Marcella Janes

Background

About Marcella Janes

Utilization Management Nurse with extensive clinical background, skilled in critical thinking, decision making, problem solving, patient advocacy and care coordination for cost effectiveness. My combined years of clinical and managed care experience bring value to organizations, patients and families. My talents include care planning for whole person care, precision utilization management, professional communication and collaborative skills, expert medical necessity review process knowledge, application of decision support criteria (InterQual and Milliman), integration of evidence based practices and policy to accurately identify gaps and barriers to care and determine medical appropriateness. I possess excellent leadership, mentoring, precepting and clinical auditor skills. I believe by concentrating on clinical excellence and compassionate care we may achieve better health outcomes at lower costs in commercial and medicaid/medicare populations.