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Highly skilled Licensed Practical Nurse and HEDIS Review Specialist with over 10 years of experience in clinical quality abstraction, medical record review, and utilization management. Expert in CMS, NCQA, and HEDIS guidelines with proven success supporting risk adjustment and quality reporting programs. Adept at leveraging data accuracy, analytical thinking, and attention to detail to optimize compliance and healthcare outcomes.

Diligent professional with proven knowledge of hands on clinical care in many areas, utilization management, and emergency response. Aiming to leverage my abilities to successfully fill the registered nurse role on your team.

Accomplished Utilization Review Nurse with a proven track record by enhancing patient care through expert clinical assessments, Medicare and Medicaid knowledge. Excelled in records analysis and interpersonal communication, significantly contributing to team support and efficient healthcare service delivery. Skilled in coordinating discharge planning, and ensuring optimum health outcomes.

Results-driven Utilization Review Nurse with strong skills in clinical documentation and medical necessity analysis. Proven ability to develop insightful reports and facilitate effective communication between providers and insurers.

Dedicated, responsible and results-oriented professional with over 20+ years experience in clinical experience and Utilization Review Nurse. Capable of thinking and acting quickly in stressful emergency situations. Effective communication and team-building skills with interdisciplinary team with proven knowledge of utilization review and clinical experience. Detail-oriented and hard working professional with excellent communication, interpersonal and creative thinking skills. Aiming to leverage my abilities to successfully fill the vacancy at your company. Dedicated professional with proven performance in management, leadership and communication. Detail-oriented in problem-solving and planning. Ready to make an immediate contribution to your organization.
Developed valuable skills in clinical setting, ready to transition into new field. Demonstrated expertise in analyzing patient data and optimizing care plans. Seeking to leverage strong analytical and communication skills in new professional environment.
Dynamic individual with hands-on experience in NICU/Pediatrics and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Patient-oriented Nurse with 20+ years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with NICUspecialty.

Nora Aguirre

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Utilization Review Nurse

Case Manager/Utilization Review Nurse

RN Nurse Trainer

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Associate of Science - Nursing

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Utilization Review Nurse

Case Manager/Utilization Review Nurse

RN Nurse Trainer

Associate of Science - Nursing

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