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