Kim Koontz

Compassionate and detail-oriented Registered Nurse with the past 10 years being employed as a Utilization Management Review nurse remotely. Have extensive experience in reviewing and analyzing patient data to determine the necessity and appropriateness of care services. Committed to improving patient care quality while reducing unnecessary costs, with a strong focus on compliance and regulatory standards in healthcare.

RN utilization management review nurse-remote; snf/IRF/ltach precerts - ELEVANCE HEALTH - Indianapolis, IN

(2014-11 - 2025-05)

• Actively participate in team meetings and case conferences to identify issues, research problems and develop/implement solutions; work effectively with other internal departments for problem identification and resolution
• Adheres to accreditation, contractual and regulatory time-frames in performing all utilization management review processes
• Adheres to quality assurance standards and all utilization management policies and procedures
• Advises supervisor of any concerns or complaints expressed by providers or members
• Demonstrates sensitivity to culturally diverse situations, members, and clients
• Participate in personal and peer based professional growth and development opportunities to ensure clinical knowledge stays current
• Responsible for providing support to teammates as directed by Management
• Reviews and processes authorization review requests for determinations within regulatory turnaround time

Associate degree - Nursing - KENT STATE UNIVERSITY -EAST LIVERPOOL, OH (1990 - 1992)