• Observant and highly trained RN skilled at multitasking while managing patient care,
• Experience caring for critically ill patients.
• Registered Nurse with experience including Clinical Review.
• Experienced in Insurance Claim Reviews and Approvals for Long term Care.
• Case Management, Obstetrics, Pediatrics, and the Operating Room, Relief Charge in multiple specialties, Certified in EFM.
• previous experience working in utilization management roles using NCQA and interqual guidelines.
• Recent experience working with CMS and understanding of requirements.
• 10 years of experience using electronic med records and charting systems.

ACCOMPLISHMENTS

• Registered Nurse with experience including Clinical Review and Utilization Management.
• Previous experience with Medicaid and Medicare.
• Experienced in Insurance Claim Reviews and Approvals for Long term Care.
• Case Management, Obstetrics, Pediatrics, and the Operating Room, Relief Charge in multiple specialties, Certified in EFM.
• Preceptor for new hires.