SUMMARY OF QUALIFICATIONS

Over ** years of professional nursing experience in a variety of nursing settings such as case management, mental health nursing, home health care, and nursing education.

Performed 5 years of member discharge transition services, helping members maintain a healthy lifestyle.

Performed onboarding for a team of 6 RN case managers, ensuring a positive transition for the new employees.

2019 Outstanding Customer Service Award (United Healthcare) for going above and beyond members’ expectations.

EDUCATION

University of North Alabama, College of Nursing, Florence, AL

Master of Science in Nursing, 2015

The University of Alabama at Birmingham, College of Nursing, Birmingham, AL

Bachelor of Science in Nursing, 1997

LICENSES AND CERTIFICATIONS

RN Multi-state License, Alabama Board of Nursing, 2021

AHA Basic Life Support for Health Care

EXPERIENCE

DCH Regional Medical Center, Tuscaloosa, AL, Acute Care Manager, Hospital Care Management RN, 09/12/2022 - Present

The Judge Healthcare, Wayne PA, Utilization Review RN, Anthem Blue Cross of Florida (05/2022 – 09/12/2022)

(06/2021 to 5/ 2022 was recovering from surgery going to therapy)

United Healthcare, Minnetonka, MN, Post-Acute RN Case Manager (04/2018 -06/2021)

Educated members on their State Employee Insurance Bureau (SEIB) benefits, guiding them on their transition from hospital stay to Acute Inpatient Rehab (AIR), Long-term Care Hospital (LTCH), Skilled Nursing Facility (SNF) or Home with Home Health Care (HHC).

Maintained a case load of approximately 30 members, ensuring they are satisfied with membership services

Reached out to members to see if they have any questions following their discharge plan or medication changes and helping schedule their follow up appointments.

The Judge Healthcare, Wayne PA, Post-Acute RN Case Manager—United Healthcare (06/2017-04/2018)

Informed members of their health benefits under the Public Education Employees’ Health Insurance Plan (PEEHIP) and the eligibility requirements for admittance to AIR, LTCH, SNF, and HHC.

Assisted members with the Denial, Appeal, and Peer-to-Peer Process (P2P).

Plantation Manor Assisted Living, McCalla, AL, Registered Nurse, Charge Nurse (06/2016-06/2017)

Admitted, transferred, and discharged 30 geriatric patients from the dementia unit and assisted with their daily activities such as feeding patients, administering medication, and preparing patients for bed.

Wrote care plans, updated medication records, and performed medication reconciliations.

ITT Technical Services, Bessemer, AL, Nursing Adjunct Faculty Member: Lab Coordinator (9/2015-9/2016)

Organized nursing laboratory supplies and helped as nursing skills tutor

Proctored HESI exams and attended weekly faculty workshops

Cigna Health-Care (MindLance), Birmingham, AL, RN Medical Authorization (6/2015-9/2015)

Performed chart reviews and evaluated surgery determinations using preauthorization programs

Communicated with doctors and patients concerning authorizations or denials following HIPPA guidelines

Cottages Assisted Living, Hoover, AL, Registered Nurse (5/2014-1/2015)

Completed comprehensive nursing assessments and conducted direct care for geriatric residents

Managed care and interdisciplinary treatment of patients through collaboration with physicians, therapists, pharmacists, and other members of the health care team

Fortis Institute- Birmingham, AL, Adjunct Faculty Member: Lab Coordinator (01/2013 to 5/2014)

Organized nursing laboratory supplies and helped as nursing skills tutor

Proctored HESI exams and attended weekly faculty workshops

Clinical Instructor for LPN Program.

Intrepid USA, INC. Birmingham, AL Registered Nurse (01/2012 to 01/2013) Staffing agency.

Virginia College at Birmingham, AL Nursing Adjunct Faculty Member: Lab Coordinator Organized nursing laboratory supplies and helped as nursing skills tutor

Proctored HESI exams and attended weekly faculty workshops

Skills: Microsoft Office Suite, Milliman medical authorization program, MDS 2.0 training

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