Customer Service Registered Nurse

Mary Sue Hupp

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

Rancho Mirage, CA 92270

(Mobile): 402-***-****

*********@*****.***

Core Qualifications

Nebraska RN license-active * Staff Development/Training

California RN license-pending * Policy and Program Development

20 years of Nursing Expertise * Strong Clinical Judgment

Utilization and Case Management * Management of Safety Programs

Enrollment in BSN program-active * Customer Service

Education

Northeast Community College, Norfolk, NE

ADN, Registered Nurse

Accelerated Nursing Program

Northeast Community College, Norfolk, NE

LPN, Licensed Practical Nurse-Diploma

Wayne State College, Wayne, NE

Bachelor of Science-Communication Management

Experience

Healthcare Risk Specialist

February, 2008 to November, 2014

Catholic Mutual Group – Omaha, NE

• Independent management of staff development for over 30 long term care facilities.

• Maintained and designed nursing website; produced nursing newsletter, nursing broadcast

emails, safety materials and presentations for staff training.

• Instrumental in the identification of risk exposures by conducting healthcare/safety

reviews; providing an analysis and recommendation to reduce claims and liabilities.

• Workman’s Compensation claims and clinical record review.

• Property and Casualty Insurance Course completion.

Clinical Coordinator RN

May, 2006 to November, 2007

Ancillary Care Management – Omaha, NE

• Preformed utilization review with attention and accuracy to time sensitive authorization

deadlines.

• Clinical liaison between payers and service providers for UHC/Bluechoice insurance

plans.

• Knowledgeable of CPT/HCPC, ICD-9 coding, Federal and State regulations.

• Strong verbal, telephonic and written customer service.

Registered Nurse

August, 2004 to April, 2006

Quality Living Inc.-Omaha, NE

• Disease management and coordination of treatment plans.

• Leader in supervising, delegating and monitoring direct care responsibilities.

• Preformed physician ordered lab work, daily documentation, medication administration,

wound care, IV therapy, and respiratory therapy.

Utilization Review RN

December, 2001 to April, 2004

Mutual of Omaha-Omaha, NE

• Medicare Utilization Review (Medicare Nurse Coordinator 12/01-1/03).

• Behavioral Health/Substance Abuse (Care Coordinator 1/03-4/04).

• Skilled in establishing relationships with providers in the community.

• Accuracy in documentation and medical record review.

Military Background

United States Army Reserve- Honorable Discharge (1986-1993)

Certifications

Healthcare Providers Basic Life Support (BLS)

Healthcare Providers Advanced Care Life Support (ACLS)

Red Cross-Adult First Aid/CPR/AED

Certified Managed Care Nurse (Active)

Organizations

Nebraska Claims Association

Case Management Society of America (National and Nebraska Chapters)

American Association of Managed Care Nurses

Computer and Office Skills

AS 400, Image Right, Windows 7

Microsoft Office (Word 2010, Excel, Power Point, Publisher)

Public Speaking/Seminars

Binding/Laminations/Scanning

References

Available Upon Request

Contact this candidate