Heather Ermolov
Louisville
Summary
Results-driven Utilization Review Nurse with proven strengths in multi-disciplinary collaboration and clinical documentation. Recognized for optimizing processes that enhance patient outcomes and mentoring new staff to ensure compliance with CMS standards. Achievements include recognition as a STAR award recipient and contributions to performance improvement initiatives that elevate quality care.
Overview
14
14
years of professional experience
Work History
Utilization Review Nurse 2
Humana
Louisville
03.2019 - Current
- Conducts comprehensive reviews of patient treatment plans for medical necessity.
- Documents review outcomes in compliance with regulatory CMS standards.
- Communicates with home health providers to ensure best patient outcomes.
- Achieved consistent productivity while delivering high-quality clinical reviews.
- Precepts new hires on executing job responsibilities and optimizing utilization review processes and best practices.
- Wrote IRR tests for evaluation in 2021 and 2022.
- Honored with Star award for exceptional contributions in 2019 and 2021.
RN Field Clinician
UT Home Health Care
Maryville
03.2018 - 03.2019
- Developed, implemented, and evaluated plans of care in conjunction with patient and physician goals.
- Provided excellent multi-disciplinary communication as well as education to patients and families.
- Assessed patient needs using OASIS standards in clinical settings.
Clinical Nurse Educator
Blount Memorial Hospital
Maryville
06.2013 - 01.2018
- Facilitated orientation for new staff, identifying critical focus areas to enhance onboarding and development.
- Developed evaluation tools and competence-based programs that improved measurement and oversight of staff development and performance.
- Created performance improvement initiatives designed to enhance quality of care outcomes.
- Ensured completion of competencies and all required education for staff.
- Mentored and guided new nursing staff, fostering their professional growth and integration into the team.
- Recognized as employee of the month for September 2014 due to exceptional performance.
Wound Team Nurse
Blount Memorial Hospital
Maryville
12.2012 - 06.2013
- Assessed acute and chronic wound patients on admission and weekly.
- Collaborated with physicians to design effective treatment plans and monitoring protocols.
- Educated staff on advanced wound treatment techniques, improving overall team competency and patient care quality.
Education
Management And Leadership Series MicroCert -
Louisiana State Unniversity
Baton Rouge, LA01-2026
Bachelor of Science - Nursing
Tennessee Wesleyan College
Athens, Tennessee05-2007
Skills
- Utilization management
- Clinical documentation
- Regulatory compliance
- Critical thinking
- Interdisciplinary collaboration
- Organization
- Innovative problem solving
- Adaptability
- Interpersonal and written communication
Timeline
Utilization Review Nurse 2
Humana
03.2019 - Current
RN Field Clinician
UT Home Health Care
03.2018 - 03.2019
Clinical Nurse Educator
Blount Memorial Hospital
06.2013 - 01.2018
Wound Team Nurse
Blount Memorial Hospital
12.2012 - 06.2013
Management And Leadership Series MicroCert -
Louisiana State Unniversity
Bachelor of Science - Nursing
Tennessee Wesleyan College