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Utilization Review Care Manager

Location:
Simi Valley, CA
Posted:
April 26, 2023

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Resume:

Kൺඋൾඇ Lඎඈආൺ

Simi Valley, CA *****

615-***-**** - adwrrj@r.postjobfree.com

Pඋඈൿൾඌඌ ඈඇൺඅ Sඎආආൺඋඒ

A skilled professional with 20 year of experience in coordination of care, med-surg, telemetry, training and development, and medical management. Exceptional leadership abilities, with the ability to train others and build organizational success. Well versed in promoting policies and protocols to achieve care measures. Demonstrates success in cultivating strong patient rapport to drive outcome goals. S අඅඌ

Case Management

Care Coordination

Strong Communication Skills

Utilization Review

Strong Clinical Judgement

Strong knowledge and skills

appropriate to the age/type of patient

population served.

Ability to read EKG/Cardiac Monitors

and Multi Tasking.

Wඈඋ H ඌඍඈඋඒ

01/2017 to 02/2018 Care Manager II

Centene Corporation – Woodland Hills, CA

Performed care management duties to access, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.

Investigated denials of claims for radiology, therapies, medications, ER visit services, Inpatient, Outpatient and lab work.

07/2016 to 12/2016 Staff Nurse

Northridge Hospital Medical Center – Northridge, CA Recognized the care and needs of individualized patients to optimize the recovery to health, and to ensure high-quality care.

Gathered patient health data through interviews and observation, and documenting all data collected in electronic monitoring. 05/2009 to 04/2014 Float Pool Staff Nurse

Los Robles Hospital & Medical Center – Thousand Oaks, CA Coordinates and implements patient care specific to the age of the patient population served on the assigned unit. Ensures that quality care is provided in an efficient and safe manner, consistent with the unit's standard of care. Eൽඎർൺඍ ඈඇ

05/2006 Associate of Applied Science: Nursing

Columbia State Community College - Columbia, TN



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