Jamie Herrington

Case Manager/ Utilization Review Nurse

Decatur, MS

Authorized to work in the US for any employer

Work Experience

Utilization Review Nurse

Molina Health Care - Remote

May 2023 to Present

I currently review medical records for IP medical necessity against MCG and Interqual. RN Case Manager/Utilization Review

St. Dominic Hospital - Jackson, MS

August 2020 to May 2023

I have been a case manager/ UR nurse for the past 4 years-I have worked as discharge planner for both a small and large hospital on general medical, orthopedic and critical care floors. I continue to grow while performing Utilization Review for Medicare, Medicaid, and commercial insurance using both Interqual and MCG criteria. I am experienced with both medical and behavioral health Utilization Review. Case Manager/Discharge Planner

Merit Health River Oaks - Flowood, MS

March 2019 to July 2020

I served as both discharge planner and utilization Review nurse on orthopedics floor using Both Interqual and MCG criteria. I was laid off two times by this employer. First in September 2019 due to cut backs, rehired again in November 2019. Reduction in hours by half in june 2020 due to covid. Transitioned to prn and was not scheduled for a month. Decided to look for FT employment elsewhere. Case Manager PRN

Anderson Regional Medical Center - Meridian, MS

February 2018 to August 2018

I worked prn as discharge planner and occasional utilization Review. Case Manager over Home Health

STA-HOME HEALTH AND HOSPICE

November 2012 to September 2017

Hospice patients

• Managed care for/educated patients on chronic disease management of DM, CHF, COPD and other co- morbidities

Staff Nurse

ANDERSON REGIONAL MEDICAL CENTER

April 2004 to July 2011

• Assessed and implemented care for cardiac bypass patients, CHF patients, and MI patients

• Prepared patients for heart catheterizations and pace maker implantations

• Assisted with cardioversions and chest tube placements Staff, LPN

HEARTFELT HOSPICE

March 2003 to November 2003

Telemetry Staff, LPN

ANDERSON REGIONAL MEDICAL CENTER

August 2002 to March 2003

Education

Associate in Nursing

East Central Community College - Decatur, MS

Skills

• Utilization Review (3 years)

• Home Health (3 years)

• Case Management (5 years)

• RN (10+ years)

• Time Management (10+ years)

• Microsoft Word (5 years)

• Hospice Care (2 years)

• EMR Systems (10+ years)

• Utilization Management

• Hospital Experience (10+ years)

• Home Care

• Nursing (10+ years)

• Acute care

• Medication administration

• Managed care

• Microsoft Office

• Cerner (2 years)

• Medical Records

• Discharge planning

• Windows

• Medicare

Certifications and Licenses

Compact State Nurse License

RN

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