Lead Medical Reviewer

• May 2023 - Present

Independent Contractor

• Jul 2022 - May 2023

Providing legal nurse reviews, third party nurse reviews, Medicare set-aside allocations, life care plans, and medical cost projections on a contractual basis. Providing legal nurse reviews, third party nurse reviews, Medicare set-aside allocations, life care plans, and medical cost projections on a contractual basis.

Medical Analyst

• Oct 2018 - Aug 2019

Preparation of Medicare set-aside allocations (WCMSA and LMSA) and life care planning products, including worker's compensation and liability settlements. Preparation of Medicare set-aside allocations (WCMSA and LMSA) and life care planning products, including worker's compensation and liability settlements.

Independent Contractor

• Apr 2018 - Oct 2018

WCRC nurse reviewer---Performed comprehensive medical records review and evaluates WCMSA proposals to make recommendation(s) to CMS for final determination on applicable coverage/coding/UR with current WCRC contractor. Reviews all submitted WCMSAs. WCRC nurse reviewer---Performed comprehensive medical records review and evaluates WCMSA proposals to make recommendation(s) to CMS for final determination on applicable coverage/coding/UR with current WCRC contractor. Reviews all submitted WCMSAs.

Workers' Compensation Case Manager Level II Reviewer--WCRC

• Sep 2015 - Mar 2018

WCRC nurse reviewer--Performed comprehensive medical records review and evaluates WCMSA proposals to make recommendation(s) to CMS for final determination on applicable coverage/coding/UR with current WCRC contractor. Reviews all submitted WCMSAs. CONTRACT ENDED MARCH 2018 WCRC nurse reviewer--Performed comprehensive medical records review and evaluates WCMSA proposals to make recommendation(s) to CMS for final determination on applicable coverage/coding/UR with current WCRC contractor. Reviews all submitted WCMSAs. CONTRACT ENDED MARCH 2018

Assistant Director of Medical Analysts

• Sep 2010 - Aug 2015

Manager of medical analyst team. Training and education of medical analyst team. Preparation of and subject matter expert for Medicare set-aside allocations (WCMSA and LMSA) and life care planning products, including worker's compensation and liability settlements. Manager of medical analyst team. Training and education of medical analyst team. Preparation of and subject matter expert for Medicare set-aside allocations (WCMSA and LMSA) and life care planning products, including worker's compensation and liability settlements.

Independent Contractor

• Jan 2010 - Sep 2010

Preparation of life care plans, medical cost projections, Medicare set-aside allocations, attorney work products, medical record analysis, and HEDIS reviews. Preparation of life care plans, medical cost projections, Medicare set-aside allocations, attorney work products, medical record analysis, and HEDIS reviews.

National QA Manager

• Nov 2008 - Jan 2010

National QA manager---covering central and eastern United States. Medicare set-aside allocation and life care plan quality assurance on a national basis, sales presentations, and training/education. National QA manager---covering central and eastern United States. Medicare set-aside allocation and life care plan quality assurance on a national basis, sales presentations, and training/education.

Manager of Clinical and Quality Services

• Jul 2004 - Sep 2008

Medicare set-aside allocation, medical cost projection, and life care plan quality assurance, staff management, and training Medicare set-aside allocation, medical cost projection, and life care plan quality assurance, staff management, and training

Field Case Manager and Life Care Planner

• Dec 1999 - Jul 2004

Field case management and telephonic case management of worker's compensation clients, critical incident stress management, medical cost projections, legal nurse consulting, and creation of the Medicare set-aside pilot program Field case management and telephonic case management of worker's compensation clients, critical incident stress management, medical cost projections, legal nurse consulting, and creation of the Medicare set-aside pilot program