Registered Nurse Manager
Resume:
Michelle Pinkerton, RN
Houston, TX 77054
***********@*****.***
Objective
Position with opportunity to utilize my skills in managed care, patient access and case management.
Qualifications
Registered Nurse with twenty years of experience in emergency room, case management, patient
access and occupational health. Currently completing my BSN with the goal of obtaining a
masters in nursing education.
Work History
2007-Present M.D. Anderson Cancer Center, Houston TX
Patient Access Supervisor, Cancer Prevention--$82,000
• Supervise daily operations of the Patient Access Center team of 11 specialists to ensure that referral,
authorization, financial activities are all carried out effectively and in accordance with hospital policies
and procedures. Performs audits to ensure staff are providing services as appropriate. Handle daily
iPayment bank of business for the clinic. Manages staff shift schedules, interviews, hiring, counseling
and performing annual evaluations of staff. Provide ongoing clinical support in a center that does not
have a Patient Access Coordinator.
2006-2007 M.D. Anderson Cancer Center, Houston, tx
Patient Access Coordinator, Thoracic/Ortho clinic $65,000
• Facilitated pt medical and financial clearance for oncology patients. Provide clinical review of
referrals, obtaining medical overrides, pre-certifications, ongoing authorizations for services.
Monitor team of 8 patient access specialists for staff performance and productivity. Participate in
employee evaluations and counseling, as well as interviewing of prospective new hires under
direction of the Access center supervisor.
2002-2005 Cyberonics, Inc, Houston, TX
RN Case manager for medical device company- $65,000+ bonus
• Educated patients and handled insurance prior authorizations, appeals, multiple state Medicaid
programs for coverage of implantable neural stimulator for prevention of seizures. Nationwide
travel with sales team. Supported team as clinical component. Presented educational seminar for
large group of psychiatrists following FDA approval of device for use in Major Depression.
Extensive interaction with physicians, insurance companies, and patients. Home base position with
travel.
1997-2002 Evercare-United HealthCare Houston, TX
• Educated patients and handled insurance prior authorizations, appeals, Long term care services.
Authorized and monitored utilization of covered services. Preceptor for new coordinators in field
training. Extensive interaction with physicians to discuss plan of care. Responsible for completion
of state mandated evaluation forms. Utilization of plan software to enter service requests,
document and monitor all aspects of patient care and service delivery. Caseload = 150 members.
Home based position.
1996-1997 First Health, Houston TX
Utilizations Review Nurse-$32,000
• Telephonic care manager for the largest third party administer in the nation. Performed pre-
certification of procedures, concurrent and retrospective reviews, discharge planning, and post
discharge management of catastrophic medical cases. Interacted with physician and other care
providers to meet patient medical needs within the plan. Authorization of home health care,
durable medical equipment, rehabilitation and other services. Use of plan software for
documentation of all services, and Interqual or Milliman for justification of length of stay.
Additional Experience
Trauma center staff nurse with adult and pediatric experience, occupational health, case management
consultant.
Education
1990-1991~ San Jacinto College School of Nursing, Associates in Applied Science in Nursing.
2011– Present~ Jacksonville University School of Nursing, BSN program. Online studies, expected
graduation date 2011. Plan to continue to obtain my MSN in nursing education.
References
On request
Accreditation
Fellowship in the American Academy of Case Management--Aug 11, 2004 Sept 21, 2008.
Computer Skills
Experienced in multiple computer software programs including Word, Excel, CARE, iPayment,
Crystal Reports, EIW. Keyboarding @ 110 WPM.
Licenses and Certificates
R.N. State of Texas, 1991. Clinical Safety & Effectiveness Program: performance of clinical practice
improvement and teaching, implementation and facilitation of teams for the management and continuous
improvement of outcomes and services in health care. September 17, 2010 Principles & Practices of
Management, Performance Management, Coaching, Situational Leadership, 2007
Contact this candidate