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Stoughton, WI 53589
Per Diem
18 years experience W2
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Registered Nurse with experience, education and knowledge in clinical care, hospice, rehabilitation, technology, insurance claims review and state Medicaid process procedures. Played key roles in the strategy development of policy and procedural processes for patient care, claims payment and Medicaid review. A high energy and passionate style committed to continuous learning and excellence in all endeavors. Versatile style with ability to work well both independently and within a team environment in critical situations. KEY COMPETENCIES

  • Utilization Management
  • CPT Codes
  • Six Sigma
  • Claims approval
  • Milliman Care Guidelines
  • Independent medical review
  • Epic software
  • Extensive clinical experience
  • Medicaid
  • Cerner software
  • Organizational Skills
  • Medical Technology
  • Communication
  • Strategic policy development
  • Teaching and Training

Per Diem
Nov 2020 - present
Perform COVID-19 testing for local manufacturing industry.
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Adjunct faculty
Nov 2020 - Nov 2020
40 hours per week Adjunct faculty for the Bachelor of Science nursing program.
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Assistant Director/Corporate Programs
Medical Devices
May 2019 - Oct 2020
40 hours per week IPRO is an independent peer review organization and QIO. The Corporate Programs division focuses on independent medical reviews of managed care insurance claims. These claims have been processed through managed care organizational guidelines and the claimant is requesting an external review. IPRO's list of Corporate Program clients includes 19 states across the U.S.
Medical Review
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Nurse Consultant / Claims Adjudicator
Medical Devices
Nov 2016 - May 2019
/ Healthcare Div. 40 hours per week Information Technology and consulting services organization providing support to business and government the number one provider of Medicaid Process Management Services. Provides contracted services for the State of Wisconsin and is responsible for managing the state's Medicaid Program.
Medicaid Nursing
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Medical Devices
Apr 2015 - Oct 2016
hours varied by assignment Contract medical staffing agency serving the needs of hospitals, clinics, hospice, and insurance companies. Provided various levels of medical support as dictated by the needs of the client. Organizations and roles included:
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Ancillary Benefits Coordinator
Apr 2015 - Apr 2015
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Case Manager
Apr 2015 - Apr 2015
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Staff Registered Nurse
Medical Devices
Jun 2014 - Apr 2015
hours varied by assignment Contract medical staffing agency serving the needs of hospitals and clinics.
Nursing Registered Nurse
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Utilization Management RN
Medical Devices
Feb 2012 - Aug 2013
40 hour week Provides health management services through individual health insurance plans. The company serves individuals and families living in south central Wisconsin.
Registered Nurse Utilization Review
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1.0 FTE
Medical Devices
Aug 2003 - Apr 2011
on vascular 0.7 FTE on rehab A 505-bed regional, referral, teaching, medical and surgical facility. Frequently listed as one of the nation's best health care providers, UW Hospital is recognized as one of the national leaders in fields such as cancer treatment, pediatrics, ophthalmology, surgical specialties, organ transplantation and excellence in patient care.
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Edit Skills
Non-cloudteam Skill
Capella University 2020
Six Sigma Green Belt
American Public University APU 2020
Technology Management
Herzing University 2019
Applied Sciences, Registered Nursing
Kankakee Community College 2016
not provided
Registered Nurse
Medical Review
Utilization Review