Utilization Management Nurse Consultant

Marci Szabo BSN, RN

**** ******* **, ******, ** *4041

440-***-**** ***********@*****.***

Education

• Ohio University

• Bachelor Degree of Applied Science in Nursing

• August 2012-August 2014

• Kent State University

• Associate Degree of Applied Science in Nursing

• August 2005-May 2008

Experience

CVS HEALTH AUGUST 2019-PRESENT

• Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management process

• Gather clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgement to render determination/recommendation along the continuum of care

• Identifies members for referral opportunities to integrate with other products, services and programs Identifies opportunities to promote effectiveness of healthcare services and benefit utilization

• Consults lends expertise to the other internal and external constituents

• Completes Pre-Cert and post acute concurrent reviews.

• Reviews acute inpatient criteria using MCG.

LAKE HEALTH SYSTEM JULY 2018-AUGUST 2019

• Utilization Review/Gatekeeping

• Care Coordination assisting with discharge planning

• Reviewed clinical documentations to determine requirements of inpatient or observation status utilizing MCG and Interqual.

• Monitored length of stay while collaborating with physicians and case managers LAKE HEALTH SYSTEM AUSUST 2008-JULY 2018

• Staff nurse for 32-bed Medical Surgical Telemetry unit

• Acted in Charge Nurse role managing unit throughout in collaboration with other units, facilitate teamwork and prioritization of patient care needs, act as resource for nursing and administrative staff

• Provided training to new employees to foster professional growth and development and assure the highest level of patient care. Worked collaboratively with interdisciplinary healthcare team members to plan a safe discharge and to optimize patient care outcomes UNIVERSITY HOSPITAL SYSTEM MARCH 2012-JANUARY 2010

• Transcribed physician dictations

• Worked independently from home in a timely manner to maintain compliance with Ohio regulatory standards

2

Contact this candidate