
Compassionate Registered Nurse (RN) with a robust clinical foundation and specialized expertise in claims review, utilization management, and care coordination. Proficient in evaluating medical necessity, interpreting insurance policies, and applying evidence-based criteria to facilitate fair and accurate determinations. Strong ability to collaborate effectively with healthcare providers, payers, and patients to achieve optimal quality outcomes while strategically managing healthcare costs. Committed to enhancing patient care through comprehensive assessments and informed decision-making in complex healthcare environments.