Deanna Wall

2659 NW Kennedy Court, Portland, Oregon 97229 503-772-1815 - 503-367-9870 - dwe3

c2e2@westpost.net
Professional Summary
Multi-talented registered nurse, as well as a certified case manager with strong
utilization management background , with a wide variety of clinical experience
since 1975, who is flexible , team -oriented and promotes quality care and servi
ce. Core Qualifications q Certified RN Case Manager q Utilization Review trainin
g q Coding training q Extensive training in Milliman Criteria q Training in Inte
rqual q Perioperative, Surgical Nurse training q Fetal Monitoring , Labor/ Deliv
ery training q Legal Nurse Consultant Training q Extensive computer training in
numerous programs
Core Qualifications
36 years of nursing experience in the healthcare environment
Areas of clinical experience include: obstetrical, pediatrics, psychiatric, surg
ical, operating room, medical, office, insurance, skilled and rehabilitation , c
hemical dependency
Experience
03/2005 to Current
Regence BC/BS of Oregon- Medical Mgmt Coordinator. Working currently in Utilizat
ion Review/ enhanced review , where I primarily review inpatient hospital admiss
ions, skilled admissions , inpatient rehabilitation, hospice , home health type
reviews coordinating discharge to alternate level of care, using Milliman Criter
ia . I also review surgical procedures, durable medical equipment and diagnostic
testing for medical necessity in collaboration with the medical director. I pre
viously worked in Catastrophic Case Management which consisted of a Collaborativ
e process of assessment, planning, facilitating and advocacy for members. Recent
ly I was assigned to enhanced concurrent review which is still evolving.
RN Medical Record Reviewer
09/2004 to 10/2004
Total Therapeutic Management
I did chart reviews for hyperlipidemia study, contract work, that was temporary.
Primarily I reviewed Physician office charts to obtain pertinent data on patien
t's for quality study.
Flight Attendant
03/04 to 10/04
Delta Connection
Responsible for Customer service, safety, welfare and comfort of passengers in a
ccordance with Company policies and FAA standards.
Registered Nurse, Claims Consultant
10/00 to 10/03
U.S. Health Care
Review insurance healthcare claims for medical necessity, appropriate coding, me
dical appropriateness, benefits, utilizing an interdisciplinary team approach to
promote quality healthcare and the most cost effective outcome for the patient,
as well as the payer.
Registered Nurse, Assessment Specialist
04/2000 to 09/2000
Capitated Health Care Services, Memorial Hospita
As an assessment nurse, I would obtain pertinent medical history and data for be
nefit determination and for underwriting of insurance policies. Identified polic
yholders healthcare needs, and developed holistic plans of treatment for the pat
ient. I also worked in the operating room doing a variety of cases.
Registered Nurse
08/1999 to 04/2000
Genesis Eldercare Riverwood
Care Coordinator that performed hospital pre-assessments, did marketing, submitt
ed reports and summaries in compliance with policies, communicated assessment in
formation to the sercie site to prepare transition of care from the acute hospit
al setting to the skilled community and eventually to the home / assisted living
setting. Also worked as internal case manager , consulting with the interdiscip
linary treatment team, family, payor, coordinating discharge and transfers to ho
me and hospitals when needed.
Case Manager and Quality Management Coordinator
09/98 to 08/99
First Coast IPA
Performed onsite reviews for continued stay, to determine medical necessity and
appropriate level of care. Worked with hospitals, physicians, nurses, and insura
nce companies closely. Also was promoted to Quality Management for several month
s prior to leaving and served on the quality management board. Filled in for sup
ervisor periodically when she was out.
Registered Nurse
12/97 to 5/98
Advantage Health Care
Utilization Review Coordinator Did referrals, precertifications to determine med
ical necessity for various surgery's, treatments, and procedures with assistance
and guidance of a
physician advisor
04/97 to 12/97
Columbia Lakeland Medical Center
Utilization Review, Case Manager- Did case management at hospital, coordinating
discharges, admissions, transfers, working closely with insurance companies to o
btain necessary authorizations for continued stay and payment.
10/95 to 03/97
Advantage Health Care
Performed onsite reviews primarily at hospitals and imputed information into com
puters for a managed care insurance company.
Operating Room, Pool Nurse and Preadmit Nurse
10/88 to 10/95
Slidell Memorial Hospital
Worked as circulating nurse in surgery, did open heart, gynecological, orthopedi
c, thoracic, eye, ear, nose cases. As a preadmit nurse worked closely with docto
rs, anesthesiology and patients gathering physical and history information preop
eratively. Did a lot of education with family and patient. Also worked on other
medical surgical floors, labor and delivery,pediatrics, nursery, psychiatric and
rehab units.
Education
Mississippi Gulf Coast Junior College
Gulfport, Mississippi
Associates

Mississippi Gulf Coast College/ Delgado

Registered Nurse Assoc. of Science

Slidell Vocational School

Nursing
Practical

Atlantic Southeast Airlines ( Delta

Atlanta, Ga.
Certifications
Certified Case Manager
BLS - not currently active ( needs recertification)
Certified flight attendant
Community Involvement
Have volunteered in past with American RedCross for Relief of Flood Victims in L
ouisiana Blood Bank Volunteer
Susan B Komen Volunteer
Habitat for Humanity in Louisiana in the past Dougy Center in past
Easter Seals in Oregon Albertina Kerr Center in Oregon