Debra Link

Skilled communicator with a strong sense of professionalism. Ability to organize work according to priorities. Resourceful problem solver capable of implementing solutions to complex problems. Possess special sensitivity in dealing with patients, clients, and co-workers. Ability to maintain a helpful and positive regard for the patient and family.

Appeals Nurse - Centene Corporation/Spectraforce - Raleigh, NC 27603

(2025-10 - 2026-05)

• Review and interpret clinical information
• Compose clinical summary for Medical Director review
• Process the appeal appropriately

Case manager, Utilization Review - LA County Firefighters Health and Welfare Plan - El Monte, CA 91731

(2018-09 - 2025-04)

• Apply appropriate criteria and make determination for pre-service and retro reviews
• Process appeals
• Collaborate with members, provider offices, hospitals to establish appropriate care
• Interpret clinical information for LA County Firefighters Health Plan Trust
• Compose letters of denial

Utilization Management Professional - Magellan Complete Care - Miami, FL 33152

(2014-08 - 2018-08)

• Interpret clinical information for Florida Medicaid HMO MCC
• Apply information to InterQual criteria and MCG
• Approve when appropriate
• Summarize for Physician Review when appropriate
• Help customers on phone queue

Utilization Review Pre-Auth Coordinator - Coventry Cares Kentucky - Tampa, FL 33634

(2012-08 - 2014-08)

• Interpret clinical information for Kentucky Medicaid patients
• Apply information to InterQual criteria
• Approve appropriate request under Coventry guidelines and InterQual criteria
• Write summery of clinical information for Medical Director Review if criteria and /or Coventry guidelines not met

Clinical Reimbursement Director - Evergreen Woods Health and Rehabilitation Center - Springhill, FL

(2011-08 - 2012-08)

• Case Manage Medicare, Medicaid, and HMO patients clinical assessment schedule according to Medicare/Medicaid guidelines and patient needs.
• Participate in weekly interdisciplinary clinical meetings and determine nursing skill for patients.
• Meet daily with the Director of Rehab and review change of therapy, start of therapy, and end of therapy for all Medicare and HMO patients.
• Adjust the patient's assessment schedule according to Medicare guidelines with the information obtained at these meetings.
• For all new admissions, I complete all appropriate Care Plans, complete a diagnosis list including ICD 9 codes, and complete entry trackers required by Medicare/Medicaid.
• Ensure assessment completion by deadlines determined by Medicare/Medicaid.
• Participate in an interdisciplinary meeting at month end to match billing rates with assessment rates.

Admission Nurse and Surgery Scheduler - Shriners Hospital for Children - Tampa, FL

(2001-06 - 2011-08)

• Coordinate admission to hospital for pre-op patients and International patients
• Screen for surgical contraindications such as head lice, wounds, and illness
• Consult with multidisciplinary team regarding clearances
• Responsible for determining custody of pediatric patients and obtaining proper documentation
• Coordinate a multidisciplinary surgical team including staff surgeon, outside surgeon, anesthesia, radiology, and ortho tech
• Educate families of process and surgical procedure

Staff Nurse Outpatient Department - Shriners Hospital for Children - Tampa, FL

(1998-03 - 2001-06)

• Triage and coordinate patient visits
• Assess demographics, growth and development, orthopedic, psychosocial, and educational needs of patients and their families
• Assist with employee health program including TB skin test, annual health program, flu shots and occupational health needs
• Manage family concerns regarding patient problems including pain management, health services, calling in prescriptions and coordinating follow up
• Expedite the flow through the outpatient clinic by making sure that patient needs are met in a timely and organized manner
• Communicate to other health team members the various patient needs

Charge Nurse Dialysis Clinic - Gambro Healthcare - Zephyrhills, FL

(1997-08 - 1998-03)

• 11 patient hemodialysis unit
• Evaluated water system for safety prior to dialysis
• Measured and prepared medication for technicians and LPN's
• Administered medications for technicians
• Monitored lab results and changed medications accordingly
• Notified physician of changes in patients condition
• Initiated, monitored, and discontinued dialysis on individual patients and patient groups

Staff Nurse Progressive Care Unit - East Pasco Medical Center - Zephyrhills, FL

(1996-09 - 1997-06)

• Admitted and discharged patients
• Prepared patients for cardiac catheterization
• Monitored patients on telemetry
• Interpreted rhythm strips and implemented changes in care accordingly
• Monitored lab results and implemented changes in care accordingly
• Initiated and maintained critical care IV medication

Staff Nurse Surgical floor - East Pasco Medical Center - Zephyrhills, FL

(1995-06 - 1996-09)

• Educated patients on pre-operative/post-operative information
• Initiated pre-operative preparations such as IV's and medications
• Performed post-op care of patients
• Admitted and discharged patients

Associate Degree - Nursing - Pasco-Hernando Community College (1991-08 - 1995-05)