Registered Nurse Medical
Resume:
Deana Rindy
*** ******** ***** ( La Conner, Washington 98257 ( ******@****.*** (
Medical Case Management
Analytical, accomplished professional offering 15+ years' success ensuring
the provision of exceptional patient care in diverse healthcare settings.
Detail-oriented and well-organized with proven aptitude for reviewing and
analyzing medical records, leveraging experience as registered nurse in
direct patient care to properly align resources and address documentation
inaccuracies and deficiencies. Excellent written and oral communication
talents; effectively coordinate with fellow medical professionals to
promote seamless patient care. Clearly convey treatment and recovery plans
to patients and their families, providing education to expedite
recuperation.
Core Competencies
Preauthorization & Concurrent Documentation & Reporting
Review Medical Record Auditing
Utilization Management Team Building & Leadership
Discharge Planning Patient Care & Communication
Cross-functional Collaboration
Career Experience
The Regence Group, Burlington, WA
Utilization Management Nurse, 12/2011 - 4/2013
Conducted preauthorization reviews for clinical services, thoroughly
evaluating patient clinical information for preauthorization requests to
verify medical necessity. Applied clinical expertise and sound judgment to
ensure compliance with medical policy, medical necessity guidelines, and
accepted standards of care. Maintained open lines of communication with
colleagues, providers. Provided new hire orientation, educating on medical
policies and computer systems.
Key Contributions:
. Consistently met and exceeded aggressive production metrics.
. Pursued education opportunities to expand knowledge, specifically
orthopedic reviews. Recognized as "spine expert" within the department
and shared knowledge with colleagues, promoting improvement of
performance reviews.
. Compiled and distributed training materials, including step-by-step
instructions for review and determination process as well as a more
user-friendly guide for reviewing certain medical policies.
. Proactively initiated in-service programs prior to hiring of a
designated trainer.
St. David's Medical Center, Austin, TX
Clinical Documentation Liaison, 11/2009 - 10/2011
Performed concurrent review of patient medical records to identify
opportunities for enhancing quality and accuracy of patient data, improving
mortality statistics and driving increases in reimbursement. Verified
completeness of documentation to correctly reflect patient conditions and
resource usage. Communicated with Physicians, Registered Nurses, and
hospital staff to address documentation issues. Compiled reports on program
effectiveness.
Key Contribution:
. Maintained excellent record of accuracy, promptly and effectively
resolving issues.
Island Hospital, Anacortes, WA
Case Manager / Screening Colonoscopy Coordinator / Preoperative Education
Nurse, 8/2001 - 8/2009
Coordinated with patients on discharge planning, maintaining focus on
ensuring timely and successful recovery post discharge. Communicated with
patients, families, and medical staff on all aspects of discharge. Provided
patient consultations on surgery preparation and post-operative care
requirements. Screened colonoscopy referrals and managed colonoscopy
scheduling, instructing patients on procedure preparation. Performed
utilization review, analyzing clinical information for medical necessity
and coordinating with insurance companies on reimbursement.
Key Contributions:
. Supported operations by assisting with the development of pneumonia
vaccine protocol.
. Improved existing pre- and post-op curriculum.
. Successfully reduced wait time for colonoscopy referrals from two years
to one month.
Texas Peer Assistance Program for Nurses, Austin, TX
Case Manager, 4/2001 - 7/2001
Provided education and support to nurses requiring treatment for chemical
dependency or mental illness. Monitored progress, tracking and controlling
nurse participant programs. Served as referral source for treatment
providers and program advocates. Organized and maintained patient and
provider documentation.
Seton Shoal Creek Hospital, Austin, TX St. David's Pavilion, Austin, TX
Admission Coordinator / Care Manager, 8/1999 - 7/2001
Conducted intake interviews to evaluate necessity of psychiatric services,
to include providing resources and referrals to patients. Collaborated with
Physicians, Discharge Planners, medical staff, and outside professionals on
treatment planning. Coordinated care provisioning. Communicated with
insurance companies on medical necessity and reimbursement. Reviewed
psychiatric and medical records.
Key Contribution:
. Hand-selected for position by management due to proven skills across
psychiatric nursing, treatment planning, and document management.
St. David's Pavilion, Austin, TX
Nursing Supervisor, 9/1996 - 3/1998
Managed 10-member nursing team while providing direct patient care for as
many as 30 psychiatric patients. Reviewed patient records in performing
clinical assessments; leveraged therapeutic communication while working
directly with patients. Managed workflow scheduling to ensure adequate
resources. Directed staffing efforts; provided new employees with
orientation and performance appraisals, assessing patient care and intake
process.
Key Contribution:
. Rapidly promoted from patient care to leadership role as a result of
outstanding job performance.
Education and Credentials
Associate Degree in Nursing / Registered Nurse
Austin Community College - Austin, TX
Licensed Vocational Nursing Program
Austin Community College - Austin, TX
Technical Skills
Windows, MS Office Suite (Word, Outlook), Meditech, 3M Coding Software,
Trizetto / Clinical Care Advance, Facets
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