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yyyyyy x. yyyyyy 0000 xxxxxx xxxx , xxxx , xxxxx 00000
xxx-xxx-xxxx
objective
dynamic utilization review nurse eager to contribute medical expertise as well as
solid auditing and administrative skills toward supporting employer operations.
career profile
ø long-term experience, including five years in supervisory roles, in assignments including utilization review nurse, long-term care nurse, psychiatric nurse, hospital nurse and physician s nurse.
ø have served in allergy, occupational health, ob/gyn, orthopedics, medical-surgical, neurology, assisted living and adult/adolescent psychiatric assignments.
ø possess licensed practical nurse certification.
ø strong patient advocate, utilizing exemplary communication skills and team leadership; supervised 10-15 personnel; self-motivated multi-tasker possessing flexibility and the desire to successfully complete each task assignment.
ø skilled in use of epic, interqual, mckesson, ms word and excel and mm&r computer applications.
professional experience
freedom health 2010
concurrent review nurse
oversaw medical records online.
scheduled home health, iv, infusion and necessary durable medical equipment (dme).
carilion memorial hospital 2009 - 2010
utilization review nurse
utilized epic computer software to review medical records and interacted closely with insurance companies regarding authorization for inpatient treatment.
richfield retirement center 2009 - 2010
part-time licensed practical nurse
concurrently, served as supervisor, with responsibilities for managing eight employees, including certified nursing assistants and medical technologists.
provided wide-ranging patient services at this assisted living facility.
hca shared services 2007 - 2009
clinical appeals specialist
appealed claims using interqual and mm&r applications for corporation.
memorial hospital 2007
nurse case manager
planned patient discharges and performed utilization reviews.
tcp group/insurance overload 2006 - 2007
consultant & auditor / aon risk management
audited workers compensation claims.
yyyyyy x. yyyyyy
page two
southern health/coventry healthcare 2005 - 2006
pre-authorization nurse
approved mri scans and outpatient services.
claims management, inc. 2004 - 2005
workers compensation claims adjuster
provided adjusting services throughout several states.
bay medical center 2003 - 2004
utilization review nurse
cms integrated healthcare 2001 - 2003
utilization review nurse
corvel corporation 1999 - 2001
case management nurse
served on-site, overseeing workers compensation.
prior experience
earlier, at an assisted living facility, held multiple supervisory responsibilities as the resident care director. additionally, have been a supervisor at sun city center and palm gardens long-term care facilities on a part-time basis, and have worked at mariner health, libby center and home association, as well as for nursing agencies such as maxim health care and national nurses. was a correctional nurse for beaumont learning center and at variety of adult facilities.
education
hillsborough community college, tampa, fl
pre-requisites rn program, general education, 2005
j. sergeant reynolds community college, richmond, va
general education classes, 1996
fairfax school of practical nursing, richmond, va
licensed practical nurse program, 1984
licensed in florida and virginia
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