Remote mCase Management
Resume:
Houston, Texas *****
713-***-**** Email:
ad2jdt@r.postjobfree.com
DEBRA A. BLAIBLEH, RN BSN
OBJECTIVE
Seeking a full-time permanent position with an established company where I will expand my education and knowledge while utilizing both to strengthen the corporation's operations.
PROFESSIONAL ACHIEVEMENTS
SIGNIFICANT CONTIRBUTION TO ATTAINING JOINT COMMISSION CERTIFICATION
Commended by management on numerous occasions for the quality and consistency of my performance.
EARNED LEVEL OF RN III IN THE INTENSIVE CARE UNIT
Distinguished by reflecting hard work, attention to detail and meeting all required specifications while keeping costs controls and time objectives paramount.
SKILLS
ACLS and BLS certified
I speak, read, and write conversational Spanish.
WORK HISTORY
RN NURSE ADVOCATE, UNITED HEALTHCARE, HOUSTON, TEXAS
January, 2015 - present
RN HOME HEALTH NURSE, BRIGHT STAR OF DOWNTOWN HOUSTON, HOUSTON, TEXAS
August, 2012 – August, 2014
RN ELEMENTRY SCHOOL NURSE
September, 2011 – May, 2012
RN MICU, MEMORIAL HERMANN NORTHWEST HOSPITAL, HOUSTON, TEXAS
JANUARY, 2011 – JUNE, 2011
RN ICU, METHODIST WILLOWBROOK HOSPITAL, HOUSTON, TEXAS
April, 2008 – April, 2010
RN, ICU, NORTH CYPRESS MEDICAL CENTER, CYPRESS, TEXAS
January, 2007 – April, 2008
Last position: 07/2021 - 08/2022
Remote RN Claim Review
United Healthcare
Details of above positions:
Independently collaborates with Medical Director, Provider, and the Contract to identify reason per contract for claims to pay. Performs expedited, standard, concurrent, and retrospective clinical reviews for in-network and/or out of network providers. Strict turnaround time to adhere to client contract with United Healthcare.
Prior position: 07/2017 - 07/2021
Remote General Case Management
United Healthcare
General Case Management for medical, surgical, and/or mental health treatment. Created Plan of Care in conjunction with treating Physician utilizing discharge orders; arrange In-Network care to improve patient health.
Prior position: 01/2015 - 07/2021
Remote RN Patient Advocate
United Healthcare
Received calls from Queue designated to RN per States that RN is licensed. Assisted patients with questions or concerns about their health diagnosis and worked to keep patient In Network to minimize cost whole maximizing highest level of personal health.
Prior position: 07/2012 - 11/2014
Bright Star Care Home Health Care
Home visits to patient homes to assess newly discharged needs. Physician orders directed care and were followed to track and trend progress made. Also, followed up on unlicensed staff to assure all State and Federal regulations were being followed.
Prior position: 09/2011 - 05/2012
Elementary School Nurse
Managed 805 students; chronic medical and mental health conditions. I arranged annual vision, hearing, and diabetic screening. This position also monitored staff chronic conditions, medications and education.
Prior position: 04/2008 - 04/2010
Staff RN ICU
The Methodist Hospital Houston, T
Staff ICU Nurse night shift
Prior position: 04/2007 - 04/2008
Staff RN, Charge RN night shift
North Cypress Medical Center
Cypress, Texas
Prior position: 05/1997 - 04/2007
Staff RN then Charge RN
Memorial Hospital Northwest
Houston, Texas
Staff RN then trained and transitioned to Charge RN
Please let me know if you require more information.
Debra
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EDUCATION
BACHELOR OF SCIENCE, NURSING, WALDEN UNIVERSITY,
MINNEAPOLIS, MN, MAY 2014
ASSOCIATE OF APPLIED SCIENCE, NURSING, HOUSTON COMMUNITTY COLLEGE,
HOUSTON, TEXAS, MAY 1997
REFERENCES
VAN CARROLL, MSN, RN, MBA, CDD, CADD CT
Site Visitor at CHAD CT, Community Health Accreditation Partner
WANDA LEWIS, RN, DHA, CCRN
Adjunct Faculty Master of Nursing Program at Grand Canyon University
Contact this candidate