Brentwood, TN *****
Wanda Pippin, RN / RHIA
Q.A NCQA Training
Clinical staff RN with proven success in Utilization Management and Disease Management. Served in management roles, supervising up to ten employees. Track record of producing desired outcomes.
Analyzed the protocol and expressed a need for a screening tool. Result: Tool was added to protocol.
Offered eight and 12-hour shifts. Result: Increased nurse satisfaction.
Managed case loads with Utilization Management and Disease Management. Result: Positive outcomes.
Implemented quality improvements. Result: Increased performance and productivity.
Completed coding project with Utilization Management. Result: Obtained correct codes.
State of Tennessee: RN3, MEU Unit. Supervise Two Employees. Incapacity, Appeal, Reconsideration Cases. Meets and Exceeds goals. 2011-present
Williamson Medical Center: RN Case Manager. Used Interqual and Meditech for Utilization Management.
CCU, NICU, CPC, Oncology, Orthopedics, OB/GYN, Med-Surg. Medicare. 2008-2010
State of Tennessee
Health Records Auditor
Audit records using specific audit tools. Monitors medical records for compliance with local, state, and federal requirements; including ACA standards. Plans of correction for the monthly state facility monitors as well as the yearly institutional audits. Assists the infection control, and the continuous quality improvement departments with gathering of information on inmates with chronic conditions. Q.A. Projects for evaluation of continued compliance with ACA standards. Monthly chronic care survey. Interim Infection Control RN, 2007. Participated in the annual inspection of a facility and received “Best Annual Inspection” in 10 years with an “Exceptional” evaluation.
Medical Record Data Collection
Project based; responsible for medical record data collection, and capturing ICD-9-CM codes.
HMC: WellPoint Blue Cross Blue Shield
2003 – 2004
RN on the Diabetes team. Serviced CAD, CHF, Asthma, COPD, Peds, Screen Depression, and Hypertension Project. Fully productive evaluation. Consolidated and closed the Franklin office.
2002 – 2003
RHIA Outpatient Coder
Input E/M codes and ICD-9-CM codes. 3M coding. Generated billable versus non-billable visits. Fully successful evaluation.
First Health Corporation Incorporated
2000 – 2002
RN, RHIA, BCM-1. Responsible for telephone and paper record reviews for hospital stays (children through geriatrics). Input ICD-9-CM codes. Received 6.5 to 7.5 out of 9 on evaluations. Consolidated and moved to VA.
Elk Valley Home Health
1999 – 2000
Diabetic teaching, wound care, assessments, histories, and discharges.
5116 Victoria Cove
Brentwood, TN 37027
Wanda Pippin, RN / RHIA
Tennessee Christian Medical Center
Served in addictions, dual diagnosis unit. Geriatric and adult partial treatment programs. Above standard evaluation.
Middle Tennessee Mental Health
1997 – 1999, 2003
Served in acute treatment program and ETP Forensic Unit. Adults through geriatrics. Superior evaluation.
First Hospital Corporation
Psychiatric Registered Nurse
Served children through adults.
RN B.S.N. Belmont University – Nashville, TN
B.S. Health Information Management / RHIA UTHSC - Memphis, TN