Mary Jo Everson, Rn Email & Phone Number

Columbus, Oh, Us

Dublin, Ohio, United States

Columbus, Ohio Area

• Overhauled departmental metrics and KPI process, creating a specialized team that took over day-to-day operations of identifying areas for improvement, drives department and organizational goals setting, and developing process improvements within Utilization Review and Denial Departments• Doubled call columes with payer companies and increased revenue 4x to $16M by working closely with payers to standardize and reduce arbitrary calls and moving to a scheduled call process, allowing for 3 new physician advisors, and 2 newly added administrative staff to maintain growth• Increased payer involvement and doubled physician productivity by streamlining processes and creating administrative roles• Conducted root cause analysis, case audits, and facilitated multiple cross-functional projects• Trained staff to utilize multiple EHRs including Epic, McKesson, Citrix, Paragon, Meditech, and Milliman Care Guidelines (MCG) which streamlined workflows and more robust reporting capabilities• Chosen for 4-month Emerging Leader Training to develop leadership within OhioHealth• Prism Award Winner awarded to individuals who demonstrate excellence, stewardship, compassion, and integrity

Columbus, Ohio Area

Maintained productivity of 9+ inpatient cases per hour while maintaining a high accuracy rate. Reviewed initial denials from payers, including medical necessity, length of stay, retrospective, and administrative. Performed initial medical necessity reviews, concurrent reviews, and retrospective reviews, on all inpatient levels of care and specialty areas such as pediatric, newborn, and elective surgeries.• Participated in a team that decreased Inpatient Only Procedure misses by 43% in one fiscal year• Analyzed cases denied by payer and determined if cases were clinically strong enough for peer to peer or appeals by the physician advisor team• Reviewed outpatient and inpatient surgeries utilizing the correct CPT Code according to CMS guidelines• Expert in the application of Milliman Care Guidelines (MCG), a medical necessity review criteria tool. • Supports the development of performance improvement strategies in response to identified patterns and trends involving government payers• Reviewed the medical record for Observation cases to ensure accurate and timely billing of observation hours and appropriate charges

Columbus, Ohio Area

• Collaborated to establish an experimental nursing unit that shortened patient stay by 1 day compared to the national average, maintained patient satisfaction scores in the top 99% • Participated and worked on numerous continuous improvement projects for the unit including early sepsis detection, reducing patient falls, and developing patient education process• Precepted new graduate nurses to the unit • Member of Shared Governance Committee and of Education Committee

Toledo, Ohio Area

• Provided vigilant care in assessing acute stroke and oncology patients and identified physical decline and improvement• Trained to access implanted ports• NIH Stroke Certified• Geriatric Certified Nurse• Administered blood products and chemotherapy products• Floated and worked on Ortho Unit, Medical Behavior Health Unit, Cardiac Unit, and Infusion Clinic on a regular basis• Cared for grieving family members and provided safe patient care to the terminally ill• Monitored pain levels and aided in the death process by supporting the patient and the family through their difficult time

Master Of Healthcare Administration

Bachelor Of Science In Nursing

Activities and Societies: National Student Nurse Association, President of Toledo Campus Ministry