Summary
Overview
Work History
Education
Skills
Timeline
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Melissa S. Parsons

Oakland

Summary

Registered Nurse currently serving as a Utilization Management Acute Inpatient Supervisor in the Enterprise Medicare Unit at Molina Healthcare. I have been with Molina Healthcare since 2018, fully remote. Prior to joining Molina, I served as a bedside ICU RN in Florida and California. I thrive on problem-solving, multi-tasking, and networking with internal and external partners and customers. I value my ability to identify areas of opportunity and being a catalyst to improve processes, while maintaining a caring and empathetic leadership style.

Overview

16
16
years of professional experience

Work History

Nurse Supervisor, Acute Inpatient, Medicare

Molina Healthcare
01.2022 - Current
  • Currently oversees a team of 18 Nurse Care Review Clinicians and growing, and one Clinical Lead, who perform care reviews/utilization management for acute inpatient admissions
  • Supervises and evaluates staff performance, including training and development, engagement, recognition, succession planning, coaching and counseling
  • Monitors staff for quality, compliance, and productivity
  • Interviews with all candidates for my team
  • Maintains professional and thoughtful relationships with staff, colleagues, and providers
  • Daily census monitoring/management to align with business priorities and compliance
  • Dedicated toward working to provide service excellence for our customers
  • Identifies potential fraud, waste, and abuse
  • Excellent report and collaboration with Medical Directors
  • As needed, participates in Joint Operating Committee meetings and P2P calls with providers
  • Participated in 2024 CMS audit and ongoing mock-audits

Care Review Clinician, Medicare

Molina Healthcare
02.2018 - 04.2022
  • Reviewed inpatient admissions (acute and post-acute) and determination of necessity of admission and inpatient status
  • Collaborated with multiple disciplines, including RN, physician, Transition of Care team and Case Management
  • Proficient with MCG, Interqual, ICD 10 coding
  • Onboarding educator for new hires and team resource
  • Served on the quality improvement committee at the request of management

Registered Nurse, ICU, PRN Float Nurse

American Mobile Healthcare
01.2016 - 03.2018
  • Planning, advocacy, and implementation of patient care with multiple disciplines including patients and families, physicians, pharmacists, interventional services (Cath & EP Labs, Radiology, GI), respiratory, speech, physical and occupational therapy, wound care, nutrition, social work, hospice, palliative care, and organ donation services
  • Required continuing education and care standards according to evidence-based practice; constant critical thinking in a high-stress environment
  • Served as a preceptor providing knowledge of the nursing process to students and new nurses

Registered Nurse, Intensive Care Unit

Lakeland Regional Health
01.2013 - 12.2015
  • Specialized in Cardiac and Stroke Critical Care patients

Buyer

Lakeland Regional Health
01.2009 - 05.2013
  • Built long-term supplier relationships with vendors to establish quality and competitive pricing.
  • Collaborated with internal departments to better understand needs and determine purchasing requirements.
  • Reduced procurement costs through strategic sourcing, competitive bidding, and effective negotiations.
  • Developed strong relationships with suppliers to secure favorable pricing terms and conditions for the company''s benefit.

Education

Associate of Science - Nursing

Polk State College
Winter Haven, FL
05-2013

Bachelor of Science - Journalism And Mass Communication

University of Florida
Gainesville, FL
06-2004

Skills

  • PEGA
  • QNXT
  • UMK2
  • MCG AND INTERQUAL
  • MICROSOFT OFFICE (EXCEL, POWERPOINT, WORD, OUTLOOK, TEAMS, ONENOTE)
  • EMR SOFTWARE INCLUDING CERNER, EPIC
  • LAWSON
  • ADVANCED CARDIAC LIFE SUPPORT CERTIFIED (ACLS)
  • NIHSS CERTIFIED
  • PREVIOUS HOSPITAL IN-HOUSE CODE BLUE RESPONSE TEAM MEMBER

Timeline

Nurse Supervisor, Acute Inpatient, Medicare

Molina Healthcare
01.2022 - Current

Care Review Clinician, Medicare

Molina Healthcare
02.2018 - 04.2022

Registered Nurse, ICU, PRN Float Nurse

American Mobile Healthcare
01.2016 - 03.2018

Registered Nurse, Intensive Care Unit

Lakeland Regional Health
01.2013 - 12.2015

Buyer

Lakeland Regional Health
01.2009 - 05.2013

Associate of Science - Nursing

Polk State College

Bachelor of Science - Journalism And Mass Communication

University of Florida

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Melissa S. Parsons