Sang Kim
Cary,NC
Summary
Experienced utilization manager focused on meeting or exceeding objectives seeking Utilization Review Team Lead position. Flexible with specific needs of different assignments. Driven,detail oriented, and recognized for planning abilities and clear, direct communication style.
Overview
14
14
years of professional experience
Work History
Utilization Manager
Duke University Hospital
Durham, North Carolina
04.2019 - Current
- Evaluate accuracy of patient class based on the medical necessity, regulatory and reimbursement requirements of various commercial and government payors.
- Conduct initial review and continued stay reviews as designated in UM plan.
- Initiate actions to obtain appropriate determination.
- Examine patient medical records and validate with Care Team to compile an accurate account of patient's clinical picture to relay information to external reviewers.
- Perform denial management activities by actively works to overturn threatened denials and partners with Physician Advisors to facilitate peer-to-peer conversations.
- Collaborate with CM, Physicians and Care team to assist in discharge planning and utilization management.
- Manage assignment and serves as a resource person for 5-7 staffs every other weekends.
- Precept new staffs to weekend workflow and organization skills.
- MCG Super User.
Registered Nurse
Duke University Hospital
Durham, North Carolina
09.2009 - 04.2019
- Provided direct care and stabilized oncology and medical-surgical patients.
- Administered chemo and biotherapy based on physician orders and monitored responses.
- Managed central lines and collected blood for lab testing.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and patient care instructions.
- Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
- Skin care champion
- Epidural Super User
- Charge Nurse
- CN III
Registered Nurse
Atlanta Medical Center
Atlanta, Georgia
08.2008 - 08.2009
- Provided total patient care to oncology medical-surgical patients.
- Administered chemotherapy, pain medications and other medicines based on physician orders and patient requirements.
- Provided palliative and end-of-life care.
- Educated patients and families on disease processes, medications, plan of care, and safety.
Education
Bachelor of Science - Nursing
Georgia State University
Atlanta, GA05.2008
No Degree - Pre-Nursing
University of Georgia
Athens, GASkills
- BLS
- ACLS
- OCN
- CCM
- Chemotherapy/Biotherapy certified
Timeline
Utilization Manager
Duke University Hospital
04.2019 - Current
Registered Nurse
Duke University Hospital
09.2009 - 04.2019
Registered Nurse
Atlanta Medical Center
08.2008 - 08.2009
Bachelor of Science - Nursing
Georgia State University
No Degree - Pre-Nursing
University of Georgia
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