Denise M. Wesley

Topeka, Kansas *****

785-***-**** (cell)

512-***-****

ac58tt@r.postjobfree.com

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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