Utilization Review Care Nurse

LINDA PINSKY, BSN, RN

917-***-**** / *********@***.***

Qualifications

Diplomate, American Board of Quality Assurance and Utilization Review Physicians.

Twenty years of experience in Quality Assurance and Utilization Review.

BSN, Columbia University School of Nursing.

Licensed RN in New York and Connecticut since 1982.

Experience

St. Luke’s-Roosevelt Hospital, New York, NY

Utilization Review and Quality Assurance Nurse Coordinator / 1986-1996

Implemented policies and procedures to achieve the most effective and efficient utilization of hospital services by screening the medical record for medical necessity and appropriateness.

St. Vincent’s Hospital, New York, NY

Home Care Nurse / 1997-2000

Provided home care with coordination of benefits.

Young Adult Institute, New York, NY

Home Care Nurse / 1997-2000

Provided home care for patients with intellectual disabilities.

Senior Health Partners, New York. NY

Home Care Nurse / 2000-2004

Provided home care with coordination of benefits for patients.

Auto Injury Solutions, NJ (remote work)

Utilization Review and Quality Assurance Nurse / 2010-2020

Conducted utilization review of hospitalized and post-hospitalized MVA patients on behalf of major insurance companies including Geico, USAA and Nationwide. Reviewed virtual charts for appropriateness of care related to MVA and carved out unrelated care charges where appropriate. Interacted with physicians for further review as needed.

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