Regina Titus
Aurora
Summary
Registered nurse with extensive experience in utilization review and clinical assessments. Proven ability to oversee clinical records and ensure compliance with healthcare standards. Strong leadership skills and attention to detail contribute to high-quality patient care. Seeking to leverage expertise in a dynamic healthcare organization.
Overview
13
13
years of professional experience
Work History
RN Psych
Cleveland Clinic
Cleveland
10.2024 - Current
- Collaborated with interdisciplinary healthcare teams to develop and implement tailored patient care plans.
- Performed comprehensive patient assessments and monitored vital signs to ensure optimal care.
- Provided education to patients and families on health management strategies and treatment options to promote understanding and compliance.
- Advocated for patients by respecting their rights, values, and beliefs.
- Provided compassionate support during treatments and procedures.
- Utilized critical thinking skills to assess clinical situations promptly.
- Maintained accurate patient records using electronic health record systems.
- Documented patient progress notes efficiently in the electronic medical record system.
Director of Utilization Management
Windsor Laurelwood Hospital
Willoughby
08.2023 - 10.2024
- Managed utilization review processes, ensuring compliance with healthcare regulations and standards.
- Coordinated with medical staff to implement patient care efficiency strategies, improving service delivery.
- Led development and implementation of hospital policies to maintain professional standards.
- Monitored performance metrics for utilization management outcomes, driving insights on length of stay and readmission rates.
- Reviewed clinical criteria for authorization decisions, ensuring alignment with industry standards.
- Oversaw daily workflow of utilization review cases, ensuring timely completion of reviews.
- Analyzed utilization data trends to pinpoint and address quality of care improvement opportunities.
- Developed and maintained relationships with health plan partners, providers, and internal stakeholders.
Faculty Nurse Educator/Adjunct Instructor
Bryant and Stratton College
09.2018 - 08.2023
- Conducted Med/Surg I lectures to prepare students for advanced practice.
- Led Nursing Fundamentals lab sessions to develop essential skills.
- Facilitated mental health lectures to deepen knowledge of the subject.
- Guided students through clinical and classroom processes, improving comprehension and application of nursing concepts.
- Encouraged active participation and questioning during discussions, fostering a dynamic learning environment.
- Engaged students in collaborative discussions, enhancing critical thinking and problem-solving skills.
- Promoted experiential learning opportunities to foster student growth.
- Supported diverse learning experiences within clinical and academic settings.
Utilization Management Administrator and Residential Nursing Manager
Stella Maris, Inc
12.2019 - 01.2023
- Created a Utilization Management department from the ground up
- Trained and hired staff for UM department, enhancing team capability and service delivery.
- Conducted clinical reviews to assess patient needs and provide education
- Promoted to assist in the development of a new residential unit
- Developed policies and procedures to ensure compliance and improve operational efficiency.
- Developed educational programs for new hires addressing mental health and substance use disorders
- Contributed to Outreach Team serving homeless in Cleveland, facilitating access to essential health services.
Director of Utilization Review
Windsor Laurelwood
Willoughby
05.2017 - 12.2019
- Conducted utilization reviews ensuring compliance with healthcare standards, enhancing quality of patient care.
- Collaborated with healthcare teams to evaluate and enhance patient care plans.
- Developed guidelines to promote effective resource utilization across departments.
- Reviewed documentation for accuracy and completeness in patient records, contributing to improved patient outcomes.
- Maintained up-to-date knowledge of regulations impacting utilization review processes.
- Facilitated communication between providers and payers on claim denials and appeals, streamlining resolution processes.
- Monitored quality assurance activities for ongoing improvement in utilization reviews.
- Created a tracking system for utilization reviews to ensure timely completion.
Behavioral Health Registered Nurse
Windsor Laurelwood
Willoughby
05.2013 - 05.2017
- Conducted assessments, developed treatment plans and monitored progress.
- Facilitated patient assessments and screenings to identify behavioral health needs.
- Monitored medications for effectiveness and side effects, providing education about medication use to patients and families.
- Provided education on medication management and available behavioral health resources to enhance patient understanding.
- Collaborated with psychiatrists, psychologists and other healthcare professionals to ensure quality patient care.
- Participated in multidisciplinary team meetings to discuss patient progress and treatment plans.
- Delivered education to patients and families on mental health topics, including stress management, coping skills, and relapse prevention strategies.
Education
Graduate Program - Nursing Education
Robert Morris University
08-2017
Nursing/RN, BSN -
Robert Morris University
04-2016
RN ADN -
Lakeland Community College
01-2013
LPN -
Central School of Practical Nursing
01-1999
Skills
- Clinical assessment
- Utilization review
- Utilization management strategies
- Prior authorization processes
- InterQual familiarity
- Medicaid and Medicare knowledge
- HIPAA compliance knowledge
- Milliman guidelines understanding
- Documentation skills
- Insurance verification techniques
- Time management
- Clinical judgment
- Discharge planning
- Interpersonal communication
- Microsoft Word and Excel
References
Available upon request
Volunteer Experience
- Monthly volunteer as a 'Listener' at the men’s shelter 2100 Lakeside.
- Developed an education program regarding Women’s Health and Sobriety. This is presented quarterly to women living in sober housing in the Cleveland area.
- Renee Jones Empowerment Center-Street outreach that is focused on advocating for those who are or have been victims of human trafficking.
Timeline
RN Psych
Cleveland Clinic
10.2024 - Current
Director of Utilization Management
Windsor Laurelwood Hospital
08.2023 - 10.2024
Utilization Management Administrator and Residential Nursing Manager
Stella Maris, Inc
12.2019 - 01.2023
Faculty Nurse Educator/Adjunct Instructor
Bryant and Stratton College
09.2018 - 08.2023
Director of Utilization Review
Windsor Laurelwood
05.2017 - 12.2019
Behavioral Health Registered Nurse
Windsor Laurelwood
05.2013 - 05.2017
Graduate Program - Nursing Education
Robert Morris University
Nursing/RN, BSN -
Robert Morris University
RN ADN -
Lakeland Community College
LPN -
Central School of Practical Nursing