Utilization Review Full Time
Resume:
Kristen Pinkerton RN
****************@*********.***
****-**** ** ******** **********, Full Time
Kabafusion
Cerritos, California
Case management responsibilities for in home IVIG, chemo., IVAB, Biologicals, SCIG, hydration, via central, Ports, PIV and PICC access. Curlin pump. Multiple delivery systems.
2012-2016 RN Case Management. Per Diem
Los Angeles Care Provider
Los Angeles, California
Case Management responsibilities for home care.
2008-2014 RN Infusion Specialist. Per Diem/Full Time
(Crescent) Walgreens Infusion Services
(Santa Fe Springs, California) Ventura, California
Responsibilities as above including multiple pumps and TPN therapy.
2006-2009 RN Case Management, Full time
Help Unlimited
Ventura, California
Case management responsibilities as above.
2001-2006 Utilization review RN, Anthem Blue Cross
Approx. Newbury Park, California
Skilled RN review of in hospital stay and homecare authorization and evaluation for insurance benefits.
Case Managers perform a function of UM and CM activities demonstrating clinical judgement and independent analysis, collaborating with members, including clinical nurses and treating MDs.
Determines develops and implements the plan of care based on accurate assessment of the member and current or proposed treatment plan in cases of: member inquiry, triage, chronic conditions, multi-pharmacy, prenatal care, and voluntary member health assessment, and indication of multiple monthly emergency room visits.
Apply detailed knowledge of established medical departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.
Kristen Pinkerton RN
****************@*********.***
0498-1098 Supervisor Clinical: Area from Santa Barbra to Long Beach
Professional Home Health Services
Thousand Oaks, California
Home Care Responsibilities and Duties as below
1992-1998 Supervisor of Specialties: Infusion Therapy, Oncology, AIDS, and Concept
Livingston Memorial Visiting Nurses Association
Ventura, California
Achievements: + Built a 3 RN Specialty Team to a 35 RN Team with 2 assistants
including a second office site
+ Generate MD specific protocols used as standard for their patients
+ Arrange for great speakers to be involved in case conference including
MD’s, pharmacists, new products and specific topic speakers
Specialties needs
Conducts full interviews and hiring and perform full discipline and
termination procedures
Responsibilities: + Create and participate in QA/Utilization Review aspects to specialty
Issue
+ Create new programs to update of specialty care
+ Seek out financial opportunities thus coordination of contracts and
subcontracts
+ Negotiate rates with insurance companies for patient care, including
Medi-Cal and Medicare
+ Participate in clinical decisions and responsibilities in pharmaceutical
Partnerships
+ Acts as a liaison for the organization with referral sources, infusion
Companies and provide with specialty information and instruction
+ Develop specialty policies and procedures
+ Determine staffing needs, reconciles patient schedules and to ensure
Coverage for on call staff
+ Conduct field supervisory visits for evaluation on performance and
Adherence to organizations policies and procedure
BRN CA expires 02/2023
BLS expires 06/2024
Covid vaccination 2 plus booster
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