Utilization Management Nurse Resume Sample

A nurse in this career reviews the utilization of health services and their provision against the need demonstrated by customers. They review documentation of patient management, evaluate the performance of hospital staff, use the data to make patient management efficient, help prevent patient complications, compile reports, co-ordinate with colleagues and report to the manager of the utilization team.

For many people, writing a resume can be daunting. If you are working on your own, it is easy to become overwhelmed with the amount of information you need to include and how best to present yourself.

The sample resumes below provide great examples of how to write an effective resume.

The Best Utilization Management Nurse Resume Samples

These are some examples of accomplishments we have handpicked from real Utilization Management Nurse resumes for your reference.

Utilization Management Nurse Resume Sample 1

  • Reduced the number of patients being sent back to the Emergency Department for lack of available beds.
  • Pinpointed and resolved patient grievances.
  • Established a community of dependable and cooperative inter-departmental employees.
  • Utilized an existing database to coordinate hospital resources; saved $$$$ for the institution.
  • Prescribed compassionate care to maintain established relationships with patients and their families; recognized by corporation as a Nurse Hero for maintaining high patient satisfaction ratings and providing excellent clinical care.

Utilization Management Nurse Resume Sample 2

  • Supervised group of ten patients with multiple chronic illnesses.
  • Interfaced with the patient care unit to ensure proper patient care.
  • Ensured that all units of medication, equipment, and supplies were properly utilized by the patients.
  • Met visit goals for physical assessment, physical therapy plan, psychotherapy progress notes, and specialty consultations.
  • Accurately monitored group of eight dialysis patients for adverse drug reactions.

Utilization Management Nurse Resume Sample 3

  • Assigned primary responsibility for the primary, secondary, and tertiary care of hospitalized patients.
  • Supervised all nursing actions on surgical patients to ensure patient safety.
  • Recognized as a skilled nurse by the on-site surgeon on two occasions for maintaining patient safety during surgery.
  • Delivered critical care to patients in multiple states during an emergency response evacuation due to Hurricane Katrina.
  • Collaborated with administration to establish new ER protocols for emergency response after each hurricane.

Utilization Management Nurse Resume Sample 4

  • Gave first aid to cardiac arrest victims.
  • Reported advance directives to medical records management team members.
  • Aided in saving at least twenty-five life-saving surgeries during the month of January.
  • Adhered to strict organizational procedures, professional standards, and accepted state standards of medical ethics regarding the utilization of medications.
  • Conducted extensive planning, coordination, and education regarding patient transfers during the short-staffing period.

Utilization Management Nurse Resume Sample 5

  • Represented healthcare provider at a hospital market share meeting to discuss quality metrics and performance.
  • Collaborated with physicians, patient representatives, and hospital executives to produce a high-quality product that was delivered on time.
  • Maintained financial focus by designing a budget model that used available internal resources for staffing, hiring, and annual conventions.
  • Assisted hospital director to implement a long-term healthcare plan for the community; saved the facility from near closure.
  • Planned for client care needs by accurately forecasting the number of patients who would be admitted during a specified time period using data from medical records.

Utilization Management Nurse Resume Sample 6

  • Prescribed and administered rehabilitative treatment after medical, trauma, and psychiatric injuries to patients, including amputees and burn victims.
  • Served as a subject matter expert and advisor for medical students during their rotations in the pulmonary function lab.
  • Coordinated with other health care providers to ensure excellent care of patients.
  • Documented patient progress and regularly reported findings.
  • Trained respiratory therapists in the use of respiratory equipment such as mechanical ventilators, heat exchangers, humidifiers, scavenger systems, and humidifier disinfection systems.

