Work:
GEISINGER HEALTH PLAN Jul 2012 to 2000
SENIOR COORDINATOR RN, UTILIZATION MANAGMENT
HEALTHCARE EXCEL Sep 2011 to 2000
REMOTE NURSE CONSULTANT
HEALTHCARE EXCEL - VALLEY, WYOMING, US Jan 2012 to Jul 2012
SURGICAL CLINICAL REVIEWER
HEALTHCARE EXCEL Oct 2011 to Jan 2012
VASQIP RN
HEALTHCARE EXCEL Oct 2008 to Oct 2011
Utilization Review Nurse
GEISINGER SOUTH WILKES BARRE Aug 2006 to Sep 2008
Clinical Access Specialist RN
GEISINGER SOUTH WILKES BARRE Jun 2004 to Aug 2006
Utilization Review Nurse
MERCY HOSPITAL May 2002 to Jun 2004
Emergency Room RN
Education:
Luzerne County Community College - Nanticoke, PA 2002
AS in Applied Science Nursing
Skills:
utilization review milliman care guidelines interqual criteria cms criteria. prospective, concurrent, post service reviews, retrospective medical necessity claim review, provider and member appeals, denial letter QA, staff audits, stop loss and high dollar review, PA medicaid, health plan policies procrdures benefit structure facility contracts education and trainging