Remote Utilization Review Nurse Clinician

Karen Harvey, RN

Registered Nurse Utilization Review Utilization Management

Clinical Review

Contact: Moncks Corner, SC 843-***-**** ***************@*****.*** Professional Summary

Dedicated Registered Nurse with extensive experience in correctional nursing, rehabilitation, long-term care, leadership, and primary care. Skilled in patient assessment, clinical documentation review, care coordination, interdisciplinary collaboration, and evidence-based clinical decision-making. Seeking a Remote Utilization Review/Care Review Clinician position where strong clinical judgment and patient advocacy support medical necessity determinations and quality outcomes. Foundational knowledge of InterQual and MCG Guidelines. Core Qualifications

Utilization Review • Medical Necessity Review • Clinical Documentation Review • Care Coordination • Patient Advocacy • Clinical Judgment • Evidence-Based Practice • Quality Improvement • Regulatory Compliance • Case Management • CDI • Resource Utilization • EMR/EHR • Epic • HIPAA • Microsoft Office • InterQual (Foundational) • MCG (Foundational) Professional Experience

Registered Nurse / Charge Nurse – Genesys Health (Nov 2025–Present) Reviewed physician orders, nursing documentation, laboratory results, and clinical findings; collaborated with providers; coordinated care; maintained regulatory-compliant documentation; prioritized care for complex patients and mentored staff. Assistant Director of Nursing – Wellmore of Daniel Island Supervised nursing operations, audited documentation, monitored compliance, and supported quality improvement initiatives.

Registered Nurse – Wellmore of Daniel Island

Performed assessments, reviewed physician orders, coordinated care plans, and educated patients and families.

Registered Nurse – MUSC Rehabilitation Hospital – Encompass Health Managed medically complex rehabilitation patients, coordinated discharge planning, and maintained comprehensive documentation.

Registered Medical Assistant – Primary Care

Supported referrals, prior authorizations, EMR documentation, patient education, EKGs, phlebotomy, injections, and care coordination.

Education

Associate Degree in Nursing (ADN), ECPI University Associate Degree in Medical Assisting, ECPI University Licensure & Certifications

Registered Nurse (RN) • Registered Medical Assistant (RMA) • BLS/CPR