Anna Long

Supervise the appeals department, managing 16 employees. Oversee assignments, staffing, evaluations, and audits while assisting in writing Standard Operating Procedures. Collaborate closely with peers, Medical Directors, and pharmacy staff.

Handled appeals for pharmacy, pre-service, post-service, and claim review. Gained knowledge of commercial and Medicare lines of business.

Contracted as a Utilization Management Nurse, reviewing inpatient and outpatient cases to ensure appropriate care levels.

Reviewed inpatient hospitalizations for appropriate care levels, collaborated with physicians, and assisted with appeals and precertifications. Precepted new employees and managed staff scheduling.

Assisted members and families with acute health events, provided resources, and established care plans for better outcomes while collaborating with physicians.

Conducted comprehensive clinical assessments, administered intravenous medications, and monitored patient responses while collaborating with healthcare professionals.

Provided care to patients in the Intensive Care Unit, focusing on intravenous therapy and central line catheter management.

Cared for patients in Medical Surgical, Telemetry, and Intensive Care Units, completing critical care courses.

Pursued a Bachelor of Science in Nursing, focusing on advanced nursing practices and patient care management.

Completed a nursing diploma program, gaining essential skills and knowledge in nursing practices and patient care.