Registered Nurse Medical
Resume:
Anna Sauls
Ripley, WV *****
Phone: 304-***-****
E-Mail: ************@*****.***
Professional Summary
Always first and foremost, an advocate of the patient optimizing priority and respect. Striving for excellence and eager to learn while demonstrating honesty, responsibility and flexibility. A team player promoting respect for the individual. Accentuating the qualities of your association. Skills
Data entry
Skilled in Microsoft Outlook, Microsoft Word
Client assessment and analysis
Strong verbal communication
Interpersonal and written communication
Report writing
Data analysis
Self-motivated
Data management
Document scanning
Process implementation
Work History
January 2009 to March 2012
Wells Fargo Third Party Administrators Charleston, WV Utilization Review Nurse/Care Manager
Performed admission reviews for medical necessity based upon Millaman, Aetna and PEIA specification.
Devised or identified solutions for irregular requests and issues. Performed prior authorization review of services requiring notification. Served as subject matter resource, providing information related to unusual or emergent situations.
Obtained authorizations from multiple insurance carriers for various levels of care. Evaluated medical guidelines and benefit coverage to determine appropriateness of services. Reviewed documentation for compliance with requirements and accuracy of information. Partnered with team of registered nurses to achieve overall well-being of all patients. June 2008 to January 2009
West Virginia Medical Institute Charleston, WV
Utilization Review Nurse-Medicaid/Data Abstractor-American College of Cardiology RN review via of Medicaid claims via right-fax (computer submission) Pre-authorization of Medicaid reviews per Interqual criteria Verified important patient information such as history, current condition and medications for entry into the patient management system
Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
Reviewed documentation for compliance with requirements and accuracy of information. Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions, and follow-up care.
Accurately recorded and reported test results according to established procedures. May 2001 to June 2008
Charleston Area Medical Center Health System Inc. Charleston, WV Circulating Nurse- Cardiac Cath Lab
Evaluated patient care needs, prioritized treatment, and maintained patient flow. Confirmed accurate completion of forms/reports for the admission, transfer and/or discharge of each patient.
Provided patient education.
Investigated and reported issues relating to patient care or conditions that might hinder patient well-being.
Managed care for post-operative patients through discharge to next unit. Certified that equipment and supplies were properly maintained for quality patient care and safety.
Interviewed and monitored patients to obtain medical information, weight, level of consciousness, hemostasis, EKG, comfort/pain levels and vital signs. Transported patients to and from different departments. Partnered with team including physician and visiting representatives to achieve overall well- being of all patients.
Instructed patients and family members on proper discharge care. Education
2001 West Virginia University at Parkersburg Parkersburg, WV Associate Degree Applied Science Nursing
Vice President Student Nurse's Association
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