Jami L. Young Email & Phone Number

Tennessee, United States

Houston, Texas, United States

Prior Authorization / Utilization Review in Clinical Services supporting UnitedHealthcare’s Medicare, Medicaid special needs population. Key responsibilities:Provide clinical coverage review of medical service requests based on relevant clinical information and applicable criteria including benefit plan language, state and federal mandates, Milliman Care Guidelines, Interqual, Local and National coverage determinations. Collaborate closely with the Medical Director.Expertise in a managed care plan Utilization Management process.Assess and interpret customer needs and requirements Excellent written and verbal communication skills. Identify solutions to non-standard requests and problems.Solve problems and conduct analyses.

Part Time

Provide in-home patient visits, complete OASIS Medicare assessments and re-certifications, ensure proper Medicare reimbursement for patient care episode.

Provided Medicare education and conducted needs analyses / insurance sales to Medicare beneficiaries transitioning from company group plans to Individual Medicare plans.

Pompano Beach, Fl

Managed peritoneal dialysis program, administered infusion therapy and testing, provided education, training, home visits, and nursing care support for the Home Peritoneal Dialysis (PD) patients and their families.

Houston, Texas Area

Administered and supervised nursing/dialysis technician staff in delivery of hemodialysis treatment to chronic patients in 30 chair treatment facility with two shifts per 6 days/week.

Bachelor Of Science (Bs), Registered Nursing/Registered Nurse

Activities and Societies: Nursing Honor Society Sigma Theta Tau – charter member Iota Iota chapter

Graduate Certificate Course, Health Care Informatics

Education record