THERESA FINN
San Diego,CA
Summary
Experienced and patient-oriented nurse with a strong background in direct inpatient care, staff supervision, and outpatient services. Proficient with documentation systems, utilization review, medication management, and admissions/discharges. Specializing in case management, psychiatric nursing (including addiction use disorders), med-surg, home health, public health, long-term care, and telehealth services.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Utilization Review Case Manager
Southern California Physicians Managed Care Services
12.2024 - 08.2025
- Reviewed and approved referral requests for medical necessity, ensuring compliance with health plan benefits and provider criteria.
- Evaluated care setting and place of service; documented determinations and authorization decisions accurately.
- Coordinated medical necessity denials with physicians and processed denials using standard industry language, providing alternative options.
- Managed urgent, routine, and retrospective requests to meet legislative and accreditation compliance standards.
- Reviewed and verified appropriate CPT codes to ensure accurate service authorization and alignment with clinical documentation.
Registered Nurse Case Manager
Alvarado Parkway Institute Behavioral Health System
08.2022 - 12.2024
- Conducted patient triage during admissions and coordinated discharge resources for continuity of care.
- Managed telephonic and faxed medication orders, including refills.
- Supported monthly psychiatric provider visits (virtual and in-person).
- Educated patients and caregivers on chronic care management and medication side effects in accessible terms.
- Handled lab paperwork, results, and medical/psychiatric emergencies.
- Secured insurance authorizations for various levels of care.
Registered Nurse Case Manager
Lorian Home Health
02.2022 - 08.2022
- Determined and implemented individual treatment plans by completing detailed assessments and reviewing documentation.
- Managed patients recovering from medical or surgical procedures.
Public Health Nurse (Contract)
Pioneer Healthcare
08.2021 - 02.2022
- Handled a wide variety of emergency psychiatric disorders in homeless population.
- Continuously maintained proper safety and took precautionary measures to avoid spread of disease and infection.
- Performed additional clinic and non-triage nurse duties such as instructing patients in general and specific medical care and health issues, administering medication, and making follow-up appointments.
- Delivered key information to patients regarding COVID-19 and identified appropriate resources within community.
Charge Registered Nurse
Hillcrest Rehabilitation Center
07.2018 - 08.2021
- Administered PO, injection, IV, and feeding tube medications as well as providing wound care and other medical procedures such as placing catheters and trach care.
- Coached and trained new employees to promote knowledge of responsibilities and position requirements using evidence-based practices.
- Responded to numerous volatile situations and violent outbreaks to restore safety and security of patients and staff, particularly on locked dementia unit.
- Collaborated with a diverse patient population, including individuals on med-surg, hospice, dementia care, and long-term care units.
- Telephonic intakes and discharges of COVID-19 patients and those at high risk for COVID-19 including general population, homeless.
Home Health Nurse
Ecumen Pathstone
06.2017 - 06.2018
- Provided care to patients with chronic illnesses, post-surgical recovery and terminal conditions.
- Performed in-depth assessments, developed care plans, and collaborated with multidisciplinary teams.
- Ensured continuity of care by coordinating follow-up visits, referrals to specialists, and necessary medical equipment and supplies.
- Implemented infection control protocols to minimize risk of hospital readmissions and ensured patient safety at home.
- Maintained accurate patient records, ensuring compliance with healthcare regulations and insurance companies.
Education
Nursing - BSN Degree -
Minnesota State University
Mankato, MN05.2021
Nursing – ASN Degree - undefined
South Central College
Mason City, IA12.2017
Skills
- Case Management
- Psychiatric Nursing
- Medication Management
- Chronic Disease Management
- Denials/Appeals/ICD-10
- Quality Improvement
- Medicare/Medicaid/HMO/PPO
- Admission/Discharge Planning
- EMR/Epic/Interquel/Charting Systems/Microsoft Office/MDS
- Care Coordination
- Medical Assessment
- Patient Advocacy
Certification
- State of California RN Nursing License #95254880 Issuance Date: 2021-08-06 Expiration Date: 2027-04-30
- Basic Life Support/First Aid Certification #245416774979 Issuance Date: 2024-03-15 Expiration Date: 2026-03
Timeline
Utilization Review Case Manager
Southern California Physicians Managed Care Services
12.2024 - 08.2025
Registered Nurse Case Manager
Alvarado Parkway Institute Behavioral Health System
08.2022 - 12.2024
Registered Nurse Case Manager
Lorian Home Health
02.2022 - 08.2022
Public Health Nurse (Contract)
Pioneer Healthcare
08.2021 - 02.2022
Charge Registered Nurse
Hillcrest Rehabilitation Center
07.2018 - 08.2021
Home Health Nurse
Ecumen Pathstone
06.2017 - 06.2018
Nursing – ASN Degree - undefined
South Central College
Nursing - BSN Degree -
Minnesota State University