Megan Chase
Lyman,ME
Summary
Accomplished Utilization Review Coordinator with a proven track record at MaineHealth Maine Medical Center Biddeford, enhancing utilization processes and fostering interdisciplinary collaboration. Expert in HIPAA compliance and critical thinking, significantly improved review efficiency. Skilled in navigating complex healthcare regulations, ensuring clinically appropriate and cost-effective care.
Overview
20
20
years of professional experience
Work History
Utilization Review Coordinator
MaineHealth Maine Medical Center Biddeford
01.2004 - Current
- Promoted a culture of continuous improvement by actively participating in departmental initiatives aimed at enhancing the effectiveness of utilization review processes.
- Supported positive working relationships between physicians, nursing staff, and other healthcare professionals through clear communication and collaboration on patient-centered goals.
- Assisted leadership in setting annual objectives for the Utilization Review Department based on organizational priorities.
- Managed complex cases involving multiple medical conditions, coordinating care among various specialists while adhering to strict timelines for decisionmaking.
- Evaluated medical necessity criteria using evidence-based guidelines to ensure that services provided were both clinically appropriate and costeffective.
- Increased efficiency of the utilization review process through regular communication with insurance companies for timely authorizations.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Education
Master of Science - Health Administration
New England College
Henniker, NH05.2008
Bachelor of Science - Nursing
University of Maine
Orono, ME05.2002
Skills
- HIPAA Compliance
- Quality Improvement
- Healthcare regulations
- Interdisciplinary Collaboration
- Utilization Management
- Medical Necessity Assessment
- Medicare knowledge
- Utilization review
- Critical Thinking
Timeline
Utilization Review Coordinator
MaineHealth Maine Medical Center Biddeford
01.2004 - Current
Master of Science - Health Administration
New England College
Bachelor of Science - Nursing
University of Maine
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