Amy Neshat
Johnson City
Summary
Results-driven RN with expertise in critical thinking, utilization management, and compliance monitoring. Proven ability to conduct thorough assessments and collaborate effectively with multidisciplinary teams to ensure optimal patient outcomes.
Overview
10
10
years of professional experience
Work History
RN
UnitedHealth Group
Minnetonka
02.2021 - Current
- Conducted comprehensive concurrent and retrospective medical necessity reviews using InterQual and MCG criteria, ensuring compliance with regulatory standards.
- Collaborated with physicians, social workers, and interdisciplinary teams to streamline discharge planning processes, enhancing patient transition to home care.
- Proficient in working in various EMR systems to maintain accurate and detailed patient records.
- Collaborated with providers to assign ICD-10-CM diagnosis and CPT procedure codes accurately, achieving a 97% target audit accuracy rate.
RN Core Staff
Ballad Health
Johnson City
07.2024 - Current
- Utilized critical thinking skills to assess clinical situations quickly and accurately.
- Conducted assessments to identify patient needs and risks.
- Implemented infection control practices to ensure patient safety standards.
- Administered medications and treatments according to established protocols.
- Educated patients and families on health management and discharge instructions.
- Assisted in training new nursing staff on procedures and protocols.
- Maintained accurate medical records using electronic health systems.
Utilization Management Nurse
Ballad Health
01.2017 - 02.2021
- Conducted comprehensive reviews of patient care plans for medical necessity.
- Collaborated with multidisciplinary teams to ensure optimal patient outcomes.
- Utilized electronic health records for tracking and documenting utilization management activities.
Education
Bachelor of Science - Nursing
East Tennessee State University
Johnson City, TN12-2005
Skills
- Utilization management
- Electronic health records
- Compliance monitoring
- Discharge planning
- Clinical education
- Critical thinking
- Team collaboration
- Patient advocacy
Timeline
RN Core Staff
Ballad Health
07.2024 - Current
RN
UnitedHealth Group
02.2021 - Current
Utilization Management Nurse
Ballad Health
01.2017 - 02.2021
Bachelor of Science - Nursing
East Tennessee State University