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Regina
rvedwards92@yahoo.com
321-961-8962
Saint Petersburg, FL 33702
Utilization Review Nurse
23 years experience W2
0
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Average rating
14
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Summary

Experience
Medical Devices
Jul 2016 - present
Tampa, FL
Review clinical by faxes, Web and apply the clinical to interqual criteria if the clinical meet the criteria able to process for authorization approval. If clinical do not meet send to medical director for second review and approval or denial.
No skills were added
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Nurse Case Reviewer
Medical Devices
Apr 2015 - Nov 2015
San Antonio, TX
Responsibilities provide a wide range of Case Managerment support services to soldiers found to have medical issues or concerns that are medically not ready for mobilization/training and require referral management for care treatment or for appropriate medical board. Accomplishments Impact during my time at this job was the case Mangerment services I provided for the military soldiers. Skills Used Computer skills with outlook, Excel, etc. Precertfication
Case Management Nursing
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LPN
Medical Devices
Aug 2012 - Oct 2014
Tampa, FL
Responsibilities Utilization Review Nurse Answer Phone calls communicate with hospitals and providers. Approve or pend authorizations depending on clinical assessment using interqual for criteria to meet medical necessary, and may approve authorizations if criteria are met
No skills were added
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Medical Record Reviewer
Medical Devices
Jun 2010 - Jun 2010
Travel to physician office
  • Review medical records
  • Copy medical records
  • Send to Unival for evaluation.
No skills were added
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LPN Hedis Project
Feb 2010 - Mar 2010
Medpro -
HEDIS LPN
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Telephonic Nurse Case Manager
Medical Devices
Oct 2007 - May 2008
Full time LPN
  • To perform initial evaluation assessments and evaluate
  • need for alternative treatment
  • to negotiate claims with providers and employers
  • and to provide case direction and supervision to field
  • case specialists when on-site
  • intervention is required ensuring quality and appropriate service delivery. LPN Site Review Consultant MEDASSURRANT -
LPN Nursing
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Full time LPN
Medical Devices
Jun 2006 - Sep 2006
Took lab top to facilities or offices
  • and review medical charts abstract information
  • from the medical charts that confirms the diagnosis
  • and scan the information into a scanner to send medassurrant to evaluate.
No skills were added
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LPN
Medical Devices
Apr 2005 - May 2006
Orlando, FL
Contracted to work at orange regional juvenile detention center.
No skills were added
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LPN
Oct 2002 - Jan 2003
New Haven, CT
Review care plans.
  • Take geratric patient vital signs and monitor compliance with care plans.
  • Interface with interdisciplinary team members.
  • Focus on patient education and emotional issues facilitate patient recovery.
  • Administered medications on an ongoing basis.
No skills were added
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LICENSED PRACTICAL NURSE
Medical Devices
Apr 2001 - Dec 2001
New Haven, CT
Performed patient assessments admissions health histories.
  • Interfaced with physicians to discuss inmate behavior and conduct.
  • Provided one-on-one and support group counseling.
  • Monitored and update inmate progress. Conducted discharge planning.
  • Monitored 26 patients in need of a medically detoxification from alcohol or illicit drugs.
LPN Nursing
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LICENSED PRACTICAL NURSE, Female Juvenile Delinquents
Jan 2000 - Jan 2001
Orlando, FL
Review Geratric patient care plans.
  • Took geriatric patient vital signs and monitor compliance with care plans.
  • Supervise CNA's in the discharge of their duties.
  • Interface with interdisciplinary team members.
  • Focus on patient education and emotional issues facilitate patient recovery.
  • Administer medications on an ongoing sis.
Compliance Geriatric LPN Nursing
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Edit Skills
Non-cloudteam Skill
Education
Bullard Haven Technical School 2017
Certifications
CPR certified
Skills
LPN
2010
2
Nursing
2015
2
Compliance
2001
1
Geriatric
2001
1
Case Management
2015
1
HEDIS
2010
1
Utilization Review
0
1