Michelle Williams-Hadley BSN, RN

515-***-**** adz7nt@r.postjobfree.com

Summary: Highly skilled and dedicated professional with comprehensive experience delivering quality, evidence-based patient care. Demonstrates exceptional communication and interpersonal skills, distinctively committed to establishing and strengthening working relationships with multi-disciplinary teams and providers. I am a very detailed oriented acute care nurse with a demonstrated clinical background and action-oriented leadership skills. Recently obtained utilization review experience and HEDIS with Remote Learning Services. I pride myself on having a solid knowledge base, high- level critical thinking skills, and ability to apply evidence-based guidelines during the determination process. My clinical background in Surgical Services has given me the foundation that is needed in utilization review by using my knowledge through experiences in acute care environments. I am ready to identify gaps in care and utilize my recent training knowledge of HEDIS specifications and data collection to help improve health care. I am looking forward to becoming part of a remote dynamic team. Skills

● Utilization Review

● OR/Surgical Services

● Hospice-Home Health

● Ambulatory Care

● Admissions/Assessments

● Infection Control

● Appeals/Denials/Preauthorizations

● Discharge Planning/DME

● Medicare/Medicaid Regulations

● Knowledge of Claims/Billing

● HEDIS/Data abstraction

● BPD Blood Pressure/Diabetics

● CBP Controlling High Blood Pressure

● BCS Breast Cancer Screenings

● TRC Transitions of Care

● NCQA Standards

Experience:

● Concurrent Reviews

● Retrospective Reviews

● Management/Nursing Leadership

● Evidence-Based Guidelines

● EMR/EHR-Various Systems

● Quality Time Management

● Care Plan Development

● Advanced Critical Thinking

● Efficiency/Attention to Detail

● Effective Customer Service

● MS office

● COL Colon Cancer Screening

● HBD Hemoglobin A1c/Diabetes

● COA Care of Older Adult

● EED Eye Exam/Diabetes

● Excellent Time Management

RN-Clinical Manager- Ambulatory Surgical Services, March 2023-current Lakeview Surgery Center, Orlando, Florida

● Managing operations daily and 20 plus staff, infection reports, quality improvement and auditing charts for completion.

● Utilized excellent interpersonal skills while working with people from diverse backgrounds

● Analyzes situations and makes informed decisions based on knowledge and critical thinking.

● Maintains excellent customer service standards while providing compassionate care.

● Utilized the nursing process to assess, plan, intervene, and evaluate patient care. RN-Clinical Specialty Coordinator- Surgical Services, August 2021-April 2023 Advent Hospital, Kissimmee, Florida

● Providing exceptional organizational skills to manage the daily operating room schedule.

● Evaluate workflow, establish priorities for time sensitive assignments to ensure quality of work.

● Coordinating with medical device representatives and other vendors to ensure all supplies and implants would be there on time for surgeries.

● Provided nursing care to a diverse patient population with acute and chronic conditions.

● Keep all company systems and data, (including sensitive member data), secure and safe, according to the company's data and security policies and HIPAA guidelines. RN-Staff, Surgical Services, February 2011-August 2021 Hibbeln Surgery Center, Avon, Indiana

● Rendered exceptional patient care including management of surgical supplies.

● Provide excellent customer service and comply with HIPAA confidentiality.

● Educated clients, patients, and caregivers on post-surgical care.

● Clear communication with team members to foster successful collaboration in the workplace. RN-Home Health/Hospice, May 2006-December 2008

Hospice of Central Iowa, West Des Moines, Iowa

● Maintains excellent customer service standards while providing compassionate care.

● Worked collaboratively with an interdisciplinary team to provide patient-centered care.

● Responsible for admissions and discharge planning duties with DME ordering at discharge. Gap in Employment: Jan 2009 to Jan 2011

● Carding for young children; Attending professional development courses Professional Education:

Utilization Review-101, Certificate of Completion - August 2023

● Remote Learning Services, LLC, taught by Marie Peppers LPN and Judy Clarke, RN Grand View University, Bachelor of Science in Nursing 1994 License: Registered Nurse, Florida- Compact, Multistate - current

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