Registered Nurse
Resume:
Denise M. Wesley
Topeka, Kansas *****
785-***-**** (cell)
*********@*****.***
PROFILE
A well-organized Registered Nurse with significant experience in client assessment, patient education, and medical reviews. Proficient experience with case management, Utilization review with Portal Medicaid forms/claims on the Medicaid websites, and discharge planning with emphasis on discharge planning to LTAC’s, Rehabs, NF and Home Health. I have worked medical reviews on such systems as, Interqual and Miliman. My skillset encompasses fifteen plus years of general nursing with knowledge in the hospital, clinic, skilled nursing environments, and Insurance environments.
KEY COMPETENCIES
Utilization Review Discharge Planning Medical Research
Case Management Home Health OSHA Regulations
Insurance Claims/Medicaid Hospice Care Interqual/Miliman systems
Medical Documentation Wound Care Electronic Medical Records
Established in Case Management, Utilization Review (prospective, concurrent and retrospective reviews), Care Coordination with Safe Discharge Planning, Long term care reviews, and Wound Care. Assessment, Education, Lab work review and implementation of Plan of Care. Computer knowledge of Electronic Data Records, On-base. Fair-Hearings, and worked in a Nursing Call-Center.
PROFESSIONAL EXPERIENCE
Georgetown Behavioral Health. RN floor nurse
Austin,Tx. 06/4/18 to present
Courtyard Marriott Front desk attendant
Topeka, Ks. 01/2018 - 05/04/18
LTC Medical Reviews W3R Consultants/Accenture Southfield, MI 07/2016 - 01/2017
Concurrent Review Nurse Centene Corp/ Superior Health Plan Austin, TX 01/2015 – 05/2015
Hospice Registered Nurse Hospice Austin Austin, TX 08/2014 – 09/2014
Care Coordinator Parkland Memorial Hospital Dallas, TX 06/2013 – 04/2014
Case Manager St. David’s South Austin Hospital Austin, TX 09/2012 –0 5/2013
Home Health Nurse Homecare Dimensions Austin, TX 10/2011 – 04/2012
Wound Care Nurse Stormont Vail Medical Center Topeka, KS 08/2007 – 06/2011
Hospice Nurse Southern Care Hospice Lawrence, KS 05/2003 - 10/2005
Nursing Supervisor Kelly Home Care Topeka, KS 05/2001 –05/2003
EDUCATION
Bachelors of Science in Nursing Washburn University, Topeka, Kansas 2001
Master’s in Divinity - currently. 2018- present
Credentials
License, State of Kansas 2019
License, State of Texas 2019
AFFILIATIONS
Former Member, Texas Nurses’ Association
Former Member, Kansas Nurses’ Association
Former Member, American Nurses’ Association
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