Review Nurse Case Manager
Resume:
Dany Harfush
*** * **** ****** **, NY *****
********@*****.***
Summary:
Dedicated acupuncturist with a strong clinical knowledge. Compassionate practitioner who integrates nutrition and lifestyle coaching into the practice. Passion for integrating the holistic perspective of Acupuncture with the scientific knowledge of conventional medicine. Current license NYS 005566-01
Seasoned Utilization review nurse with 13 years experience as an onsite concurrent reviewer. Achieved exceptional results in minimizing costs for the managed care company by safely transitioning the patient into a lower level of care. Current RN License NYS.415553
Education
Master of Science in Acupuncture Pacific College of Oriental Medicine December 2014 Bachelor of Science in Nursing American University in Beirut 1978. Skills:
Active listening
Patient oriented
Team player
Critical Thinking
Ability to multitask
Excellent communication skills
Languages: English /French/Arabic
Microsoft Office
Professional Experience
March 2011-Jan 2019
Worked independently overseas. Meditrilania Acupuncture Strategically inserted thin needles into specific points on the channels in order to unblock the stuck life energy that cause disease and stimulate healing, balance the body and mind and promote relaxation.
• Educated patients on lifestyle and dietary changes to enhance benefits of acupuncture treatment used knowledge of acupuncture channels and points to treat various ailments
• Assisted patients with management of diverse issues such as infertility
/back pain/ headache/ water retention/shoulder pain/piriformis syndrome/Sciatica/Weightgain/Menopause/PMS/Nausea/vomiting/GERD/ hot flashes
• Diagnosed patients’ conditions and implemented treatments based on TCM theory.
• Helped to balance and patient’s mind body and spirit
• Evaluated treatment outcome to restore and maintain healing
• Followed standard quality, safety, environmental and infection control policy and procedures.
RN Utilization Concurrent review nurse Empire Blue Cross Blue Shield October 1993 to May 2010
• Analyzed the condition of each patient carefully and followed InterQual and Milliman criteria according to company policy to decide if the patient still needs to stay in the hospital
• Compared service levels with patient records to verify that all medical standards are being followed.
• Reviewed charts and updated records in a timely fashion.
• Collaborated with clinical staff involved in the patient care like case managers, social workers, physicians to assist members to transition to another setting like rehab, home care, hospice when needed.
• Referred cases to medical director as needed
• Advocated for patients by identifying coverage and communicating care preferences to the healthcare team and verifying treatment goals
• Documented completely and accurately within an electronic record
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