Tamara Bender Higgs

• Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices in utilization review nursing
• Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
• Conducted reviews on patients

in observation, new inpatient and

concurrent

• Collaborated with Physician Advisor

and Medical Staff to discuss medical

necessity on all reviews

• Enhanced patient satisfaction by collaborating with interdisciplinary teams to develop individualized care plans, ensuring appropriate level of care.
• Streamlined the case management process by effectively prioritizing high-risk cases for timely intervention and followup.
• Coordinated discharge planning efforts with Physicians, Social Workers & other multidisciplinary team members

for a smooth transition post

hospitalization.

• Improved patient outcomes by providing high-quality nursing care and implementing evidence-based practices.
• Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
• Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
• Mentored new nursing staff, contributing to a supportive work environment and improved retention rates.
• Participated in professional development opportunities regularly to stay current on best practices in the field of nursing.

• Contributed to organizational success by providing expert advice on medical necessity criteria and evidence-based practices in utilization review nursing
• Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
• Conducted reviews on patients

in observation, new inpatient and

concurrent

• Collaborated with Physician Advisor

and Medical Staff to discuss medical

necessity on all reviews

• Enhanced patient satisfaction by collaborating with interdisciplinary teams to develop individualized care plans, ensuring appropriate level of care.
• Streamlined the case management process by effectively prioritizing high-risk cases for timely intervention and followup.
• Coordinated discharge planning efforts with Physicians, Social Workers & other multidisciplinary team members

for a smooth transition post

hospitalization

• Enhanced patient care by providing telephonic support and guidance to individuals with chronic illnesses.
• Reduced hospital readmission rates by closely monitoring patients'' progress and addressing potential complications in a timely manner.
• Developed individualized care plans based on comprehensive assessments of patients'' medical, psychological, and social needs.
• Educated patients on self-management techniques to promote independence and improve quality of life.

• Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
• Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
• Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care
• Educated patients and families on available community resources, facilitating access to necessary support services.