Marsha Robertson

Marsha Robertson Email and Phone Number

Primary Nurse Case Admin I @ Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas
Keller, TX, US
Marsha Robertson's Location
Keller, Texas, United States, United States
Marsha Robertson's Contact Details

Marsha Robertson work email

Marsha Robertson personal email

n/a
About Marsha Robertson

I am a well rounded individual with excellent communication skills and drive to do my job well. I have worked in administration from 2005 until nursing school in 2009. Now I have the best of both worlds. My objective is to keep climbing the corporate ladder, in whatever company I work for, to one day be in charge of more than just one clinic, insurance company and/or hospital.

Marsha Robertson's Current Company Details
Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas

Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas

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Primary Nurse Case Admin I
Keller, TX, US
Employees:
595
Marsha Robertson Work Experience Details
  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Primary Nurse Case Admin I
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Keller, Tx, Us
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  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Primary Nurse Case Admin I
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Mar 2023 - Present
     Audit PA exemption providers for ERS, TRS, TX fully insured/ASO Non-ERISA accounts for elective inpatient and outpatient  Assist other teams with utilization review cases: Pre-certifications, initial/concurrent, retro reviews, predeterminations, CHC, HIT, EOP, DME, etc. Communicate with facilities, providers, and co-workers Send cases to MD for medical necessity reviews when appropriate Assist with providing additional tips on efficiency to staff Assist management with projects/special assignments as needed
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  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Manager Of Clinical Operations –Utilization Review
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Oct 2021 - Mar 2023
     Hire, oversee, train, and audit staff – manage timecards, yearly appraisals Reassign caseloads as needed Communicate with providers, co-workers, medical directors, and other departments as needed Assist with projects for processes as needed, create work arounds, run reports Create Standard Operating Procedures, Job Aids, and Audit Tools Update Medical Management Policies, HCM program description/evaluation/timeliness reports, update business continuity plan
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  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Utilization Management Coordinator
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Jun 2020 - Oct 2021
     Navigate healthcare system to assist members to INN providers Communicate with facilities, providers, and co-workers Pre-certifications, initial/concurrent, retro reviews, predeterminations, PDN, CHC, HIT, EOP, DME, etc. Send cases to MD for medical necessity reviews when appropriate Assist with providing additional tips/training to staff Assist management with projects/special assignments as needed, run reports for TAT Assist with the monthly team newsletter
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  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Care Coordinator Um/Cm Ii
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas Jun 2019 - Jun 2020
     Navigate healthcare system to assist members to INN providers Communicate with facilities, providers, and co-workers Pre-certifications, concurrent, and retro reviews, predeterminations, PDN Send cases to MD for medical necessity reviews when appropriate Assist with providing additional tips on efficiency to staff Assist management with projects and processes as needed
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  • Children'S Health
    Utilization Review Manager
    Children'S Health Dec 2016 - Jun 2019
    Irving, Tx
     Assist with utilization review of all cases (concurrent, procedure, DME, Therapy, OTL, PDN) Oversee and train staff – Coordinators, RN’s, manage timecards, yearly appraisals, Fair Hearings Reassign caseloads as needed Communicate with providers, members, co-workers, and state Assist Director with projects for processes as needed, create work-arounds, run reports Create Standard Operating Procedures, Job Aids and Audit Tools
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  • Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas
    Utilization Review Rn
    Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas May 2015 - Dec 2016
    Richardson, Tx
     Add and create cases in Aerial, TEAM LEAD Navigate healthcare system to assist members in INN providers Communicate with facilities, providers, patients and co-workers Pre-certifications, concurrent, and retro reviews  Send cases to MD review for medical necessity reviews when appropriate Assist with training new employees for UM Assist management with projects and processes as needed Assist compliance with projects for URAC and NCQA
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  • Healthsmart
    Um Nurse
    Healthsmart May 2014 - May 2015
    Irving, Tx
     Pre-certifications, concurrent, and retro reviews for self insured groups, Appeals and denials Send cases to MD review and outside agency for same state medical necessity reviews when appropriate New Pilot program-Cigna designating HealthSmart for UM on existing groups that use Cigna Network Assist with training new employees for UM Created an efficient process and wrote the training documents for UM Add and create patients and cases in program Communicate with facilities, providers, patients and co-workers
  • Vein Clinics Of America
    Rn
    Vein Clinics Of America Aug 2013 - May 2014
    Southlake, Texas
    Basic Nursing care provided to all patients: Focused assessment before, during, and after treatments, vitals, medication administration through needle sticks into veins with STSCommunicate with patientsThorough charting via computer and paper, attention to detailAssist doctor and ultrasound technician with procedures with lasers and injectionsStock and clean roomsOrder medical and office suppliesAssist front office administration with rooming of patients, chart preparation, filing, faxingMedication preparation for daily procedures
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  • Baylor Health Care System Recruiting
    Or Rn
    Baylor Health Care System Recruiting Mar 2013 - Jul 2013
    Fort Worth, Texas
    PRN OR RN-circulator floatBasic Nursing care during intraoperative experience: transport, positioning, prep, equipment, draping, surveillance of the OR room, maintain sterilityThorough charting abilities, attention to detailCommunicate with patients, families, and healthcare workersAssist surgeon and tech during surgeryStock and clean the OR
  • Texas Pediatric Surgery Center
    Or Rn
    Texas Pediatric Surgery Center Jun 2012 - May 2013
    North Richland Hills, Texas
    OR circulator-all servicesBasic Nursing care during intraoperative experience: transport, positioning, prep, equipment, draping, surveillance of the OR room, maintain sterilityThorough charting abilities, attention to detailCommunicate with patients, families, and healthcare workersAssist surgeon and tech during surgeryStock and clean anesthesia cart and ORPrepare OR rooms for next days cases
  • Scott And White
    Or Rn
    Scott And White Jan 2012 - Jun 2012
    Temple, Texas
    OR internship-floatBasic Nursing care during intraoperative experience: transport, positioning, prep, equipment, draping, surveillance of the OR room, maintain sterilityThorough charting abilities, attention to detailCommunicate with patients, families, and healthcare workersAssist surgeon and tech during surgery
  • Md Anderson Cancer Center
    Professional Student Extern
    Md Anderson Cancer Center May 2011 - Aug 2011
    Houston, Texas
    Basic Nursing care provided to all patients: shift assessment, vitals, bathing, linen change, dressing changes (central line included), ambulation, positioning/turning patients, medication administration(except for chemotherapy and blood products), catheter insertion/removalCommunicate with patients, families, and healthcare workerThorough charting abilities, attention to detail
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Marsha Robertson Education Details

Frequently Asked Questions about Marsha Robertson

What company does Marsha Robertson work for?

Marsha Robertson works for Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma & Texas

What is Marsha Robertson's role at the current company?

Marsha Robertson's current role is Primary Nurse Case Admin I.

What is Marsha Robertson's email address?

Marsha Robertson's email address is ma****@****sil.com

What schools did Marsha Robertson attend?

Marsha Robertson attended Saint Joseph's College, Midwestern State University.

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