Mariel Decena Email & Phone Number | In my present role as a Utilization Management Nurse, I am responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Adventist Health employees and their dependents with the right care at the right place at the right time. I provide daily review and evaluation of members that require hospitalization. I also provide medical necessity reviews for outpatient services that require prior authorization. I am involved in repatriation and redirection of employees and their dependents who fall out of network or who seek services outside of the Adventist Health system. I am knowledgeable in Interqual criteria and Milliman Care Guidelines. In addition, I have worked for reputable health plans such as, Molina Healthcare, Care 1st Health Plan and Healthcare Partners. My role was to ensure appropriate and timely movement through the various levels of care in the inpatient setting and assured that services were provided at the most cost effective level needed to meet the client’s medical needs while maintaining safety and quality. Other duties included discharge planning, such as coordinating skilled nursing facility transfers, arranging home health and social services, as well as setting up transportation and durable medical equipment in order to maintain continuity of care. At Molina and Care1st Health Plan, I was given the opportunity to orient utilization management nurses who were newly hired. Currently, at Adventist Health, I am a part of the interview panel for potential candidiates and have been given the responsibility to train new UM nurses. I have excellent communication skills and can maintain a large workload with a high degree of competency. I have the ability to lead, communicate, problem solve, and work effectively with people. I have excellent organizational skill with the ability to manage multiple priorities.

Mariel Decena

In my present role as a Utilization Management Nurse, I am responsible for inpatient medical necessi...
Roseville, California, United States

*50 free lookup(s) per month.

No credit card required.

Mariel Decena’s Email mariel.decena@molinahealthcare.com

Mariel Decena’s Phone Numbers

Get MARIEL’s Phone Number (For Free)

Social Media

Mariel Decena’s Location Roseville, California, United States

Mariel Decena’s Current Industry Adventist Health

Mariel Decena’s Prior Industry Molina Healthcare | Care1st Health Plan Yes Its All About You | Healthcare Partners | Verdugo Hills Hospital | College Vista Convalescent Hsp

Not the Mariel Decena you were looking for?

Find accurate emails & phone numbers for over 700M professionals.

Work Experience

Adventist Health

Utilization Management RN

2016-01-01T00:00:00.000Z - Present

Molina Healthcare

RN Care Review Clinician III

2015-02-01T00:00:00.000Z - 2016-01-01T00:00:00.000Z

Care1st Health Plan Yes Its All About You

Utilization Review LVN

2008-09-01T00:00:00.000Z - 2012-10-01T00:00:00.000Z

Healthcare Partners

Inpatient Case Manager, LVN

2006-05-01T00:00:00.000Z - 2008-05-01T00:00:00.000Z

Verdugo Hills Hospital

LVN

2004-04-01T00:00:00.000Z - 2005-08-01T00:00:00.000Z

College Vista Convalescent Hsp

LVN

2003-08-01T00:00:00.000Z - 2004-03-01T00:00:00.000Z

Skills

No Skills Available

Languages

No Languages Available

FAQ About Mariel Decena

Mariel Decena is located at
Roseville, California, United States

Mariel Decena is a In my present role as a Utilization Management Nurse, I am responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Adventist Health employees and their dependents with the right care at the right place at the right time. I provide daily review and evaluation of members that require hospitalization. I also provide medical necessity reviews for outpatient services that require prior authorization. I am involved in repatriation and redirection of employees and their dependents who fall out of network or who seek services outside of the Adventist Health system. I am knowledgeable in Interqual criteria and Milliman Care Guidelines. In addition, I have worked for reputable health plans such as, Molina Healthcare, Care 1st Health Plan and Healthcare Partners. My role was to ensure appropriate and timely movement through the various levels of care in the inpatient setting and assured that services were provided at the most cost effective level needed to meet the client’s medical needs while maintaining safety and quality. Other duties included discharge planning, such as coordinating skilled nursing facility transfers, arranging home health and social services, as well as setting up transportation and durable medical equipment in order to maintain continuity of care. At Molina and Care1st Health Plan, I was given the opportunity to orient utilization management nurses who were newly hired. Currently, at Adventist Health, I am a part of the interview panel for potential candidiates and have been given the responsibility to train new UM nurses. I have excellent communication skills and can maintain a large workload with a high degree of competency. I have the ability to lead, communicate, problem solve, and work effectively with people. I have excellent organizational skill with the ability to manage multiple priorities.

Mariel Decena currently works in the Adventist Health |

No Languages Available

Mariel Decena has prior
experience in the following industries:
Molina Healthcare | Care1st Health Plan Yes Its All About You | Healthcare Partners | Verdugo Hills Hospital | College Vista Convalescent Hsp

Mariel Decena has the following professional experience:
Adventist Health | Molina Healthcare | Care1st Health Plan Yes Its All About You | Healthcare Partners | Verdugo Hills Hospital | College Vista Convalescent Hsp