Melissa Muela
Austin,TX
Summary
Experienced nursing professional bringing demonstrated clinical expertise, leadership skills and technical knowledge. Proficient in updating charts, monitoring medications and working with multidisciplinary teams to optimize patient care. Quality-driven and efficient with strong interpersonal abilities.
Overview
14
14
years of professional experience
Work History
Utilization Review Nurse
Abrazo Healthcare
Phoenix, AZ
10.2023 - Current
- Assessed patient medical records to determine the appropriateness of requested services and procedures.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Analyzed data from patient surveys, interviews and other sources to assess healthcare service quality.
- Provided education to providers regarding utilization management processes and protocols.
- Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
RN Case Manager
Dignity Health
Phoenix, AZ
05.2022 - Current
- Communicated regularly with family members regarding patient care needs and progress toward goals.
- Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
- Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans.
- Monitored and evaluated effectiveness of treatment plans and interventions.
- Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
RN Case Manager
Banner Heath Care Phoenix
Phoenix, AZ
09.2019 - 03.2022
- Communicated regularly with family members regarding patient care needs and progress toward goals.
- Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
- Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans.
- Monitored and evaluated effectiveness of treatment plans and interventions.
- Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
RN Case Manager
Valleywise Health
Phoenix, AZ
02.2019 - 07.2021
- Communicated regularly with family members regarding patient care needs and progress toward goals.
- Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
- Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans.
- Monitored and evaluated effectiveness of treatment plans and interventions.
- Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
Utilization Review Nurse
United Healthcare
Phoenix, NY
09.2016 - 02.2019
- Assessed patient medical records to determine the appropriateness of requested services and procedures.
- Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
- Analyzed data from patient surveys, interviews and other sources to assess healthcare service quality.
- Provided education to providers regarding utilization management processes and protocols.
- Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
RN Case Manager
Banner Healthcare
Sun City West, AZ
09.2015 - 09.2016
- Communicated regularly with family members regarding patient care needs and progress toward goals.
- Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
- Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
- Developed discharge plans for patients transitioning from acute care settings to home or alternate facilities.
RN Triage
Hospice of the Valley
Phoenix , AZ
05.2010 - 02.2014
- Assessed patients' physical and psychological needs, developed individualized care plans, and monitored progress in meeting goals.
- Provided patient and family education regarding disease process, symptom management, end-of-life issues, and available resources.
- Performed initial assessments of new patients to determine hospice eligibility.
- Conducted regular visits with assigned patients in their home setting or at long-term care facilities to assess health status changes.
Education
Bachelor of Science - Nursing
Grand Canyon University
Phoenix, AZ06-2013
Skills
- HIPAA Compliance
- Medicaid Knowledge
- Utilization Review
- Patient Transfers and Transitions
References
References available upon request.
Timeline
Utilization Review Nurse
Abrazo Healthcare
10.2023 - Current
RN Case Manager
Dignity Health
05.2022 - Current
RN Case Manager
Banner Heath Care Phoenix
09.2019 - 03.2022
RN Case Manager
Valleywise Health
02.2019 - 07.2021
Utilization Review Nurse
United Healthcare
09.2016 - 02.2019
RN Case Manager
Banner Healthcare
09.2015 - 09.2016
RN Triage
Hospice of the Valley
05.2010 - 02.2014
Bachelor of Science - Nursing
Grand Canyon University