Utilization Management Nurse Resume Sample 7

  • Created a new patient zero risk population by monitoring compliance with screening criteria.
  • Dedicated to patient safety and utilization of resources, establishing an environment that encouraged collaboration among team members.
  • Promoted patient education with patients and the community at large by creating a culture of professionalism, teamwork, accountability, and respect.
  • Co-authored a journal article released in the peer-reviewed literature on the relationship between the recovery of an opioid antagonist, naloxone, and blood levels of pain medication.  Appeared as a guest speaker for mental health convention in different cities across the nation discussing recovery advocates for substance abuse recovery programs.
  • Established a triage system for the hospital based on resource utilization and financial risk to the hospital.

Utilization Management Nurse Resume Sample 8

  • Collaborated with the physician, nursing staff, and case manager to plan, implement, and evaluate long-term care programs.
  • Designed, implemented, and evaluated screening programs for the screening of new clients.
  • Reviewed patient records; treated chronic illnesses; monitored progress; wrote orders; prepared documentation.
  • Observed patients during hospitalization and reviewed patient progress at follow-up visits.
  • Adhered to all departmental policies and procedures in consultation with the medical staff.

Utilization Management Nurse Resume Sample 9

  • Collaborated with physicians to develop discharge plans for patients utilizing medical equipment.
  • Provided consultation on rehabilitative services for functional restoration.
  • Assisted in determining appropriate levels of care, based on medical needs of patients, resulting in improved quality of life.
  • Constructed flow charts to indicate the need for referrals of clients to community resources.
  • Identified funding sources to assist in covering cost of patient care and enabled customers with sufficient coverage.

Utilization Management Nurse Resume Sample 10

  • Collected data from patient records to monitor, trend, and analyze utilization patterns by provider.
  • Developed utilization management plan to maximize patient benefit.
  • Maintained integrity among providers and office staff by performing transactions to total expenditures.
  • Communicated with financial manager regarding impact of policies on cash flow and benefits.
  • Established positive relationships with providers through effective communication and motivation.

Utilization Management Nurse Resume Sample 11

  • Implemented the diagnosis, management, and treatment of patients with acute, critical, chronic conditions.
  • Assessed patient’s needs for medical supplies and equipment.
  • Trained nursing staff in utilization management techniques including infection control, safety procedures, and patient handling techniques.
  • Visited patients’ homes to identify potential safety hazards and develop solutions to eliminate or minimize these risks.
  • Provided testimony on behalf of patients advocating for Medicare reimbursement.

Utilization Management Nurse Resume Sample 12

  • Facilitated and coordinated employee patient medical treatment and employee’s return to work.
  • Resolved employee medical treatment claims, and identified and communicated cooperatively with health care providers to ensure medical treatment and return to work.
  • Monitored employees’ medical treatments for accuracy, appropriateness, cost effectiveness, and timeliness of medical treatment.
  • Planned patient care assignments according to established departmental priorities.
  • Participated in hospital industry committees such as Quality Improvement Committee (QIC), Clinical Data Tracking Team (CDT), Patient Safety Committee (PSC), etc., as well as the Illinois Hospital Association (IHA) Patient Safety Conference.

Utilization Management Nurse Resume Sample 13

  • Metered assigned patients’ utilization of services to ensure appropriate use.
  • Established rapport with patient’s physician to ensure continuity of care.
  • Educated patients on how to manage their health, identify symptoms, and avoid hospital admission through wellness programs.
  • Assisted patients in obtaining appropriate services in a timely manner by explaining appropriate providers and procedures in layman terms.
  • Participated in frequent code reviews to assess treatment plans, resource requirements, appropriateness of orders, and overall appropriateness of patient’s continued care at the facility.

Wrap Up

To work as a Utilization management nurse, you must be a CCNE-accredited nursing degree holder, registered and state licensed with a certificate in utilization management. The work requires utilization management skills, Microsoft Office skills, excellent interpersonal skills, administrative skills, organizational skills, advocacy skills, a team player and independent thinker.

Resumes are a crucial aspect of any job search. In order to make a good first impression, it is important that your resume be formatted and written professionally. To create the perfect resume, think about what skills and qualities you want your future employer to see.

Hope these samples gave you an idea of what your resume should look like and some tips on how to make sure that your resume stands out from the rest.

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