Nurse
Tina Cebe
Humana
LOUISVILLE,KY
1
Certification
31
years of professional experience
Versatile nursing professional with experience across sales, postpartum care, access to care support and utilization review. Recognized for skills in training new nurse, guiding workflow, and communicating clinical rational to providers and members. Known for accurate prior authorization decisions, clear documentation, and collaboration with providers and care teams.
Work History
Utilization Management Nurse
10 Years 11 Months- Reviewed prior authorization requests for medical necessity using utilization management guidelines and clinical criteria.
- Trained all new hires (nurses) on how to perform their role, how to use Humana systems such as CGX, physician finder plus, provider at a glance and service read only systems.
- Use my clinical knowledge, communication skills, and independent critical thinking skills toward interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for Humana members.
- Collaborated with physicians and care teams to coordinate reviews.
- Coordinated and communicated with providers, members, or other parties to facilitate optimal care and treatment. Understand own work area professional concepts/standards, regulations, strategies and operating standards.
- Documented clinical determinations accurately in utilization review systems and case notes.
- Made decisions regarding own work approach/priorities, and follow direction.
- Communicated coverage decisions, clinical rationale, and next steps to providers and members.
Clinical Access Team (CAT) Nurse
1 Year 1 Month- Used clinical knowledge, communication skills, and independent critical thinking skills toward best helping facilitate access to care issues for Humana members.
- Coordinated and communicated with members, providers, or other parties to try and facilitate optimal care and treatment for Humana members when they were having access to care issues.
- Conducted comprehensive patient assessments to support care coordination.
- Collaborated with multidisciplinary teams to align treatment goals and resolve barriers to care
- Monitored clinical documentation for accuracy, compliance, and continuity across care transitions
Postpartum Registered Nurse and Womens Med-Surg
6 Years 3 Months- Performed comprehensive assessments on both mother and newborn during each shift, identifying any potential problems early for prompt intervention.
- Led postpartum assessments, identifying maternal and newborn changes and escalating concerns promptly.
- Administered medications and monitored recovery, maintaining safe, accurate postpartum care plans.
- Coordinated care with obstetric, pediatric, and lactation teams to support individualized recovery goals.
- Educated families on breastfeeding, newborn care, and discharge instructions, improving readiness for home care.
- Increased patient safety through diligent monitoring of vital signs, medications, and potential complications during the postpartum period.
- Enhanced patient satisfaction scores through effective communication and empathetic nursing practices.
- Provided critical care in emergency situations, safeguarding health of mother and child.
Specialty Sales Representative
1 Year 10 Months- Managed territory plans to drive specialty product adoption across targeted healthcare providers.
- Cultivated physician relationships through consultative selling and therapeutic product education.
- Delivered compliant product presentations aligned with FDA and company promotional guidelines.
- Coordinated access discussions with offices, pharmacies, and payer stakeholders to support prescribing decisions.
- Gained clinical knowledge of medications and how they affected patient outcomes and physicians’ treatment plans.
- Advised physicians on best treatment plans for their patients.
- District leader in calls per day and speaker programs in Quarter 3 of 2007.
Medical Sales Representative
7 Years- Built physician relationships to position antidepressant and Alzheimer's therapies within assigned territory.
- Conducted product presentations for healthcare providers, emphasizing clinical benefits, indications, and patient access.
- Managed territory plans to prioritize high-value accounts and expand prescribing opportunities.
- Delivered compliant sales calls aligned with FDA and PhRMA promotional guidelines.
- Increased sales revenue by consistently meeting and exceeding sales targets through strong relationship building and product knowledge.
- Coordinated sample distribution and account follow-up to support office-level product adoption.
- Conducted informative presentations for physicians and other healthcare professionals, enhancing the understanding of product benefits and features.
Medical Sales Representative
1 Year 1 Month- Developed key relationships with medical professionals, leading to consistent referrals and increased customer base.
- Monitored market trends, competitor activity, and prescribing patterns to refine call strategy.
- Collaborated with pharmacy and office staff to resolve access, coverage, and formulary questions.
- Maintained CRM records and territory reports to track calls, opportunities, and customer engagement.
- Demonstrated proper equipment use by showing clients product setup and operation using advanced knowledge of medical and surgical processes.
- Completed thorough competitor analysis to understand market trends and identify areas of opportunity for growth.
- Prepared and delivered product presentations and answered questions about Bair Hugger warming units to increase sales.
Assistant Charge Nurse
2 Years 7 Months- Supervised clinical staff, reinforcing protocols for donor screening, vital signs, and adverse reaction response.
- Coordinated donor assessment, confirming eligibility and resolving concerns before collection procedures.
- Directed nursing workflow during blood collection operations, ensuring safe donor care and smooth team coordination.
- Monitored compliance with blood bank standards, infection control practices, and documentation accuracy.
- Evaluated donor reactions and escalated clinical issues promptly to protect donor well-being.
Education
Bachelor of Science - Nursing
Skills
Multitasking and prioritization
Collaborative teamwork
Team leadership
Utilization assessment
Care coordination
Clinical documentation
Discharge planning coordination
Demonstrated ability to lead and help motivate healthcare teams.
Excellent capacity to multitask: manage competing priorities with ease while delivering superior patient care.
Recognized as team player.
Certification
Active Nursing Licensure in Kentucky and Nevada.
Timeline
Utilization Management Nurse
Humana
02.2016 - 01.2027Read More
Clinical Access Team (CAT) Nurse
Humana
01.2015 - 02.2016Read More
Postpartum Registered Nurse and Womens Med-Surg
Norton Hospitals
10.2008 - 01.2015Read More
Specialty Sales Representative
Noven Pharmaceuticals
11.2006 - 09.2008Read More
Medical Sales Representative
Forest Pharmaceuticals Namenda and Lexapro
05.1999 - 05.2006Read More
Medical Sales Representative
Cardinal Medical
04.1998 - 05.1999Read More
Assistant Charge Nurse
American Red Cross
09.1995 - 04.1998Read More
Eastern Kentucky University
Bachelor of Science from Nursing
Read More