Christa Nenahlo
Utilization Review Nurse @Centene Corporation
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WORK HISTORY
Utilization Review Nurse @Centene Corporation
Conduct prior authorization and concurrent reviews for behavioral health services•Ensure accurate and timely clinical documentation for compliance and reimbursement•Analyze member data to improve utilization patterns and care outcomes•Collaborate with providers, medical directors, and interdisciplinary teams to enhance documentation and treatment planning•Educate providers and families on utilization processes•ASAM/Interqual•Remote and use of dual monitors
EDUCATION
Rasmussen University
Associate's degree, Registered Nursing/Registered Nurse
Capella University
Bachelor's degree, Registered Nursing/Registered Nurse
AAPC
Medical Coding CPC, Medical Insurance Coding Specialist/Coder
Fox Valley Technical College
Certified nursing assistant, Pre-Nursing Studies
Northeast Wisconsin Technical College
Nursing, Licensed Practical Nurse
ABOUT CHRISTA NENAHLO
Registered Nurse with over 10 years of experience across diverse clinical and managed care settings, including med-surg, long-term care, rehabilitation, oncology, cardiac, geriatric, behavioral health, pediatric, internal medicine, and IMCU. Currently working in a fully remote utilization review role with a strong foundation in medical record analysis, prior authorization, and concurrent review using InterQual criteria to support medical necessity and quality outcomes.Experienced in identifying documentation discrepancies, analyzing clinical data, and aligning ICD-10 and CPT coding with services rendered, bringing strong attention to detail and a compliance-focused mindset. Proven ability to work independently in a remote environment while collaborating effectively with interdisciplinary teams to support accurate, efficient, and high-quality outcomes.Bachelor of Science in Nursing with a compact RN license, allowing practice across multiple states.Interested in opportunities focused on clinical review, documentation integrity, quality improvement, and healthcare operations, where I can leverage my analytical skills and clinical expertise to support accuracy, efficiency, and improved patient outcomes.#RegisteredNurse #UtilizationReview #InterQual #RemoteRN #HealthcareQuality #CDI
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