
Lee Ann Pons
@leeannpons
Case Manager at Cigna Healthcare / EviCore / Evernorth who reviewed home health cases and improved complaint resolution time by 30%.
What I'm looking for
At Cigna Healthcare / EviCore / Evernorth, I review moderately complex home health cases to determine service needs and support appropriate care plan development. I also investigate member complaints and help drive resolutions through advocacy.
My case management work at Allegheny Health Network Neuroscience Institute included triaging telehealth nursing calls, assessing patient concerns, and coordinating follow-up care with physicians and interdisciplinary teams.
Across my nursing and utilization management experience, I’ve supported complex patient care and clinical quality efforts. My achievements include reducing complaint resolution time by 30% and completing 95% of clinical reviews and care coordination on time.
Experience
Work history, roles, and key accomplishments
UM Clinical Reviewer, Senior Analyst
Cigna Healthcare / EviCore / Evernorth
Nov 2022 - Present (3 years 11 months)
Reviewed moderately complex home health cases for Cigna members to determine service needs and support appropriate care plan development. Managed daily clinical review and care coordination independently in a remote setting while maintaining consistent workflow ownership.
Case Management Registered Nurse
Allegheny Health Network Neuroscience Institute
Feb 2021 - Aug 2022 (1 year 6 months)
Managed high-volume telehealth nursing calls, triaged patient concerns, and addressed medication refill needs to support timely follow-up care. Assessed patients by phone, identified condition changes, and alerted physicians to enable appropriate intervention.
Registered Nurse
Curahealth LTAC
Jan 2019 - Dec 2020 (1 year 11 months)
Delivered nursing care for medically complex patients in a long-term acute care and rehabilitation setting. Oversaw care for patients with complex respiratory conditions, including those requiring ventilator support.
Registered Nurse / Clinical Quality Management Analyst
Gateway Health
Jan 2018 - Dec 2019 (1 year 11 months)
Monitored care quality and evaluated compliance with legal and organizational standards to support accountable clinical practice. Analyzed customer complaints and related data to identify performance issues and improvement opportunities.
Registered Nurse
Allegheny General Hospital
Jan 2015 - Dec 2018 (3 years 11 months)
Cared for complex cardiothoracic and vascular inpatients, including heart transplant, LVAD, and open-heart surgery populations. Performed comprehensive health assessments and developed individualized plans of care for high-acuity patients.
Registered Nurse / Charge Nurse
Heritage Valley Health System
Jan 2001 - Dec 2005 (4 years 11 months)
Served as a Registered Nurse and Charge Nurse, providing nursing care and supervising nursing support staff.
Registered Nurse / Charge Nurse
Allegheny General Hospital
Jan 1996 - Dec 2000 (4 years 11 months)
Served as a Registered Nurse and Charge Nurse, providing nursing care and supervising nursing support staff.
Registered Nurse / Charge Nurse
Community Medical Center Weiss Institute of Neuroscience
Jan 1992 - Dec 1996 (4 years 11 months)
Served as a Registered Nurse and Charge Nurse, providing nursing care and supervising nursing support staff.
Education
Degrees, certifications, and relevant coursework
University of Phoenix
Bachelor of Science in Nursing, Nursing
Bachelor of Science in Nursing (BSN) from the University of Phoenix, completed in 2021.
Community Medical Center School of Nursing
Registered Nurse Diploma, Nursing
Registered Nurse Diploma from Community Medical Center School of Nursing, completed in 1992.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Salary expectations
Social media
Job categories
Skills
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