Crystal Monio, RN, BSN, ACM-RN

Experience

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  CHRISTUS Health

  Jun 2004 - Apr 2005

  Staff Registered Nurse

  Provided quality patient care to adult and pediatric patients on a 36-bed medical/surgical unit. Supervise and delegate duties to Licensed Vocational Nurse and Certified Nurse Aides. Administered chemotherapy, monitored labs, therapeutic drug levels, and equipment; performed assessments, treatments, and documentation.

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  HCA

  Apr 2005 - Oct 2008

  Staff Registered Nurse

  Served as a staff/charge nurse caring for patients suffering with cancer.Responsible for managing, supervising and assisting the nursing staff, including providing administrative support and patient care.

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  US Oncology

  Dec 2008 - Aug 2012

  Infusion Nurse

  Provided professional nursing care for oncology/hematology patients in an outpatient setting. Administered chemotherapy, hydration, and other medications as ordered by physician. Assessed patients for changes in condition, including but not limited to abnormal labs, x-rays, scans, drug reactions, symptom management, and initiated appropriate action. Assessed patient/family needs and provided teaching and other instructional material about medications and plan of care.

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  Optum

  Aug 2012 - Aug 2014

  Telephonic Case Manager

  Responsible for clinical operations and medical management activities across the continuum of care from assessing and planning to implementing, coordinating, monitoring and evaluating for members with cancer and other comorbids. Assist members with treat decision support and connects members with quality healthcare providers. Utilize written criteria to prospective and concurrent review of chemotherapy and outpatient services for oncology patients.Key Accomplishments● Recognized by leadership as top performer within the organization.● Consistently received high rating on consumer satisfaction surveys.● Served as a subject matter expert to peers regarding specific processes/procedures for the client that I supported. Show less

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  Lash Group

  Aug 2014 - Jul 2015

  Telehealth Nurse Educator

  Responsible for the education and management of patients with multiple sclerosis. Utilize motivational interviewing to support patients taking the Aubagio for multiple sclerosis. Provide education and guidance regarding insurance coverage and financial assistance options. Responsible for reporting Adverse Events to medical information in a timely manner.Key Accomplishments● Improved the amount of time staff spent looking for job aides by providing training on how to use OneNote.● Became a mentor within 6 months. Show less

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  Baylor Scott & White Health

  Jul 2015 - now

  Responsible for ensuring positive communication of UR process with staff, UR Medical Directors, and facility administration. Assist employees with making timely and appropriate decisions for favorable outcomes on concurrently denied cases. Initiate necessary actions regarding reinforcement of new policies, procedures, and programs to ensure continual improvements in effectiveness, quality, results, profitability, productivity and efficiency of the UR operation within 24 hours of a known concern. Responsible for performing quality audits monthly for all staff. Show less Responsible for providing clinical review against standard criteria for the purpose of evaluating the medical necessity for hospitalization. Provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent, and retrospective reviews. Intervenes when potential denials are determined and facilitate appeals when concurrent denials are received. Partners with physicians related to the appropriateness of admission and the prevention of denials. Show less

  • Denial Resource Center Supervisor

    May 2022 - now

  • Utilization Review Supervisor

    Nov 2017 - May 2022

  • Utilization Review Nurse

    Jul 2015 - Nov 2017