Shannon Carter

Shannon Carter

UMNC at Aetna

Location
Greensboro/Winston-Salem, North Carolina Area
Industry
Insurance

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Shannon Carter's Overview

Current
  • Utilization Management Nurse Consultant at Aetna Insurance
  • UMNC at Aetna
  • RN ICU at Morehead Memorial Hospital2005
Past
Education
  • Forsyth Technical Community College
  • Rockingham County High School
Connections

0 connections

Shannon Carter's Summary

I am looking to work from home continuing my career as a Utilization Management Nurse.

Specialties

Excellent in muti tasking, computers (different applications), Milliman Care Guidelines, committees

Shannon Carter's Experience

Utilization Management Nurse Consultant

Aetna Insurance

Public Company; 10,001+ employees; AET; Insurance industry

January 2010Present (4 years 10 months)

As a UMNC I assess clinical and voice mails sent by hospitals about patients, with the assistance of MCG to assess for medical necessity. I certify days in the hospital and also deny per my clinical judgment and the use of the MCG guidelines. Everything that I do is documented in our system and confidential. I also send information and my suggestions to our Medical director when I am unable to reach a decision per MCG guidelines about certifying or denials. I also help with discharge planning for the patient to find in-network facilities, such as SNF's, Home health, etc. I work with numerous states. I am also on the workflow committee, to help come up with easier ways for new and seasoned UMNC's to do their jobs.

UMNC

Aetna

Public Company; 10,001+ employees; AET; Insurance industry

2010Present (4 years)

Nonprofit; 201-500 employees; Hospital & Health Care industry

May 2005Present (9 years 6 months)

2007
I worked in the ICU where I worked with very sick patients. I have experience as a charge nurse and the code team. I worked with various medication drips, pushes, vents, trachs, chest tubes, A-lines, telemetry, etc. In the ICU I was exposed to various patients from overdoses, surgical orthopedic, surgical GI, strokes, heart attacks, etc. I was also on the Quality Assurance Committee.
Forsyth Medical Center2004-2005
I worked as a staff nurse on the Special Cardiac Unit, working with open heart surgery patients. This is where I had my first experience with telemetry, various cardiac drips, chest tubes, external pacing, etc.

Disease Management Nurse

Accordant Health Services

Privately Held; 201-500 employees; Health, Wellness and Fitness industry

November 2007May 2010 (2 years 7 months)

Disease Management Nurse2007-2010
As a Disease management nurse I was able to work from home. I work with rare diseases: RA, MS, Seizures, Parkinson's, Myasthenia Gravis, Crohn's and more. I would call the member and talk with them about the disease, such as understanding the disease, medication, symptoms, problems that they may have, etc. I was on a phone queue during my shift to take incoming calls. I was assigned not only to my task but I was also assigned to the company task bucket and High risk task bucket. Everything I did was documented in our system and confidential. I was licensed in every state except Hawaii and Alaska.

Shannon Carter's Education

Forsyth Technical Community College

ADN, Nursing

20012004

Rockingham County High School

Diploma

19911995

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