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Utilization Management Nurse, Senior

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Dedicated and compassionate Registered Nurse seeking an opportunity to advance professional growth. Proven ability to provide direct and indirect patient care in a fast-paced environment. Calm and level-headed with the ability to handle difficult patients and high stress situations. Use strong verbal communication skills to develop strong relationships with patients and their families.


  RN with 3 years of acute care experience in the medical-surgical unit and over 6 years of experience in utilization review, eager to leverage my clinical experience and skills to perform medical necessity reviews for inpatient admissions and outpatient services, utilizing evidence-based clinical guidelines, medical policy, and federal and state mandates in order to provide quality and cost-effective care.
  Active, Compact, Registered Nurse License in the State of Maryland.
  Bachelor's of Science in Nursing (BSN) graduate.
  Specialized in the healthcare utilization management industry, doing utilization review for major U.S. health plans and managed care models for over five years.
  Experience in various UM lines of business, such as Commercial Health Plan, Medicare, and Medicaid.
  Proficient knowledge of Milliman Care Guidelines and InterQual.
  Keen on the dynamics and logistics of working in a remote/hybrid setup, and highly efficient in Microsoft Office applications.


Registered Nurse, with an especially diverse background in the health care industry, a dedicated, client-oriented professional with superior communication and problem-solving skills, detail-oriented, independent worker that promotes positive team relations equally well, highly motivated and eager to learn.

Dedicated Utilization Management Nurse with over 15 years of experience in prospective and concurrent reviews, complex discharge planning, Skilled in collaborating with Medical Directors to determine appropriate lengths of stay for complex cases and partnering with Case Managers to facilitate safe, effective discharge plans. Proven ability to work closely with healthcare providers to improve member outcomes, optimize benefit utilization, and ensure appropriate use of healthcare resources while maintaining quality standards. Skilled training and mentoring new staff members.

MARIA KADKINA

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Utilization Management Nurse, Senior

Utilization Management Nurse

Prior Authorization Nurse

Licensed Vocational Nurse

Licensed Vocational Nurse

Education

Bachelor of Science in Nursing -

Licensed Vocational Nurse - undefined

Bachelor of Computer Science - undefined

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Timeline

Utilization Management Nurse, Senior

Utilization Management Nurse

Prior Authorization Nurse

Licensed Vocational Nurse

Licensed Vocational Nurse

Licensed Vocational Nurse - undefined

Bachelor of Computer Science - undefined

Bachelor of Science in Nursing -

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