KASANDRA MINETT, RN

UTILIZATION MANAGEMENT REVIEW RN

CONTACT

432-***-****

ad3tzg@r.postjobfree.com

PROFILE

To obtain a position as a Registered Nurse and build on years of nursing experience by providing the highest level of patient care and maintaining the mission and vision of this facility

SKILLS

Excelled in MCG

Knowledgeable in InterQual

Skilled in verbal & written communication skills

Experienced in NCQA and URAC accreditations.

Knowledgeable in HIPAA rules and regulations

Knowledgeable in CMS, HHCS, Office of Superintendent and DOD regulations.

Proven abilities to problem solve, organize, & prioritize

26 years of experience direct patient care: medical inpatient; ICU, telemetry, hospice, behavior health, home health/hospice, insurance

Managed multiple roles within the Christus health plan; UR/UM and transplant coordination. Followed guidelines for 4 different health plans, including an Indigent plan, Health Exchange plan, Medicare Advantage plan, and Tricare plan.

Effective communicator and educator to educate patients and families regarding diagnosis, treatments, medication management, signs and symptoms, and resources. communication with medical directors with written reviews for medical necessity or denial recommendations

EXPERIENCE

Christus Health System

Utilization Management and Utilization Review RN

03/2018-Present

· Review Clinical for medical necessity based upon evidence based clinical criteria and standard within governmental and contractual guidelines.

· Collaboration and coordination with case management for safe transition to next level of care

· Performs selected provider calls to address post-hospital discharge services, redirection to in network providers for appropriate steerage, durable equipment usage and utilization of other medical services and/or procedures and other telephonic follow-up as identified by the UM/UR Nurse, the medical Management Clinical Supervisor or Medical Management Director

· Transplant coordination with third party contract administrators, finding the center of excellence Transplant center to meet patient needs safely, and effectively; preventing delay in care

Texas health Cleburne PACU

Post Anesthesia Care Unit; Charge, RN

03/2017-02/2018

· Post Op Endoscopy

· Phase I and Phase II

· Moderate sedation for radiology procedures

· Monitor post-surgical patients (all ages); including general and moderate sedation

Angel Care Home Health

PRN, Case Manager; RN

01/2017-01/2018

· In depth knowledge of developing patient specific care plans

· Functional knowledge of nursing practices and their applications

· Hands on experience identifying patient needs and validating medical diagnoses

· Devised and implemented individual plans of care to cater to specific needs of patients

University Medical Center

Post Anesthesia Care Unit; RN

01/2017-03/2017

· Level 1 Trauma Hospital

· Care of multiple post-surgical patients

· Rhythms floated to outpatient surgery

· Phase I and Phase II

Beyond Faith Home Care and Rehab

Case Manager; RN

04/2014-11/2015

· Devised and implemented individuals plans of care to cater to specific needs of patients

· Functional knowledge of nursing practices and their applications

Covenant Health System

Medical Intensive Care Unit; RN

02/2012-04/2014

· Worked as part of an interdisciplinary team to care for critical patients

· Monitor Telemetry and respond to emergent calls in life saving situations

· Educate and support patients and families

· Assisted physicians with procedures and treatment protocols

· Rapid Response Team member

Covenant Health System

HOSPICE OF LUBBOCK; LVN

09/2007-01/2012

· Provide symptom management, teaching and care of the dying patient

· Answering questions to clients concerning admission to hospice

· Managing and scheduling visits for admissions

· Gathering patient information and obtaining medical records

· Using proper IDC-9/10 codes

Interim Health Care

LVN Case Manager

2001-2007

· Communicated effectively with clients, medical providers, administration and social services

· Provided care to patients of all ages and varied diagnoses

· Resolved problems quickly

· Performed wound care

Permian Basin MHMR

LVN Case Manager

1998-2001

· Coordinated continuity of care to ensure that patients received proper treatment

· Provided management of mentally and physically handicapped clients

· Taught staff how to manage overall health of patients

· Monitored patients’ health and medications

EDUCATION

Diploma of Nursing,

Covenant School of Nursing

Gpa 3.8

2010-2011

Lubbock, Texas

Nursing Prerequisites, Wayland Baptist University

2008-2010

Lubbock, Texas

Vocational Nursing,

Vocational Nursing

1993-1996

Odessa, Texas

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