Bonnie Garofalo

Results-driven Utilization Review Nurse with 30+ years of healthcare expertise specializing in clinical assessment, InterQual criteria, and resource optimization. Proven record of reducing costs, ensuring regulatory compliance, and driving care quality improvements across health plans and hospital settings.

Utilization Review Nurse - Ultimate Health Plans - Spring Hill, FL

(2021-08)

• Reviewed patient care plans against clinical guidelines, ensuring compliance and reducing unnecessary procedures
• Streamlined authorization workflows by collaborating with providers, cutting approval turnaround time significantly
• Maintained accurate utilization review documentation, ensuring adherence to regulatory and accreditation standards

Utilization Review Manager - Access Healthcare LLC - Spring Hill, FL

(2014-03 - 2020-12)

• Led utilization review operations across clinical teams, driving workflow efficiency and productivity improvements
• Implemented evidence-based practices that enhanced decision-making accuracy and reduced hospital costs
• Mentored staff on documentation best practices and compliance standards, elevating team performance

Assistant Director Case Management - Brooksville Regional Hospital - Brooksville, FL

(2000-08 - 2014-02)

• Directed case management operations at a regional hospital, overseeing cross-departmental coordination and compliance for 13+ years

Associate of Science - Nursing - Middlesex College (1977)

No Degree - Nursing Administration - Emanuel College

No Degree - Diabetes Management - Joselin Clinic