Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
24
24
years of professional experience
Work History
Senior Concurrent Review Nurse
Health Net/Centene Corporation
11.2011 - Current
Assist the Manager in leading the Under 21 Prior Authorization and Concurrent Review Teams.
Create the daily assignments. I monitor the completion of the daily assignments.
Maintain the time off and sick call calendar to ensure we have adequate staff for each day to meet the teams needs.
Perform weekly validation of the nurses work.
Perform monthly quality audit reviews of the nurse work.
Assist both teams with any questions or needs they may have.
Review policy updates and process changes with the nurses.
Facilitate weekly Multi-disciplinary inpatient reviews with nurses, Medical Director, Case Management, and Public Programs, and also facilitate CCS Reconsideration multi-discipline meeting.
Assist creating correction plans for errors on company audits.
Attend meetings for County CCS review.
Assist with onboarding new employees and assist with creating their training schedule.
Attend meetings regarding both teams as needed.
Registered Nurse, Cardiac Telemetry
Sutter Memorial Hospital
06.1999 - 11.2011
Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
Administered medications via oral, IV, and intramuscular injections and monitored responses.
Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
Provided direct patient care, stabilized patients, and determined next course of action.
Managed care from admission to discharge.
Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
Education
Master of Science - Nursing Practice
University of Phoenix Sacramento Valley Campus
Sacramento, CA
06.2010
Bachelor of Science - Nursing
San Francisco State University
San Francisco, CA
1992
Skills
Experienced with California Children Services
Experienced with InterQual
Experienced with Medi-cal regulations
Experienced with Commerical providers
Timeline
Senior Concurrent Review Nurse
Health Net/Centene Corporation
11.2011 - Current
Registered Nurse, Cardiac Telemetry
Sutter Memorial Hospital
06.1999 - 11.2011
Master of Science - Nursing Practice
University of Phoenix Sacramento Valley Campus
Bachelor of Science - Nursing
San Francisco State University
Similar Profiles
Caren R. LeheCaren R. Lehe
Workers' Compensation Claims Assistant at CORVEL CORPORATIONWorkers' Compensation Claims Assistant at CORVEL CORPORATION
TRICARE Education Specialist at Health Net Federal Services/Centene CorporationTRICARE Education Specialist at Health Net Federal Services/Centene Corporation