Staff Nurse Medical

Kathryn Tipton

**** ********* **. *******, ** ***24 440-***-**** *********@*****.***

Skills & Abilities

Extensive experience in pre-certification, concurrent review functions and discharge planning for psychiatric inpatient, partial hospitalization and outpatient services. Supervisory role as interim department head for inpatient utilization review department. Department Head for ADR. Process of legal appeals for Worker’s Compensation claims. Experience in outpatient psychiatry as triage nurse. Detail oriented and computer skilled in Microsoft Word.

Education

BACHELOR OF ARTS JUNE 1986 HIRAM COLLEGE

Major: Social Science

Related coursework: Accounting and Psychology

ASSOCIATE DEGREE JUNE 1978 LAKELAND COMMUNITY COLLEGE

Major: Nursing

Experience

ADR NURSE UHCOMPCARE NOVEMBER 2012-JUNE 2017

Current role in MCO for Worker’s Compensation as appeals nurse for legal appeals of MCO medical decisions. Utilization review for medical requests and drug utilization review. Approval or denial of requests include medical and surgical treatment, chiropractic treatment, physical therapy, pain management and psychiatric treatment.

UTILIZATION REVIEW RN WINDSOR-LAURELWOOD MAY 1985-NOVEMBER 2012

Pre-certification and concurrent review for inpatient caseload. Familiar with InterQual criteria. Responsible for appeals of any denied cases. Interim department head in extended absence of utilization review manager. Staff nurse on inpatient detox unit.

PATHWAYS MARCH 1999-MAY 2000

Staff nurse for outpatient community mental health center. Independent in managing daily patient volume including telephone triage, medication administration and patient education.

MT. SINAI MEDICAL CENTER JUNE 1983-MAY 1985

Staff nurse working on an endocrine and renal unit. Responsibilities included directing diabetic education and endocrine testing for Saltzman Institute for Clinical Investigation.

CLEVELAND HOME HEALTH CARE APRIL 1981-APRIL 1983

Staff nurse in a community health care setting.

LAKE COUNTY MEMORIAL HOSPITAL APRIL 1978-APRIL 1981

Staff nurse on medical-surgical, orthopedic and pediatric floor.

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