Data Entry Utilization Review

ALIA GURHAN

614-***-**** ***********@*****.***

Summary: Dedicated and detailed-oriented Registered Nurse with a strong clinical background, great communication skills, and attention to detail. Recently obtained utilization review experience with Remote Learning Services course. I take great delight in having a broad knowledge base, advanced critical thinking skills, and the capacity to use rules of evidence when making decisions. My clinical background in home health nursing has given me the foundation needed in Utilization Review by using my knowledge through experiences in acute and chronic care settings.

Skills

●Knowledge of Preauthorization

●Patient Care Management

●Knowledge of Claims/Billing Management

●Treatment Planning

●Managed Care

●Care Coordination

Employment History:

●Positive Patient Relationship

●Critical Thinking

●Conflict Resolution

●Time Management

●Utilization Review-101 Course

LPN/RN, March 2020 - Current

Diversified Health Management, Ohio

●Leverages effective communication skills in initiating therapeutic relationships with patients

●Evaluates patients' reports while offering home-based care services

●Conducts comprehensive assessments and compares the previous and the latest findings

●Documents all findings in the system and send reports to the case managers

LPN/RN, August 2019-October 2021

Registered Nursing Care, Ohio

●Assisted patients with their routine functions

●Administered medications and treatment plans following physicians' orders

●Assisted with routine tasks to enhance the quality of life for various patients

●Monitored patient reactions to medications

●Educated clients and families to implement and practice wellness activities, self-care techniques, and prevention strategies

LPN, Feb 2013 – Aug 2019

Columbus Home Health, Ohio

●Supported patients emotionally through effective communication to address their issues

●Provided excellent customer service and complied with HIPAA confidentiality

●Educated clients, patients, and caregivers on medical diagnoses, treatment options, chronic

disease self-management, and wound management

LPN, May 2013 – June 2015

Buckeye Home Health, Ohio

●Conducted training sessions for educating patients and staff members about preventative health measures

●Assessed, planned, implemented, or evaluated patient care plans

●Educated and Instructed clients and family members about disease processes and management

●Collaborated with individuals, groups, or families to plan or implement programs designed to improve the overall health of clients

●Monitored all aspects of patient care, including diet and physical activity

●Modify patient treatment plans as indicated by patients' responses and conditions

●Recorded patients' medical history

Clinical Experience:

Preceptorship, April 2017 – June 2017

Morrow County Hospital-Medical Surgical Unit/Intensive Care Unit

Mt, Gilead, Ohio

●Offered Remote Client Management Services via telephone, email, and online chat service

●Administered medications and nebulizer treatments. Monitor assigned patients, updating information on vital signs, and treatment progress

●Documented data related to patient's care, including assessment results, interventions, medications, patient responses, or treatment changes

Professional Education:

Utilization Review-101, Certificate of Completion 7/202022

Remote Learning Services, LLC, taught by Marie Peppers LPN and Judy Clarke, RN

American Institute of Alternative medicine

April 2016 – June 2017

Columbus, Ohio

Associate Degree in Registered Nursing

Fortis College of Nursing

November 2010 – January 2012

Columbus, Ohio

Diploma of Practical Nursing

License:

Registered Nurse License, Ohio Current-COMPACT RN.494188

Software Knowledge

Axxess Software

Pointclickcare Software

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