Quality Registered Nurse
Send a job offer directly to this candidate
Experienced Quality Management Nurse Consultant with expertise in clinical auditing, utilization management, and EMR navigation. Skilled in regulatory compliance, abstraction best practices, and workflow optimization, with a proven record of leading audits, policy development, and team mentorship at CVS Aetna Healthcare. Dedicated to advancing quality benchmarks, enhancing patient care, and driving continuous improvement across healthcare operations.
I bring extensive expertise in quality management, clinical auditing, and utilization review, with a proven record of driving strategic improvements and elevating clinical standards. My background includes leading claim review operations, directing offshore vendor audits, and developing evidence-based policies that enhance patient care and regulatory compliance. I have managed multidisciplinary teams, mentored staff, and facilitated cross-functional collaboration to implement actionable quality enhancements.
Skilled in clinical chart review, discharge planning, and care coordination, I ensure accurate reimbursement, reduce unnecessary hospitalizations, and improve patient outcomes. My experience spans acute care delivery across telemetry, cardiology, medical/surgical, and gynecology/urology units, supported by strong data analysis and documentation practices that inform clinical decisions and optimize resource allocation.
