Joanna Swindle
@joannaswindle
Experienced Utilization Management RN specializing in post-acute care transitions.
What I'm looking for
I am a driven Utilization Management Nurse with a BSN and active compact RN licensure, focused on ensuring appropriate, timely care transitions from acute to post-acute settings. I pioneered and helped develop the UM Post-Acute Pre-Authorization (PAPA) pilot, conduct clinical reviews using CMS and InterQual guidelines, and serve as a weekend medical on-call nurse managing Medicare appeals.
My strengths include strong clinical judgment, attention to detail, high autonomy, and professional communication that builds collaborative relationships with SNFs, providers, PCPs, case management directors, members and families. I consistently advocate for patient-centered discharge planning and resource coordination to optimize continuity of care and outcomes.
Experience
Work history, roles, and key accomplishments
Led Utilization Management for post-acute pre-authorization (PAPA) operations, piloted the PAPA program and developed role guidelines, and conducted timely clinical reviews for SNF admissions while supporting weekend on-call medical decisions and Medicare appeals.
Case Manager RN
Boca Raton Regional Hospital
Nov 2015 - Dec 2017 (2 years 1 month)
Managed utilization review and discharge planning using InterQual criteria, assessed resources and negotiated treatment options to coordinate appropriate care transitions and referrals.
Education
Degrees, certifications, and relevant coursework
Auburn University
Bachelor of Science, Nursing
2000 - 2000
Grade: Cum Laude
Completed a Bachelor of Science in Nursing, graduating Cum Laude in June 2000.
Coffee Springs High School
High School Diploma, High School Diploma
1991 - 1991
Grade: Top 5% of class
Graduated with a High School Diploma in May 1991 and ranked in the top 5% of the class.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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