Melody Healy, BSN, RN
Eighty Four,PA
Summary
Registered nurse with acute care, post acute care and case management / utilization review experience. Experienced in Medicare and Commercial insurances. Employed currently with Aetna/CVS as a Post Acute / Acute Utilization Management Nurse Consultant.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Utilization Management Nurse Consultant
Aetna / CVS
11.2021 - Current
- Enhanced member care by conducting thorough reviews of medical records and assessing appropriate utilization of services.
- Reduced healthcare costs by identifying potential overuse and misuse of medical resources.
- Improved interdisciplinary communication by effectively collaborating with physicians, case managers, and other healthcare professionals.
- Minimized readmissions by providing comprehensive discharge planning and coordinating post-acute care services for high-risk patients.
- Mentored team members, sharing best practices in utilization management nursing practice to facilitate professional growth and optimize overall team performance.
- Obtained authorizations from multiple insurance carriers for various levels of care.
Registered Nurse
WVU Medicine - Ruby Memorial
08.2020 - 11.2021
- Completed WVU Medicine's one year nurse residency program.
- Managed care for post-operative patients from initial recovery through discharge.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use and disease management.
- Admissions and discharges.
- Tracheostomy and laryngectomy care.
- Blood and blood product administration.
Licensed Practical Nurse Supervisor
Manor Care - Greentree
06.2008 - 03.2011
- Monitored patients' condition and progress, reevaluating treatments as necessary.
- Charted changes in patient conditions and discussed concerns with supervising healthcare provider.
- Delegation to Assistive Personnel
- Medication Administration (Multiple Routes of Administration)
- IV Therapy; Feeding Tubes; Tracheostomy Care
- Wound Care / Wound Vac Therapy
Certified Nursing Assistant
Greenery Center For Rehab And Nursing
03.2006 - 06.2008
- Documented clinical information in patient medical records daily.
- Monitored patient condition by recording vitals.
- Supported patients with daily activities and attending to personal hygiene, feeding (with documentation), transporting patients, and assisting them in walking and exercising.
- Responded immediately to calls from patients for assistance and alerted medical staff to emergency situations.
Education
Bachelor of Science - Nursing
Chamberlain University
Downers Grove, IL07.2022
Associate of Science - Registered Nurse
Community College of Allegheny County
Pittsburgh, PA05.2020
Licensed Practical Nurse - Nursing
Western Area Career And Technology Center
Canonsburg, PA06.2008
Certifications and Licensures
- PA Practical Nurse License
- WV Registered Nurse License
- ACLS Certified
- BLS Certified
Certification
Available upon request.
Timeline
Utilization Management Nurse Consultant
Aetna / CVS
11.2021 - Current
Registered Nurse
WVU Medicine - Ruby Memorial
08.2020 - 11.2021
Licensed Practical Nurse Supervisor
Manor Care - Greentree
06.2008 - 03.2011
Certified Nursing Assistant
Greenery Center For Rehab And Nursing
03.2006 - 06.2008
Bachelor of Science - Nursing
Chamberlain University
Associate of Science - Registered Nurse
Community College of Allegheny County
Licensed Practical Nurse - Nursing
Western Area Career And Technology Center