Brittany M. Thomas
Winchester,VA
Summary
Registered Nurse with 7+ years of experience in utilization management, case management, and clinical documentation review across complex patient populations. Skilled in evaluating medical necessity, level of care, and resource utilization to ensure alignment with evidence-based guidelines and regulatory standards. Proven ability to collaborate with interdisciplinary teams, conduct clinical audits, and improve care delivery processes. Seeking a Utilization Management Coordinator role to support high-quality, cost-effective patient care.
Professional with strong background in nursing leadership, focused on delivering high-quality patient care and operational efficiency. Expertise in team collaboration, staff development, and resource management. Known for adaptability and achieving results in dynamic healthcare settings. Proficient in clinical skills, patient advocacy, and regulatory compliance.
Overview
10
10
years of professional experience
Work History
Nurse Manager – Hospice
Hospice of the Panhandle
09.2025 - Current
- Oversee clinical operations and evaluate care delivery to ensure appropriate utilization of healthcare services and resources
- Conduct clinical documentation audits to ensure accuracy, regulatory compliance, and alignment with quality standards
- Review patient care plans to assess medical necessity and appropriateness of services
- Collaborate with interdisciplinary teams to optimize care coordination and address gaps in service delivery
- Implement workflow improvements to enhance efficiency, compliance, and patient outcomes
- Serve as a clinical resource for staff on documentation standards, utilization principles, and best practices
- Managed 10 nurses and nursing activities in [Number]-bed hospital by providing comprehensive nursing guidance and maintaining outstanding patient satisfaction and care standards.
Registered Nurse – Hospice
Hospice of the Panhandle
11.2018 - 09.2025
- Managed a caseload of 15–22 patients, coordinating care and evaluating service effectiveness for complex populations
- Reviewed clinical documentation to ensure compliance with CMS, Medicare, and organizational standards
- Assessed care plans and interventions to support appropriate level of care and resource utilization
- Applied utilization management principles to evaluate medical necessity and avoid unnecessary services
- Identified workflow inefficiencies and collaborated on process improvements to enhance care coordination
- Provided telephonic support and education to patients and caregivers, supporting adherence to care plans
- Communicated with providers and interdisciplinary teams to ensure timely, appropriate care delivery
- Mentored junior nursing staff, enhancing clinical skills and fostering a supportive learning environment.
- Conducted comprehensive assessments to evaluate patient needs and adjust care strategies accordingly.
- Implemented quality improvement initiatives to enhance patient satisfaction and care delivery outcomes.
Certified Nursing Assistant (CNA)
Winchester Medical Center
11.2015 - 12.2016
- Delivered patient-centered care in a fast-paced acute care environment
- Monitored and reported changes in patient condition to support timely clinical decision-making
- Collaborated with nursing staff to develop individualized care plans for patients.
- Educated patients and families on health management and wellness strategies.
Education
Associate of Applied Science - Nursing
Lord Fairfax Community College
Certificate - Health Sciences
Lord Fairfax Community College
Middletown, VASkills
- Utilization Review & Medical Necessity Determination
- Clinical Documentation Review & Auditing
- Care Coordination & Case Management
- Regulatory Compliance (CMS, Medicare, Medicaid)
- Interdisciplinary Collaboration
- Workflow Evaluation & Process Improvement
- EMR/EHR Systems
- Quality Improvement & Data Analysis
- Utilization Management Principles
- Microsoft Office (Excel, PowerPoint, Outlook)
- HIPAA & Regulatory Compliance
- Staff supervision
- Critical thinking
- Quality improvement
- Patient education and advocacy
- Performance improvement
- Compliance oversight
Timeline
Nurse Manager – Hospice
Hospice of the Panhandle
09.2025 - Current
Registered Nurse – Hospice
Hospice of the Panhandle
11.2018 - 09.2025
Certified Nursing Assistant (CNA)
Winchester Medical Center
11.2015 - 12.2016
Associate of Applied Science - Nursing
Lord Fairfax Community College
Certificate - Health Sciences
Lord Fairfax Community College