Summary
Overview
Work History
Education
Skills
Timeline
Generic

Marcia Hill

Grand Prairie,TX

Summary

Enthusiastic Registered Nurse eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of Utilization Review/Utilization Management and Motivated to learn, grow and excel.

Overview

14
14
years of professional experience

Work History

Utiliza

UTSW Medical Center
Dallas, Texas
09.2021 - Current
  • Critically examine patient medical records, paying close attention to the appropriateness of healthcare expenditures
  • Timely processing of all denial-related and member oriented written communication and that it meets all Federal and State requirements. Coordinate and communicate with care coordinators, physicians, health plan representatives and providers regarding denial or determination and follow up as needed.
  • Communicate internally and externally with customers, including Providers, members, and Quality Organizations.
  • Ensure second level reviews have been performed and received and confer with Medical Directors.

UR Nurse

Parkland Hospital
Dallas, TX
09.2013 - 01.2021
  • Responsible for reviewing and accurately performing comprehensive review of medical records using established guidelines in a Fast-Paced environment.
  • Used the Interqual Criteria Guidelines as a first-level screening tool to assist in determining if the proposed services are clinically indicated and provided in the proper level of care.
  • Ensured the delivery of efficient and effective health care relying on my experience, education and awareness of appropriate review criteria to compile an accurate accountt of the patient s clinical picture.

Instructor/Writer

United States Army
Grand Prairie, TX
08.2008 - 07.2014
  • Assisted with development of the overall unit organization and readiness status, prepared soldiers for skills training to transfer to other assignments, annual medical qualification which includes immunization skill certification ad physical qualification. EMT certification, career counseling and implementation of guidelines and policies.
  • Provided, promoted advocated the soldier's wellbeing
  • Evaluated and revised lesson plans and course content to achieve student-centered learning.
  • Maintained integrity and dedication as a soldier in the United States Army utilizing critical thinking skills and sound judgment to ensure positive oitcomes.

Education

Associate of Science - Nursing

St. Petersburg High School
Saint Petersburg, FL
05.2000

Skills

  • IV Instructor
  • EMT Instructor

Timeline

Utiliza

UTSW Medical Center
09.2021 - Current

UR Nurse

Parkland Hospital
09.2013 - 01.2021

Instructor/Writer

United States Army
08.2008 - 07.2014

Associate of Science - Nursing

St. Petersburg High School

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