Review Nurse Utilization
Resume:
Rose Wagman, LPN
advopw@r.postjobfree.com
Summary: Compassionate Licensed Practical Nurse with 30 years of experience in multiple specialties. Actively seeking a position as a Chronic Care Manager, Remote Care Coordinator, HEDIS/Data Abstraction or Utilization Review nurse where I can utilize my recent training and assist patients.
Skills
●Chronic Care Management
●Medicare-Medicaid
●Transitional Care
●Rehabilitation/Geriatrics
●Preventative Health
●Admissions/Discharges
●Excellent Time Management
●Critical Thinking
●Utilization Review/Preauthorization
●Appeals/Denials
●Concurrent/Retroactive Reviews
●Remote Patient Monitoring
●Clear Verbal Communication
●HEDIS/Data Abstraction
●Motivational Interviewing
●HIPAA Regulations
●Community Health
●Psychiatric
●Addiction
●Advanced Care Planning
Excellent Customer Service
Professional Experience
LPN/ Psychiatric Staff Nurse
March 2017-Current
Children’s Home of York,RTF -York PA
●Served as a liaison between healthcare providers, families of patients, and patients themselves.
●Conducted ongoing assessments to evaluate needs as ordered.
●Assisted in the education of preventative health options to adolescents with mental health disorders.
●Utilized excellent interpersonal skills while working with people from different backgrounds.
●Participated in multidisciplinary collaboration with various members of the healthcare team to provide quality, evidence-based, and safe care
●Prior Authorization for medications
LPN/Agency Nurse/Home Health Care
June 2014-April 2017
Faithfull Nursing – Lancaster, PA
●Provided patient and family teaching regarding the diagnosis of acute and chronic conditions, treatment plans, medications, resources, and possible outcomes.
●Participated in multidisciplinary collaboration with various members of the healthcare team to provide quality, evidence-based, and safe care.
LPN/Psychiatric Staff Nurse
April 2016-April 2017
Northwestern Health Services – York, PA
●Educated patients, families, and caregivers on diagnosis/prognosis, treatment options, disease process, management, and lifestyle options.
●Maintained confidentiality concerning treatment and personal information.
●Provided education and guidance for clients and their families regarding their healthcare needs.
●Addressed interventions in the treatment plan to close gaps in care.
LPN/ LTC Charge/Staff Nurse
March 2015-April 2016
Clearmont Nursing Home, LTC – Carlisle, PA
●Educated patients on ways to improve their health collaborated with them to make an attainable goal for health improvement.
●Educated patients, families, and caregivers on diagnosis/prognosis, treatment options, disease process, management, and lifestyle options.
LPN/ Correction Shift Lead Nurse
May 2014-August 2015
Prime Care (Cumberland County Prison) – Carlisle, PA
●Educated patients on ways to improve their health collaborated with them to make an attainable goal, or health improvement.
LPN/ Shift Lead Nurse/Nursing Supervisor
June 2008-January 2014
White Deer Run of Lancaster – Lancaster, PA
●Educated patients on ways to improve their health collaborated with them to make an attainable goal for health improvement.
●Assisted in the education of preventative health options to adults with addiction
●Upon admission and every 1-2 weeks went through process of contacting insurance company for prior authorization for admission and concurrent reviews to continue treatment
Education and Training
Medicare Chronic Care Management - Medicare CMS-Approved Software
Remote Learning Services, LLC by Marie Peppers LPN
Medicare Care Management, Remote Patient Monitoring - 2022
HEDIS 101/Data Abstraction, Certificate of Completion– 2022
Utilization Review 101, Certification of Completion - 2023
Licensed Practical Nursing Education
Lancaster School of Nursing, Willow Street, PA - 1993
License
Licensed Practical Nurse, PA – CURRENT- License Number - PN105318L
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