Marianna Raleigh
Verona
Summary
Dynamic Utilization Review Nurse with extensive experience at Humana, skilled in clinical documentation and medication administration. Proven ability to evaluate medical necessity and develop individualized care plans, ensuring optimal patient outcomes. An enthusiastic caregiver dedicated to enhancing patient care through comprehensive assessments and effective communication.
Overview
21
21
years of professional experience
Work History
Utilization Review Nurse
Humana
10.2020 - Current
- Performed admission reviews based for medical necessity.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Med/Surg Registered Nurse
Baptist Health System
La Grange
01.2020 - 02.2020
- Assessed patients using comprehensive evaluation techniques and sound clinical judgment.
- Recorded any action or behavior of clinical significance in EPIC chart and kept physicians informed.
- Developed and implemented individualized care plans to meet each patients' unique needs.
Registered Nurse
Northern Kentucky Youth Development Center
Crittenden
11.2015 - 08.2016
- Administered medications, tracked dosages and documented patient conditions.
- Collected lab specimens, ordering and interpreting diagnostic tests and lab results.
Med/Surg Registered Nurse
St Elizabeth Florence
Florence
02.2013 - 04.2015
- Assessed patients using comprehensive evaluation techniques and sound clinical judgment.
- Delivered physician-ordered treatments and monitored responses to quickly spot complications and side effects.
- Cared expertly for individuals with wide array of medical issues.
- Administered oral, IV and intra-muscular medications and monitored patient reactions.
Clerical Coordinator
St. Elizabeth Florence
Florence
07.2004 - 02.2013
Education
Bachelor of Science - Nursing
Western Governors University
Salt Lake City, UT06.2021
Associate of Applied Science - Nursing
Beckfield College
Florence, KySkills
- Computerized charting specialist
- Utilization review
- Clinical documentation
- Medication and IV administration
- Patient monitoring
- Enthusiastic caregiver
Education
other
Timeline
Utilization Review Nurse
Humana
10.2020 - Current
Med/Surg Registered Nurse
Baptist Health System
01.2020 - 02.2020
Registered Nurse
Northern Kentucky Youth Development Center
11.2015 - 08.2016
Med/Surg Registered Nurse
St Elizabeth Florence
02.2013 - 04.2015
Clerical Coordinator
St. Elizabeth Florence
07.2004 - 02.2013
Bachelor of Science - Nursing
Western Governors University
Associate of Applied Science - Nursing
Beckfield College
Similar Profiles
James NapierJames Napier
Professional 1, Production at HumanaProfessional 1, Production at Humana
Patricia Y. FrazierPatricia Y. Frazier
Enrollment Specialist at HumanaEnrollment Specialist at Humana
Tim HowardTim Howard
Medicare Agent at HumanaMedicare Agent at Humana
Sonya SimsSonya Sims
Medicare Sales Agent at HumanaMedicare Sales Agent at Humana
Courtney DarrowCourtney Darrow
Kitchen Staff Member at Kwik TripKitchen Staff Member at Kwik Trip