Stephanie W. Fagan, RN

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

Richmond, Texas 77406

281-***-****- home

832-***-**** – cellular

OBJECTIVE: Staff position with progressive facility.

EDUCATION: Associates Degree, Nursing, May 1994

Houston Community College System

Houston, Texas

RN – BSN Program – in Progress

WORK EXPERIENCE:

July 2014 – August 2023 United Healthcare/Optum, Houston, Texas. Case Manager, Managed Transplant Program. Outbound calls assessing member’s current health status, identified gaps and barriers to transplant/care and discharge calls to ensure members received the necessary services and resources. Provided patient education for self-management, pre- and post-transplant. Interacted with Medical Directors on challenging cases/issues, utilized Milliman/InterQual criteria to determine care settings. Clinical documentation/UR reviews daily with multiple transplant centers, physician offices and other care facilities. Targeted gene therapy expertise.

Clinical Investigator, Waste Fraud Abuse and Error. Medical claims review to ensured adherence to state and federal compliance policies, reimbursement policies and contrast compliance. Clinical and/or expertise in the application of medical and reimbursement policies within the claim adjudication process through file review. Performed clinical coding review to ensure accuracy of medical coding and utilized clinical knowledge and judgement to determine correct coding and billing. Identified aberrant billing patterns and trends, evidence of fraud, waste or abuse. Maintained and managed daily case review with emphasis on quality, self-directed.

Health Advisor/ Nurse Advocate, A4Me. Telephonic member triage for medical conditions, acute and chronic, telephonic pre-establishment of case management for medical conditions, acute and chronic, telephonic counselling for members using proven, evidence-based treatments for multiple disease processes, assisting members and case managers to decipher benefits, claims, pharmacy and accessing healthcare systems locally, nationally and abroad. Participated in the training of new staff and served as a clinical resource for other UHC/Optum teams. Company awards for innovation in claims processing.

Three companywide awards for innovation in documentation.

Stephanie Fagan, RN

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November 2010 – August 2011 ProHealth Staffing, Houston, Texas. Relief Pre/Post-Operative Nurse in a pain management facility and circulator in procedure/OR in outpatient surgical centers. Long-term contract with The Houston Methodist Hospital System Physicians Organization-Cardiology, Division of Heart Failure/Heart Transplant, assisting five (5) physicians and supervising medical assistants in daily clinical operations.

Med Relief Staffing, Houston, Texas. Contract staff nurse in ICU, CVICU, MICU, PACU, Ambulatory ER and observation.

August 2011 – January 2014 Methodist DeBakey Cardiology Associates, Houston, Texas. Division of Heart Failure/Transplant. Telephone triage of patients with heart failure/transplant, including lung, liver and kidney transplant with components of heart failure. Assisted in five (5) heart failure clinics per week, provide physicians with assistance in all aspects of their practice, including out-patient workflow, responding to emergencies, admissions, referrals to inside and outside of the organization, direct patient care of walk-ins, misdirected calls, medication questions and education, education of family and caregivers, appointments, testing, resolutions of patient concerns, resource for colleagues and supervision of assistants in all clinics. Assisting other physicians as necessary in Congenital Defect Clinic, Pulmonary Hypertension Clinic and electrophysiology. Developed the questionnaire and assessment tool for the PAH Clinic. Member of MDCA Heart Failure Outreach and Education Committee.

July 2005 – September 2010 Texas Orthopedic Hospital, Houston, Texas. PACU nurse, and Pre- and Intra-operative nurse as needed, Department of Pain Management. Charge Nurse, Department of Spinal Diagnostics. Radiology, Pre-Admissions, Admissions and Discharge Nurse in Patient Care Unit. Infusion, phlebotomy services, ICU, CDU and ER nurse as needed. All diabetic teaching for Department of Pain Management. Worked as a shared employee in four HCA facilities as needed. Nurse Advisory Committee, Peer Review and Education Committee.

March 2002 – January 2010 IPR Healthcare, Houston, Texas. Critical Care Nurse in SICU, MICU, NTICU, CVICU, CCU, Transplant and Ambulatory Care.

April 1998 – March 2000 Arcadia Healthcare, Houston,Texas. Critical Care Nurse in SICU, MICUS, NTICU, CVICU, CCU, Transplant and Ambulatory Care. An 18 month contract with Memorial Hermann Hospital’s Cardiology Clinic and Hematology/Oncology Clinic.

Stephanie Fagan, RN

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August 1995 – April 1998 The University of Texas M. D. Anderson Cancer Center, Houston, Texas. Critical Care Nurse in the Department of Surgery and Anesthesia, post a six month internship. Pharmacy Liaison for all Critical Care Units.

July 1994 – August 1995 Memorial Hermann Hospital, Northwest, Houston, Texas. Staff Nurse and weekend Charge Nurse in a 40 bed Medical-Surgical unit.

CERTIFICATIONS: BLS, ACLS

CCRN – Eligible

Pain Management – Eligible

Certification, Case Management - Eligible

HONORS: HCCS Foundation Scholarship

VIP, Houston Independent School District

Volunteer, St. James School Volunteer, Lions Club of Houston (Royal Oaks)