Summary
Overview
Work History
Education
Skills
Timeline
Generic

Melissa Guy

Carthage,NC

Summary

Detail-oriented registered nurse with experience in utilization review, case managment and electronic health records. Proven track record in streamlining treatment plans and improving care coordination. Focused on achieving better patient outcomes through targeted interventions and efficient resource management.

Overview

13
13
years of professional experience

Work History

Registered Nurse

FirstHealth
Pinehurst, North Carolina
10.2017 - Current
  • Reviewed patient records for appropriate level of care and medical necessity.
  • Collaborated with healthcare teams to streamline adherence to effective treatment plans.
  • Communicated findings to physicians and nursing staff regarding utilization decisions.
  • Documented review outcomes in electronic health record systems promptly and accurately.
  • Participated in interdisciplinary meetings to align patient care strategies with team goals.
  • Assessed patient medical records to determine the appropriateness of requested services and procedures.
  • Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
  • Monitored patient admissions and discharges to optimize care coordination and resource utilization.
  • Collaborated with case managers to facilitate timely discharge planning and transition of care.
  • Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
  • Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
  • Achieved departmental goals and objectives by instituting new processes and standards for in-patient care.
  • Conducted comprehensive reviews of patient treatment plans for medical necessity.
  • Educated staff on utilization review processes and best practices in healthcare compliance.

Oncology Nurse

Cape Fear Valley Medical Center
Fayetteville, North Carolina
08.2013 - 09.2017

Education

Bachelor of Science - Nursing

Southern New Hampshire University
Hooksett, NH
03-2021

Skills

  • Utilization review
  • Electronic health records
  • Care coordination
  • EMR/MAR Review
  • Epic
  • Cerner
  • Meditech
  • Zoom
  • Teams

Timeline

Registered Nurse

FirstHealth
10.2017 - Current

Oncology Nurse

Cape Fear Valley Medical Center
08.2013 - 09.2017

Bachelor of Science - Nursing

Southern New Hampshire University
Melissa Guy