Amanda Scheffler

Responsible for clinical review for Medicaid STAR and STAR Plus members against medical based criteria to determine if admission is warranted. Apply critical thinking skills and nursing judgement, and decision-making skills to interpret rationales of decisions. Refer clinical reviews to physicians for secondary reviews.

Responsible for reviewing of medical necessity for outpatient services, medications, and durable medical equipment utilizing Milliman criteria. Provide patients with education on their diagnosis, treatment and resources to achieve their prior level of functioning. Utilize iSuite for documentation and for creating task lists to help organize the tasks that are due that day.

Utilize telephonic and in person support to educate patients regarding diabetes, hypertension, and hyperemesis gravidarum. Responsible for patient care and patient education in the patient


's home. Performs assessment and medication administration.

Responsible for utilizing proper and prompt assessment skills and clear communication to achieve optimal patient and fetus safety. Application of critical thinking skills for interventions and communication amongst the healthcare team of nurses and physicians. Ensures that appropriate policies and procedures are being followed, as well a safe staffing and practices are in place.

Actively and frequently assessing maternal and fetal vital signs, and intervening in a prompt and safe manner. Utilization of appropriate and effective communication across the healthcare team. Recognizing immediate intervention in a high acuity situation.

Actively and frequently assessing maternal and fetal vital signs, and intervening in a prompt and safe manner. Utilization of appropriate and effective communication across the healthcare team. Recognizing immediate intervention in a high acuity situation.

Studied the fundamentals of nursing, including patient care, pharmacology, and medical procedures. Gained practical experience through clinical rotations in various healthcare settings.