Prior Authorization Vocational Nurse
Resume:
PETER T. PHAM
Houston, Tx *****
Cell Phone – 225-***-****
********@*****.***
OBJECTIVE Seeking a Prior Authorization (WFM) position
EXPERIENCES Clinical Appeal Specialist Nurse – December 2016 – December 2021
Parallon Corp, Houston, Texas
●Review medical clinical for appeal requests using Clinical Policies and Interqual
●Document clear and accurate information supporting the decision
Prior Authorization Nurse – December 2014 – December 2016
Universal American, Houston, Texas
●Review medical clinical for prior authorization requests using Clinical Policies and Interqual 2016
●Document clear and accurate information supporting the decision
●Communicate with providers and members on the status of requests
Prior Authorization Nurse – January 2012 – October 2014
Louisiana Healthcare Connection, Baton Rouge, Louisiana
●Review medical clinical for prior authorization requests using Clinical Policies and Interqual 2014
●Document clear and accurate information supporting the decision
●Communicate with providers and members on the status of every request
●Investigate retro authorization requests
Licensed Vocational Nurse – February 2011 – December 2011
Port Allen Care Center LLC, Port Allen, Louisiana
●Documented and maintained patient medical history and treatment data
●Provided bedside care and assistance with medications as needed
●Implemented treatment plans at direction of physicians
Licensed Vocational Nurse – August 2010 – January 2011
Maxim Healthcare, Baton Rouge, Louisiana
●PRN for various nursing homes within the region
●Documented and maintained patient medical history and treatment data
●Provided bedside care and assistance with medications as needed
EDUCATION Licensed Vocational Nurse – June 2009
Gurnick Academy of Medical Arts
San Mateo, California
Bachelor of Science – May 2002
Department of Computer Engineering
San José State University, San José, CA
Texas LVN license #323575
SKILLS Computer Programs – Interqual 2021, Windows 11, Word, Excel, Outlook
Fluent in Vietnamese
REFERENCES Available upon request
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