1155 Bruce Street
Maryland Heights, MO 63043
Job Objective A Call Center Nurse job that allows for the growth of the position within the hospital to develop it as well.
Call Center Nurse, August 2005 – Present
PeaceHealth, Maryland Heights, MO
- Provided telephonic advice to members.
- Ensured adherence to all company policies concerning the preauthorization process.
- Educated members and providers on the authorization process.
- Communicated to assigned supervisor all cases needing a higher level of intervention.
- Documented all pre-certifications and authorization requests.
- Supervised non-clinical team members.
- Participated in Quality Improvement processes.
Call Center Nurse, May 2000 – July 2005
Los Alamos Medical Center, Maryland Heights, MO
- Documented all calls to meet requirements of management and regulatory compliance.
- Coordinated interdepartmental communication for integration purposes.
- Assisted members in problem resolution.
- Conducted initial assessments within designated timeframes on patients identified as having complex case management needs.
- Prioritized care needs, set goals and developed initial plan of care.
- Ensured compliance to local, state, and federal laws and regulations.
- Participated in Ethics and Integrity education programs.
Summary of Qualifications:
- Outstanding experience in direct patient care within ambulatory setting
- Deep Knowledgeable in Medicare, JCAHO, and Dept. of Health regulations pertaining to ambulatory care
- Wide knowledge of the different disciplines and disease states
- Ability to provide services in an environment that involves multiple health care systems
- Ability to interact with all relevant components of the health care system
- Ability to provide services that deal with the individual’s broad spectrum of needs
- Excellent verbal and written communications skills
- Strong decision making and telephone skills
Bachelor of Science in Nursing, Midwestern State University, Wichita Falls, TX