Utilization Management Nurse Resume
Utilization management nurses are hired to assess and evaluate the quality of care provided to patients and develop strategic medical care plans. The chore responsibility of this job is to ensure patients medical and nursing needs are duly met. For this, the nurses have to work as a team with the medical staff and contribute towards patients' well-being and overall reputation of the facility. The jobholders need to have a bachelor's degree or associate degree in nursing. Since the job also involve managing and directing resources through proper channel, interested candidates are required to hold managerial skills as well.
Utilization Management Nurse Resume Example
Lisa R. Fortenberry
145 Bartlett Avenue
Southfield, MI 48235
Phone: 248-598-9539
Email: lrfortenberry@anymail.com
Career Objective:
A science graduate in care and nursing management with thorough knowledge and experience of monitoring and assessing patient treatment seeks a challenging role as an utilization management nurse in a reputed hospital.
Summary of Skills:
- Experience of utilization management, planned discharge and concurrent reviews
- Thorough knowledge of hospital administration and management, Milliman Care and Medicare guidelines
- Familiarity with the diagnosis, medical treatment procedures, and insurance claims procedures
- Ability to take sound decision and exercise wise judgment
- Well-versed with MS office and all the systems of healthcare, like Med Decision, Clinical Care Advance and EPOCH
Work Experience:
Utilization Management Nurse
Pinnacle Health Services, Southfield, MI
October 2014 - Present
- Reviewing and documenting patients' information and the type of medical treatment provided
- Assessing and ensuring the facility is following medical rules and regulations and providing optimum care to patients
- Working closely with the medical staff towards improving health and aiding recovery of patients
- Examining medical reports and identifying gaps in the provided treatment
- Referring special cases to the medical director and ensuring proper action against negligence in duty
- Planning and recording each medical interventions done and to be done
Utilization Management Nurse
City Center Hospital, Southfield, MI
February 2013 - September 2014
- Properly organized, gathered, and entered medical information of patients into the computer system
- Evaluated and improvised outpatient and inpatient nursing services by taking feedbacks from patients and family members
- Supported and helped all inpatients in acquiring their insurance benefits and finance
- Gave excellent healthcare benefits to every patient through utilization management services
- Monitored, supervised, and performed medical interventions and inpatient service management
- Implemented effective and positive utilization nursing functions
Education:
- Bachelor's Degree in Nursing
ABC Hospital, Southfield, MI
2012
Reference:
On request.
