Pamela M Glisson
Auburn,USA
Summary
Healthcare professional specializing in utilization review and application support. Demonstrated success in collaborating with providers to streamline prior authorization processes, ensuring compliance with established criteria. Enhanced operational efficiency and improved quality of patient care through effective communication and problem-solving skills.
Overview
32
32
years of professional experience
Work History
Utilization Review Denial and Reimbursement Coordinator
East Alabama Medical Center
Opelika, AL
07.2019 - 02.2025
- Collaborated with providers to secure clinical information for timely prior authorization requests.
- Documented and tracked utilization review findings in electronic health records to ensure compliance.
- Referred cases to secondary review for non-compliance with established criteria.
- Maintained comprehensive records of utilization review activities, findings, and decisions in patient databases to support decision-making.
Application Support Analyst
East Alabama Medical Center
Opelika, AL
01.2013 - 01.2019
- Provided technical support for application users across multiple departments, ensuring timely issue resolution.
- Collaborated with development teams to implement software updates and enhancements.
- Documented troubleshooting procedures and created user guides for applications.
- Conducted training sessions for end-users on application functionalities and best practices.
- Addressed customer queries through phone, email, chat, or remote desktop tools, enhancing user satisfaction.
- Managed user account access by assigning credentials, distributing permissions, and terminating inactive users.
- Assisted in implementing new software solutions within the organization.
- Created scripts to automate processes, improving application performance and reducing manual workload.
Registered Nurse Surgery Center
East Alabama Mecial Center
Opelika, AL
01.2005 - 01.2013
- Assessed patient conditions to implement timely care interventions that enhanced patient outcomes.
- Administered medications and monitored patient reactions for safety.
- Monitored vital signs, administered injections, and assisted with medical procedures.
- Educated patients and families on health management and recovery strategies to promote adherence and improve recovery.
- Maintained accurate patient records using electronic health systems.
- Utilized critical thinking to evaluate clinical situations promptly.
- Ensured a safe environment by adhering to infection control policies.
- Trained junior nurses on best practices and clinical procedures to elevate team competency and patient care quality.
Registered Nurse CVICU
East Alabama Medical Center
Opelika, AL
01.2004 - 01.2005
- Assisted in advanced cardiac life support procedures during emergencies.
- Monitored patient vital signs and reported critical changes to medical team to ensure timely interventions.
- Collaborated with multidisciplinary teams to develop and implement individualized patient care plans, enhancing patient outcomes.
- Provided bedside care to critically ill patients in cardiovascular intensive care unit.
- Educated patients and families on post-operative care and recovery processes to promote effective recovery and patient understanding.
- Documented patient information accurately in electronic health records.
- Trained new nursing staff on cardiovascular intensive care unit procedures.
- Maintained compliance with hospital policies for safe delivery of quality patient care.
Registered Nurse PACU
Northside Hospital Forsyth
01.2002 - 01.2004
- Monitored patient vitals and conditions post-anesthesia in recovery area, ensuring patient safety and timely interventions.
- Collaborated with surgical teams for seamless transitions of patients from surgery to recovery.
- Administered medications and managed pain relief protocols to enhance patient comfort.
- Educated patients and families on post-operative care, enhancing understanding and adherence to recovery protocols.
- Accurately documented patient progress and changes in electronic health records.
- Responded to emergencies, providing critical care interventions.
- Implemented infection control measures in recovery area, safeguarding patient health and preventing complications.
- Assisted in training new nursing staff on PACU procedures for improved team efficiency.
Registered Nurse - Nurse Manager
Atlanta Outpatient Peachtree Dunwoody Center
01.1999 - 01.2002
- Coordinated patient care services with healthcare team, resulting in improved patient outcomes.
- Supervised nursing staff, ensuring adherence to patient care standards.
- Trained and mentored new RNs on hospital policies and best practices.
- Developed training programs to enhance staff skills and knowledge retention.
- Conducted performance evaluations, providing constructive feedback to nursing staff.
- Facilitated effective communication among physicians, nurses, and support personnel to enhance collaboration.
- Ensured compliance with safety standards and infection control procedures consistently.
- Enforced infection control policies to maintain a safe environment for patients.
Registered Nurse - Staff Nurse
Atlanta Outpatient Peachtree Dunwoody Center
01.1995 - 01.1999
- Monitored vital signs and reported changes promptly to ensure timely interventions.
- Administered medications and treatments per established protocols while monitoring patient reactions.
- Educated patients and families on health management and care procedures, enhancing understanding and promoting adherence to treatment plans.
- Advocated for patients by actively respecting their rights, values, and beliefs, ensuring individualized care during treatment.
- Utilized critical thinking skills to assess clinical situations quickly and effectively.
- Ensured compliance with safety regulations and infection control practices to protect patient health.
- Documented patient progress accurately in electronic health records to maintain up-to-date information.
- Trained and mentored new nursing staff on center policies and best practices, fostering a knowledgeable and compliant team.
Registered Nurse
EAMC CVICU
01.1993 - 01.1995
- Delivered direct patient care in critical and high-acuity environments.
- Monitored vital signs and administered medications as prescribed.
- Collaborated with interdisciplinary teams to develop and execute individualized care plans, enhancing patient outcomes.
- Educated patients and families on post-operative care and health management, fostering compliance and recovery.
- Assisted in advanced procedures, ensuring sterile conditions and patient safety.
- Documented patient assessments and interventions accurately in electronic health records.
- Mentored new nursing staff by sharing clinical knowledge and best practices.
- Participated in quality improvement initiatives, contributing to elevated patient care standards and improved service delivery.
Education
RN PROFESSIONAL DEVELOPMENT CERTIFICATE - Informatics, Clinical Care Coordination and Quality Improvement
AUBURN MONTGOMERY
AUBURN, AL07-2013
BSN -
NORTH GEORGIA COLLEGE AND STATE UNIVERSITY
Dahlonega, GA05-2004
ADN -
SOUTHERN UNION STATE JUNIOR COLLEGE
Valley, AL06-1993
Skills
- Utilization review
- Prior authorization
- Claims management
- Reimbursement strategies
- Utilization metrics
- Patient database management
- Clinical documentation
- HIPAA compliance
Timeline
Utilization Review Denial and Reimbursement Coordinator
East Alabama Medical Center
07.2019 - 02.2025
Application Support Analyst
East Alabama Medical Center
01.2013 - 01.2019
Registered Nurse Surgery Center
East Alabama Mecial Center
01.2005 - 01.2013
Registered Nurse CVICU
East Alabama Medical Center
01.2004 - 01.2005
Registered Nurse PACU
Northside Hospital Forsyth
01.2002 - 01.2004
Registered Nurse - Nurse Manager
Atlanta Outpatient Peachtree Dunwoody Center
01.1999 - 01.2002
Registered Nurse - Staff Nurse
Atlanta Outpatient Peachtree Dunwoody Center
01.1995 - 01.1999
Registered Nurse
EAMC CVICU
01.1993 - 01.1995
RN PROFESSIONAL DEVELOPMENT CERTIFICATE - Informatics, Clinical Care Coordination and Quality Improvement
AUBURN MONTGOMERY
BSN -
NORTH GEORGIA COLLEGE AND STATE UNIVERSITY
ADN -
SOUTHERN UNION STATE JUNIOR COLLEGE