Lynnette J. Wakefield has over 20 years of nursing experience including 10 years working as a prior authorization nurse reviewing cases for Tricare, AHCCCS, and Medicare. She has extensive experience and expertise in AHCCCS, Medicare, and clinical criteria. While working as a prior authorization manager and supervisor, she created tools to increase productivity and consistency for reviews. She resigned from her management roles to focus solely on production nurse duties where she exceeded quotas and accuracy standards.

1. Lynnette J. Wakefield RN, BSN
10110 E. Hay Loft Road
Florence, AZ 85132
H 520-233-6114
C 480-225-9675
Email: LWakefieldRN@yahoo.com____________________________________________________
Dear Sir or Madam,
I have been a nurse since 1999. I worked as an LPN from 1999 until 2009 when I
graduated from the University of Phoenix with my BSN. I was a part of the first
graduating class of the LPN to BSN bridge at the University of Phoenix. In the clinical
setting I have worked in the long-term care, sub-acute and medical-surgical settings. I
began my career in managed care at TriWest Healthcare Alliance as a prior
authorization nurse and telephonic utilization review nurse. When my husband and I
moved to Florence, AZ I moved into the AHCCCS and SNP arena, Over the years I
have become very well versed in AHCCCS, Medicare, InterQual and Milliman Criteria. I
have memorized AHCCCS, Medicare National Coverage Determination and Local
Coverage Determination Criteria and Policies. I am the resource person for all questions
regarding AHCCCS and Medicare covered benefits and indications of coverage. I have
created tools to increase productivity and consistency for nurse and medical director
review. I have also created tools for denial letters for productivity and consistency, the
letters I created meet the eighth (8th) grade language Medicare requirement. All of my
tools are CPT code driven for ease of use. In the AHCCCS arena I created a tool for
denial letters that met the sixth (6th) grade level requirement. My letters passed an
AHCCCS letter audit for two (2) quarters. The tool I created was used after I resigned
my position.
I have 6 years experience as a long-term care floor nurse.
I have 3 years in the sub-acute setting, 8 months working the medical-surgical floor.
I also have 10 years prior authorization nurse review and concurrent /utilization review
for Tricare, AHCCCS, and Medicare.
At one-time I was the prior authorization manager, supervisor and prior authorization
production nurse. I resigned my position as manager/supervisor over the prior
authorization nurses and representatives and resumed my roll as prior authorization
production nurse. I found all three roles to be too demanding, I was replaced by a prior
authorization nurse manager and a prior authorization representative manager. I broke
production nurse review production quotas and accuracy standards.
Kind Regards,
Lynnette J. Wakefield, RN, BSN,CPUR