Sophia Somers
Seminole,FL
Overview
20
20
years of professional experience
Work History
Registered Nurse, Outpatient Utilization Review, Manager
Simply Healthcare
Tampa
11.2021 - Current
- Developed and managed the discharge planning team to assist in coordinating member’s discharge needs
- Managed a team of 19 associates in utilization review for members with home health and DME needs
- Received Impact award from director of provider relations
- Worked closely with medical directors to provide safe and effective care for our members.
Registered Nurse, Inpatient Utilization Review, Team Leader
Simply Healthcare
Tampa
01.2021 - Current
- Worked closely with management to meet interdepartmental goals
- Provided daily coaching and education for associates
- Worked closely with outpatient team and home health care and DME vendor to ensure safe discharge planning for members
- Arranged training for new system go live
- Received exceeds expectations on annual eval.
Registered Nurse, Inpatient Utilization Review
Simply Healthcare
Tampa
07.2017 - 01.2021
- Reviewed inpatient stays for FL Medicaid members and coordinated planning for safe discharge
- Acted as SME for PAC team
- Worked directly with Medical Directors to determine medical necessity for inpatient stays
- Became a FL Ambassador and attended monthly meetings while relaying new and upcoming information back to our team.
Registered Nurse, Supervisor in Nurse Pre Cert
Amerigroup
Tampa
10.2012 - 07.2017
- Pre-authorized procedures for Medicaid and Medicare members
- Promoted to fax team, pends team, team leader, spine team leader, and nursing manager.
Registered Nurse, Surgical Circulating Nurse
Largo Medical Center
Largo
12.2009 - 04.2012
- Circulated surgical cases including general, orthopedics, spine and neurology.
Registered Nurse
Largo Medical Center
Largo
06.2009 - 12.2009
- Provided care for 4-6 patients at a time on telemetry and post cardiothoracic surgery unit.
Registered Nurse, Surgical Circulating Nurse
Altru Hospital
Grand Forks
06.2008 - 06.2009
- Circulated surgical cases including general, gynecological, trauma, plastics, urology, orthopedics, spine and neurology.
Licensed Practical Nurse
Altru Hospital
Grand Forks
01.2007 - 05.2008
- Provided care for 4-6 patients at a time on telemetry and post cardiothoracic surgery unit
- Received Nursing Excellence Awards from patients and peers.
Certified Nursing Assistant
Valley Memorial Homes
Grand Forks
01.2005 - 12.2006
- Alzheimer's Dementia Unit
- Assisted Nurse in providing care for up to 28 residents.
Timeline
Registered Nurse, Outpatient Utilization Review, Manager
Simply Healthcare
11.2021 - Current
Registered Nurse, Inpatient Utilization Review, Team Leader
Simply Healthcare
01.2021 - Current
Registered Nurse, Inpatient Utilization Review
Simply Healthcare
07.2017 - 01.2021
Registered Nurse, Supervisor in Nurse Pre Cert
Amerigroup
10.2012 - 07.2017
Registered Nurse, Surgical Circulating Nurse
Largo Medical Center
12.2009 - 04.2012
Registered Nurse
Largo Medical Center
06.2009 - 12.2009
Registered Nurse, Surgical Circulating Nurse
Altru Hospital
06.2008 - 06.2009
Licensed Practical Nurse
Altru Hospital
01.2007 - 05.2008
Certified Nursing Assistant
Valley Memorial Homes
01.2005 - 12.2006