Zeynep Dizaye
Rancho Cucamonga,CA
Summary
Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Overview
14
14
years of professional experience
Work History
Utilization Management Nurse
Inland Empire Health Plan
06.2014 - Current
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Devise or identify solutions for irregular requests and issues.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Utilization Management Nurse
RUHS
03.2013 - 06.2013
Hospice LVN
Pacific Hospice
12.2009 - 02.2013
Education
Licensed Vocational Nurse - Nursing
Summit Career College
Colton, CA11.2009
Skills
- Obtaining Authorizations
- Procedures Compliance
- Determine Medical Necessity
- Benefits Guidelines
- Utilization Management
- Utilization Review
Timeline
Utilization Management Nurse
Inland Empire Health Plan
06.2014 - Current
Utilization Management Nurse
RUHS
03.2013 - 06.2013
Hospice LVN
Pacific Hospice
12.2009 - 02.2013
Licensed Vocational Nurse - Nursing
Summit Career College
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