Natasha Monteilh
Jacksonville
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Senior Clinical Strategist
Aetna Life Insurance, a CVS Health Company
01.2020 - 01.2025
- Led projects to support the successful implementation and optimization of digital tools and technology solutions used by clinical and non-clinical staff within the Utilization Management and Care Management departments, maximizing value from digital investments.
- Led end-to-end initiatives, overseeing planning, execution and delivery to ensure that internal teams effectively adopted and utilized the digital tools available to them.
- Assisted with Quality Assurance (QA) and User Acceptance Testing (UAT) as part of content delivery lifecycle.
- Designed in-app guidance and communications using various technologies to inform end users.
- Identified, documented and communicated best practices.
- Developed user-centric resources and training content.
- Collected, analyzed and incorporated changes based on user and leadership feedback.
- Monitored usage and managed business specific reporting for digital solutions.
- Managed the helpdesk mailbox including triaging, troubleshooting and resolving reported end user issues.
Clinical Supervisor
Aetna Life Insurance, a CVS Health Company
01.2018 - 01.2020
- Responsible for the oversight of Utilization Management staff, providing supervision and guidance to clinicians that performed medical necessity reviews for prior authorizations.
- Supervised a team of clinicians, providing guidance, mentorship and support.
- Conducted performance evaluations and supported professional development.
- Ensured that clinical practices complied with internal and external policies.
- Monitored and distributed case workload.
- Assessed and adjusted staff schedules as needed to accommodate twenty-four-hour coverage.
- Tracked and reported on productivity, case outcomes, and team performance metrics.
- Acted as a liaison between clinical staff, leadership and other departments.
- Recruited, interviewed and onboarded new staff as needed.
Utilization Management Nurse Consultant
Aetna Life Insurance, a CVS Health Company
01.2014 - 01.2018
- Responsible for the review of medical services received by the health plan member to assess for medical necessity while supporting care coordination by applying clinical guidelines and health plan benefits.
- Reviewed clinical information and applied appropriate criteria while using clinical judgment to render coverage determination or recommendation.
- Documented clinical review findings in compliance with regulatory, accreditation, and internal standards.
- Identified members who may benefit from case or disease management and made referrals as needed.
- Collaborated and communicated with members, providers, facilities and interdisciplinary teams including medical directors to ensure timely processing of prior authorizations.
- Identified opportunities to promote quality effectiveness of healthcare services and benefit utilization.
Registered Nurse
Baptist Medical Center
01.2014 - 01.2014
- Provided direct patient care on a high-acuity medical-surgical telemetry unit, monitoring patients with complex conditions and cardiac needs.
- Delivered hands-on nursing care including assessments, interventions and monitoring.
- Developed individualized care plans based on patient’s needs, rights, and preferences.
- Collaborated with physicians, specialists, therapists and other healthcare professionals to develop and deliver care plans.
- Taught patients and families about health conditions, treatments, medications, and preventative care.
- Served as a key liaison between patients, families and the interdisciplinary medical team.
- Complied with healthcare regulations, policies and ethical standards.
Complaint and Appeals Quality Analyst
Aetna Life Insurance, a CVS Health Company
01.2011 - 01.2014
- Monitored appeal cases, using appropriate policies, workflows and manuals. Responsible for the review and resolution of clinical complaints/grievances and appeals.
- Review and evaluate information and documentation to assess accuracy in appeal and original claim decision.
- Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
Care Management Associate
Aetna Life Insurance, a CVS Health Company
01.2008 - 01.2011
- Supported clinical teams in utilization management processes by performing administrative and non-clinical tasks that help streamline patient care and coordination.
- Support compliance of turn-around times for prior authorizations and referrals.
- Outreach to members and providers to obtain required health-related information.
- Accurately document health-related information into internal system or electronic health record.
- Monitor and communicate status of prior authorizations to members and providers as needed.
Quality Assurance Specialist
Aetna Life Insurance, a CVS Health Company
01.2006 - 01.2008
- Support call center team, serving as a subject matter expert on internal processes and systems.
- Handle escalated and urgent requests from members and providers.
- Monitor key performance metrics of call center team members.
- Perform monthly audit of recorded calls to ensure quality and compliance.
- Provide feedback, coaching and training to call center team members as needed.
- Implement and support adoption of new tools, workflows, and policies.
Customer Service Representative / Inbound Queue Associate
Aetna Life Insurance, a CVS Health Company
01.2002 - 01.2006
- Responsible for managing and processing incoming calls from members and providers in a call center setting.
- Respond to incoming inquiries related to claims, benefits, referrals and other health insurance related items.
- Accurately enter or update information in internal systems.
- Coordinate with internal and external departments to fully resolve all member and provider requests.
Education
Associate in Science - Nursing R.N.
Florida State College of Jacksonville
Jacksonville, Florida01.2011
Associate in Arts - undefined
Florida State College of Jacksonville
Jacksonville, Florida01.2009
Skills
- Customer support
- Customer Service
- Document Management
- Process Improvement
- Cross-Functional Collaboration
- Problem-solving expertise
- Effective written communication
- Effective verbal communication
- Strong organizational skills
Accomplishments
Completed nursing school while working full-time.
Certification
Certified Digital Adoption Project Manager, 2025
Timeline
Senior Clinical Strategist
Aetna Life Insurance, a CVS Health Company
01.2020 - 01.2025
Clinical Supervisor
Aetna Life Insurance, a CVS Health Company
01.2018 - 01.2020
Utilization Management Nurse Consultant
Aetna Life Insurance, a CVS Health Company
01.2014 - 01.2018
Registered Nurse
Baptist Medical Center
01.2014 - 01.2014
Complaint and Appeals Quality Analyst
Aetna Life Insurance, a CVS Health Company
01.2011 - 01.2014
Care Management Associate
Aetna Life Insurance, a CVS Health Company
01.2008 - 01.2011
Quality Assurance Specialist
Aetna Life Insurance, a CVS Health Company
01.2006 - 01.2008
Customer Service Representative / Inbound Queue Associate
Aetna Life Insurance, a CVS Health Company
01.2002 - 01.2006
Associate in Arts - undefined
Florida State College of Jacksonville
Associate in Science - Nursing R.N.
Florida State College of Jacksonville
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