Neta Addy
Longview
Summary
39 years of experience ranging from a Nurse's Aide to Nurse Extern to Graduate Nurse and ultimately a Registered Nurse. Holding positions from the only nurse's aide on a busy general surgical floor on the 3-11pm shift in 1987 to managing a triage call center to being a Case Manager and Utilization Review Nurse.
Dynamic Utilization Review RN with over 39 years of experience in healthcare. Skilled in judgment, decision-making, and time management, contributing to successful care coordination and compliance with medical necessity guidelines. Committed to ensuring quality patient care and improving operational efficiencies.
Overview
37
37
years of professional experience
Work History
Utilization Review RN/RN Case Manager
Christus Good Shepherd Medical Center
06.2017 - Current
- Conducted comprehensive utilization reviews to ensure compliance with medical necessity guidelines.
- Collaborated with healthcare teams to facilitate care coordination and optimize patient outcomes.
- Analyzed clinical documentation for accuracy and adherence to regulatory standards.
- Precepted new hires on best practices in utilization review processes and policies.
- Served as a liaison between healthcare providers, insurance companies, and patients for efficient resolution of coverage issues or denials following a utilization review assessment.
- Ensured continuity of care across transitions by collaborating with healthcare providers, patients, and families to facilitate communication and coordination of services.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
Healthy Hotline Manager
Good Shepherd Medical Center
01.2007 - 01.2017
Charge Nurse - Pre Admissions Testing/Staff Nurse
Good Shepherd Medical Center
02.1995 - 01.2007
Circulating OR Nurse/PACU Nurse
Good Shepherd Medical Center
12.1993 - 02.1995
Charge Nurse/Staff Nurse
Good Shepherd Medical Center
12.1989 - 02.1995
Education
Bachelor of Science - Nursing
The University of Texas At Tyler
Tyler, TX12-1989
Skills
Active Listening/Learning
Critical Thinking
Judgement and Decision Making
Time Management/Organized
Complex Problem Solving
Self Starter
Timeline
Utilization Review RN/RN Case Manager
Christus Good Shepherd Medical Center
06.2017 - Current
Healthy Hotline Manager
Good Shepherd Medical Center
01.2007 - 01.2017
Charge Nurse - Pre Admissions Testing/Staff Nurse
Good Shepherd Medical Center
02.1995 - 01.2007
Circulating OR Nurse/PACU Nurse
Good Shepherd Medical Center
12.1993 - 02.1995
Charge Nurse/Staff Nurse
Good Shepherd Medical Center
12.1989 - 02.1995
Bachelor of Science - Nursing
The University of Texas At Tyler