Accomplished Medical Management Nurse with a proven track record at Anthem, specializing in Utilization Management and Case Management. Expert in clinical assessment and patient advocacy, demonstrated through impactful collaboration with medical directors and providing emotional support to patients. Excelled in training peers and special projects, showcasing exceptional critical thinking and healthcare collaboration skills.
Experience at Anthem in Case Management, Triage and currently Utilization Management
Assist with training new hires
Act as a resource for peers
Use Nursing judgment to analyze clinical information and apply it to clinical guidelines and policies to evaluate medical necessity.
Collaborate with Medical Directors, CDCs as well as Internal and External customers.
Participate in special projects such ICA and Time studies
Care for 2-3 patients in labor; Care for 1 patient in active labor
Prep patient for deliver; both vaginally and c/s
Assist in OR. Recover patient post-op.
Recover mother and newborn post vaginal delivery
Collaborate with MD as needed