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Medical Registered Nurse

Allentown, Pennsylvania, United States
February 12, 2018

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Home Address:

**** ******** *****

Allentown, PA 18104


Reading Hospital and Medical Center Nursing Program

Registered Nurse, Commonwealth of Pennsylvania


Medical Management, Utilization Review, Quality Assessment (2002 - 2017)

Capital Blue Cross

Case Management (1996 - 2002)

Lehigh Valley Hospital Transitional Skilled Unit

Good Shepherd Acute Rehabilitation

Muhlenberg Skilled Nursing Center

Assistant to Director of Medical Records, Medicare Coordinator

Fellowship Manor (1995 - 1996)

Utilization Management, Quality Assurance (1986- 1991)

Kidspeace Acute Psychiatric Hospital

St. Luke's University Hospital

KEYPRO Medicare Management.

Critical Care (1976 - 1984)

Allentown General Hospital

Lynn Hospital of MA

Muhlenberg Medical Center.

Strengths and Accomplishments:

As a medical management nurse, I provided concurrent review for acute hospital care, skilled nursing facilities, acute rehabilitation hospitals, and long term acute care facilities. I adhered to policies and procedures including regulatory, notification and documentation, along with timeliness standards. I supported the

implementation of programs directed to improve health cost and member/provider

satisfaction. I worked with cross functional teams by providing referrals to clinical programs to enhance member management.

Acted as a liaison between the medical provider and managed care organizations. I provided utilization reviews for both medical and private insurance recipients

within an acute and sub-acute facility network.

I implemented the Utilization Management Program for a newly established psychiatric hospital. Developed the policy and procedure along with the initiating of accreditations with Medical Assistance and private insurers.

Integrated technical skills and nursing observations along with medical knowledge to care for the critically ill patient.

Other Special Skills:

Excel, Word Applications. Computer Basics Course (Muhlenberg College)

Activities and Associations:

Critical Clinical Critical Lehigh Valley Hospital, Boston Massachusetts.

MDS Understanding Raps Seminar.

Registered Nursing licensure maintained with Pennsylvania CE's currently achieved.

Woman's Alliance of the Cathedral of St. Catherine's of Sienna.

Dream Come True Volunteer.

Meals on Wheels Volunteer

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