - Business Administration-IT
Colorado Technical University
Colorado Springs, CO12.2013
Skills
- Achieved streamlined utilization management and prior authorization workflows, resulting in improved patient engagement Delivered comprehensive data analysis and documentation management to support healthcare compliance and risk assessment initiatives Enhanced care coordination and quality improvement through effective patient assessment and critical thinking
Timeline
Patient Care Floor Nurse
Mystic Park Nursing and Rehabilitation Center
02.2024 - Current
Patient Care Home Health Nurse
Guardian Home Health
08.2023 - 02.2024
Patient Care Home Health Nurse
Adventia -Home Health
05.2022 - 12.2022
Prior Authorization Nurse
WellMed Medical Management
09.2017 - 12.2025
Bachelor of Science - Business Administration-IT
Colorado Technical University
Licensed Vocational Nurse - Nursing
Galen School of Nursing
Master of Science - Health Law Legal Regulatory Compliance
NSU Shepard Broad College of Law