Tara Hill
Bismarck,ND
Summary
Knowledgeable Nurse Consultant with strong background in healthcare consulting and patient care. Recognized for providing valuable insights into clinical practice improvements and regulatory compliance. Demonstrated ability in strategic planning and effective communication. Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
13
13
years of professional experience
1
1
Certification
Work History
QM Nurse Consultant
Aetna/CVS Health
Bismarck, ND
09.2018 - Current
- Assessed and analyzed clinical documentation for Medicare and commercial lines of business.
- Developed innovative solutions to enhance documentation review processes and streamline workflows.
- Interpreted data from clinical records, applying relevant clinical criteria and policies to support effective claims processing.
- Conducted data analysis on patient records to enhance care delivery and identify opportunities for improvement through decision tree methodology.
- Ensured compliance with company policies, procedures, and applicable state and federal laws and regulations.
- Facilitated collaboration with healthcare professionals, including MDs, coders, and colleagues, to identify effective clinical solutions.
- Surpassed production metrics through individual efficiency and effective collaboration with team members.
Registered Nurse
Bone And Joint Center
Bismarck, ND
03.2013 - 09.2018
- Administered patient care plans for post-operative orthopedic patients, ensuring adherence to best practices.
- Collaborated with multidisciplinary teams to optimize recovery protocols and enhance patient outcomes.
- Monitored vital signs and assessed patients' conditions, responding promptly to changes in health status.
- Implemented evidence-based nursing practices to improve efficiency in orthopedic procedures and reduce complications.
- Assisted surgeons during orthopedic procedures by ensuring proper positioning of patients, managing surgical instruments, and monitoring vital signs throughout surgery.
Education
Bachelor of Science (B.S.) - Nursing
Medcenter One College of Nursing
Bismarck, ND05.2011
Skills
- Case documentation
- Interprofessional collaboration
- Medical documentation
- Clinical expertise
- Records review
- Procedure optimization
- Analyzing documentation
Certification
Registered Nurse
Timeline
QM Nurse Consultant
Aetna/CVS Health
09.2018 - Current
Registered Nurse
Bone And Joint Center
03.2013 - 09.2018
Bachelor of Science (B.S.) - Nursing
Medcenter One College of Nursing