Leanne Fitzgerald
@leannefitzgerald
Experienced RN in utilization and case management optimizing care transitions.
United StatesWhat I'm looking for
I am a Registered Nurse and Certified Case Manager with over ten years of experience in utilization review, case management and care coordination. I combine clinical assessment skills with regulatory expertise to determine medical necessity and appropriate levels of care.
I have managed complex caseloads across acute and sub-acute settings, performed pre-certification, concurrent and retrospective reviews, and facilitated timely care transitions to reduce readmissions. I routinely collaborate with providers, discharge planners and interdisciplinary teams, lead meetings, and serve as a primary contact for waiver and authorization programs.
I am committed to patient-centered, evidence-based care and to maximizing effective use of resources through strong provider relations, EMR proficiency and clear communication. I seek to apply my utilization management and case coordination experience to improve outcomes and support high-quality, compliant care delivery.
Experience
Work history, roles, and key accomplishments
Clinical Nurse Reviewer
MACIPA
Feb 2022 - Present (3 years 6 months)
Screened patients for rehabilitation admissions and managed complex caseloads to ensure clinical appropriateness and regulatory compliance; served as primary contact for the MSSP 3-Day Waiver Program and led weekly team meetings.
Complex Care Manager
MACIPA
Jun 2021 - Feb 2022 (8 months)
Provided comprehensive case management for a panel of high-risk patients, developed evidence-based care plans, and coordinated transitions of care to mitigate readmission risk.
SCO PCA RN
Commonwealth Care Alliance
Feb 2020 - Jun 2021 (1 year 4 months)
Provided clinical nursing and care coordination for Senior Care Options members, managing care plans and facilitating services for enrolled seniors.
RN Case Manager
United Health Care
Feb 2018 - Oct 2019 (1 year 8 months)
Managed RN case management and utilization review activities for plan members, coordinating care transitions and authorization decisions to ensure appropriate level of care.
RN Case Manager / Weekend Supervisor
Caregroup Parmenter Homecare & Hospice
Jan 2005 - Jan 2019 (14 years)
Coordinated homecare and hospice case management, supervised weekend operations, and managed patient care plans to support safe home-based care and transitions.
Education
Degrees, certifications, and relevant coursework
LNLawrence Memorial Hospital / Regis College School of Nursing
Diploma in Nursing, Nursing
Completed a Diploma in Nursing at Lawrence Memorial Hospital / Regis College School of Nursing in May 1991.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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