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Andromeda Marquez-Hulse is listed as Clinical Review Nurse Prior Authorization at Centene Corporation, a with 17105 employees, based in Las Vegas, Nevada, United States. AeroLeads shows a matched LinkedIn profile for Andromeda Marquez-Hulse.
Andromeda Marquez-Hulse previously worked as MDS Coordinator at The Heights Of Summerlin and Review Coordinator at Livantallc. Andromeda Marquez-Hulse holds Master Of Science - Ms, Family Practice Nurse/Nursing from University Of Phoenix.
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Utilization Management, Skilled Nursing Facility Reimbursement, Knowledge of ICD-10, CPT coding, HCPCS, NCD/LCD Guidelines, Case Management, Long Term Care Survey, Post-Acute Care, Rehabilitation, Geriatrics, InterQual, Medicare, Medicaid, Managed Care Organization, Quality Improvement, Appeals & Grievances
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• Reviews prior authorization and retrospective requests for appropriate care and setting using InterQual criteria, clinical policies, and guidelines, approves services, or forwards requests to the appropriate medical advisor for secondary reviews. • Provides education to providers about the utilization management processes• Completes reviews in a timely manner
Las Vegas, Nevada, United States
• Assigns appropriate International Classification of Diseases (ICD 10 codes)• Determines the medical necessity based on clinical & Medicare/Medicaid guidelines • Coordinates the completion of the Minimum Data Set (MDS) in a timely manner• Educates staff about functional assessment and documentation
Las Vegas, Nevada, United States
• Supported physician reviewers by summarizing case facts • Performed desktop medical review• Applied payment coverage by interpreting payment policies and guidelines
Las Vegas, Nevada, United States
• Assisted the director of nursing in managing the overall nursing functions• Performed utilization and level of care reviews• Monitored the quality measures and reimbursement of the facility
Other employees you can reach at centene.com. View company contacts for 17105 employees →
Nicole Siener Lowman, Mba
Colleague at Centene CorporationGreater St. Louis, United States
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Angel Spurlock
Colleague at Centene CorporationUnited States
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Christine John
Colleague at Centene CorporationTampa, Florida, United States
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Jenelle Barry
Colleague at Centene CorporationHouse Springs, Missouri, United States
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Amber Flint
Colleague at Centene CorporationUnited States
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Christa Baez
Colleague at Centene CorporationLathrop, California, United States
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Jing Zhang
Colleague at Centene CorporationTampa, Florida, United States
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Nyarai Mehlomakulu
Colleague at Centene CorporationMaitland, Florida, United States
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Darrielle Hardge
Colleague at Centene CorporationTampa, Florida, United States
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April Bellamy-Peyton
Colleague at Centene CorporationChicago, Illinois, United States
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Quick answers generated from the profile data available on this page.
Andromeda Marquez-Hulse works for Centene Corporation.
Andromeda Marquez-Hulse is listed as Clinical Review Nurse Prior Authorization at Centene Corporation.
Andromeda Marquez-Hulse is based in Las Vegas, Nevada, United States while working with Centene Corporation.
Andromeda Marquez-Hulse has worked for Centene Corporation, The Heights Of Summerlin, Livantallc, and Las Ventanas At Summerlin | A Humangood Community.
Andromeda Marquez-Hulse's colleagues at Centene Corporation include Nicole Siener Lowman, Mba, Angel Spurlock, Christine John, Jenelle Barry, and Amber Flint.
You can use AeroLeads to view verified contact signals for Andromeda Marquez-Hulse at Centene Corporation, including work email, phone, and LinkedIn data when available.
Andromeda Marquez-Hulse holds Master Of Science - Ms, Family Practice Nurse/Nursing from University Of Phoenix.
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