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Tiffany GarvinTG
Open to opportunities

Tiffany Garvin

@tiffanygarvin

Lead Utilization Management RN delivering compliant inpatient review and audit-driven authorization decisions.

United States
Message

What I'm looking for

I’m seeking medical coding and risk adjustment experience, leveraging my utilization management and concurrent review background. I want a role where I can apply NCQA-compliant authorization review, accurate documentation, and clinical insight to support better outcomes.

I’m an Experienced Lead Utilization Management RN with deep experience in concurrent inpatient review, making medical necessity determinations, and supporting member care through interdisciplinary collaboration. In my current role, I audit authorizations, reviews, and charting to adhere to NCQA guidelines while maintaining TAT by prioritizing and delegating review work.

As a senior clinical review nurse and earlier PACU/Peri-operative RN, I’ve built a strong foundation in patient safety, clinical assessment, and provider communication. I’m also pursuing medical coding and risk adjustment experience—currently supported by my Medical Insurance & Coding Certificate and CPC-A credential—so I can connect clinical insight to coding-focused accuracy and risk-aware outcomes.

Experience

Work history, roles, and key accomplishments

Centene Corporation logoCC
Current

Lead Clinical Review Nurse

Jul 2024 - Present (2 years 1 month)

Lead concurrent review clinical work for IA and NE Medicaid inpatient authorizations and reviews. Audit authorizations, manage daily inpatient review assignments, and help maintain turnaround times while supporting interdisciplinary care team conferences.

FV

Nurse (RN/LPN)

Friendship Village

Oct 2013 - Aug 2015 (1 year 10 months)

Provide geriatric long-term care, including assessments, medication administration, and wound care. Supervise nurse aides and support resident activities of daily living while reporting condition changes to physicians.

Education

Degrees, certifications, and relevant coursework

Louisiana State University Shreveport logoLS

Louisiana State University Shreveport

Master of Health Administration, Health Administration

2025 -

Currently enrolled in a Master of Health Administration program at Louisiana State University Shreveport (Oct 2025–Aug 2027).

Des Moines Area Community College logoDC

Des Moines Area Community College

Medical Insurance & Coding Certificate, Medical Insurance & Coding

2018 - 2019

Grade: 4.0 GPA

Completed a Medical Insurance & Coding Certificate program (Fall 2018–Spring 2019) and earned a 4.0 GPA.

University of Iowa logoUI

University of Iowa

Bachelor of Science in Nursing, Nursing

Earned a Bachelor of Science in Nursing from the University of Iowa (Dec 2015), with Dean’s List recognition in Fall 2014 and Spring 2015.

Hawkeye Community College logoHC

Hawkeye Community College

Associate Degree in Nursing, Nursing

Earned an Associate Degree in Nursing at Hawkeye Community College (July 2014).

University of Northern Iowa logoUI

University of Northern Iowa

Major in Biology; Minor in Chemistry (did not complete), Biology

2009 - 2010

Studied Biology as a major and Chemistry as a minor at the University of Northern Iowa (Fall 2009–Spring 2010), but did not complete the degree.

Tech stack

Software and tools used professionally

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