Victoria Hunt

I’m a Registered Nurse Case Manager with 10+ years in telephonic case management, utilization management, and transplant prior/post authorizations across Medicaid, Medicare, DSNP, and commercial lines. I review solid organ, stem cell, CAR-T, and gene therapy cases using clinical guidelines, Milliman criteria (MCG), and InterQual to support medical necessity, intensity of service, severity of illness, and discharge readiness.

I partner with Medical Directors on appeals and P2P reviews, coordinate denial management, and guide members through complex acute and post-acute experiences with strong care planning and patient advocacy. I’ve also trained RN hires on Medicaid transplant workflows, led an On-Call weekend team of four RNs, and collaborated with state agencies and hospital systems to standardize transplant approval criteria—while drawing on earlier dialysis RN experience to strengthen clinical judgment.