Mary Ryan Email & Phone Number

Fairfax,Virginia

Quality Assurance Nurse* Audit for compliance with State and Federal regulations* Develop training programs* Perform initial and quarterly client assessments

Northern Virginia

Site Review Consultant (Medicare Contract; HEDIS)• Telework and on-site chart review and abstraction • Maintained highest level of professionalism in communications and interactions with clients• Performed Medicare Risk Adjustments and HEDIS Chart Abstractions• Utilized ICD 9 and ICD 10 in performance of abstractions/reviews

Washington, Dc

Utilization Review Nurse (Medicaid Contract)• Telework• Highly proficient and accurate in documenting clinical reviews for medical necessity • Consulted with physicians and other healthcare workers on a daily basis• Monitored for appropriateness of care resources, allocation, and demonstration of medical necessity using InterQual and Medicaid specific criteria• Perform audits to help prevent fraud• Successfully trained new reviewers and acted as a resource person for other employees

Reston, Va

Medical Review Nurse (Veterans’ Affairs Contract)• Chart review and quality checks; Condensed longer charts into smaller ones containing pertinent information • Ensured contractual compliance • Consulted with Physicians and other healthcare providers

Chantilly, Va

Utilization Review Nurse (A State Employees’ Health Insurance Contract)• Highly proficient and accurate in documenting clinical reviews for medical necessity • Monitored for appropriateness of care and resources • Coordinated with medical offices, hospitals, durable medical equipment companies, and other departments to streamline patient care• Consulted with physicians and referred cases for review• Successfully trained new medical reviewers and acted as a resource person for other employees• QA in monitoring of own work for URAC compliance

Bachelor'S Degree, Nursing

Associate Of Arts And Sciences (A.A.S.), Registered Nurse