Debra Torres

Registered Nurse with extensive experience in psychiatric nursing, addiction, and utilization review. Proven ability to lead multidisciplinary teams while delivering compassionate care that enhances patient outcomes. Strong administrative skills combined with deep knowledge of healthcare systems and insurance protocols.

Utilization Review CITC, RCT - Veterans Administration

(2021-06)

• Determined eligibility based on MCG and Medicare guidelines while considering individual veteran circumstances.
• Assessed medical necessity for community care authorization when in-house services were unavailable, adhering to Mission Act directives.
• Reviewed diverse medical needs to ensure comprehensive evaluations for each veteran.
• Processed doctors' orders with accurate coding to expedite veterans' access to necessary care.
• Managed and coordinated care from consult referral through discharge, maintaining thorough records.
• Supported healthcare initiatives at Cheyenne Healthcare System to improve service delivery.

Registered Nurse - Veterans Administration

(2019-09 - 2021-06)

• Registered Nurse working 1:1 with Veterans inpatient for substance abuse.
• Delivered comprehensive healthcare services at Cheyenne Healthcare System to improve patient outcomes.
• Utilized mental health skills, including knowledge and empathy, to support Veterans in their recovery journey.
• Offered tailored solutions to Veterans' diverse needs and intervened effectively during episodes of panic and anxiety.

Registered Nurse - University of Colorado Health

(2016-08 - 2019-06)

Registered nurse at dual diagnosis 40-bed facility.

• Performed assessments, charting, triage of walk-ins, dispensing medications, treatment plans, wound care, blood draws, and lab results; detoxed large numbers of patients using CIWA and COWS protocols, assessed delirium tremors, and responded to seizures.
• Prevented, intervened, and treated many suicide attempts.
• Contributed to interdisciplinary team of psychiatrists, RNs, care coordinators, LPNs, and health specialists to enhance patient care.
• Supervised junior staff, guiding and supporting daily tasks to ensure high-quality patient care.
• Hired to work the nursing intensive unit.
• Performed EKGs and educated staff on their use.

Utilization Review - Harmony Foundation - Estes Park, CO

(2013-02 - 2016-08)

• Reviewed patient cases for insurance approval of treatment days, ensuring compliance with coverage criteria.
• UR included full chart reviews to pull criteria necessary to justify the level of care needed.
• Facilitated appeals between doctors for patients denied coverage, advocating for necessary treatment.
• Successfully managed all doctor-to-doctor reviews, streamlining the appeals process.
• Met with patient clients regularly to address their needs.
• Understood various insurance policies and authorization requirements.
• Applied MCG guidelines for patient care evaluations.

Associate of Science - Nursing - Antelope Valley College (1998-05)

Certified Doula - Labor and Delivery - Doulas of America (1985-10)

Certificate - Early Intervention Blind Education - Hadley School For The Blind