Margaret Mitchell, RN MS CPUR Vice President of Review Operations

Margaret Mitchell

 

Ms. Mitchell has been at MedReview since 1999 and currently serves as the Vice President of Review Operations. Margaret has been instrumental in the development of several programs that are related to Health Utilization Management (HUM) and cost containment for MedReview clients.

Ms. Mitchell chaired MedReview’s URAC accreditation committee which achieved accreditation in HUM and Independent Review (IRO) simultaneously and she oversees the URAC accredited IRO program as well as the Retrospective Review, Cost Outlier and QARR/Hedis programs.  Ms. Mitchell was also instrumental in the development of Training manuals for IRO as well as the Policies and Procedures for IRO.

Ms. Mitchell has extensive background in both Utilization Management and Hospital Nursing Administration.  Prior to joining MedReview she was Director of Health Services for FPA Medical Management which consisted of seven Physician group practices where she developed the Utilization Management Program which services the members of the Physician Groups in the NY Metro area Westchester and Northern NJ.  She also directed the Health Services Department of New York Metro, Westchester and Northern New Jersey with a staff of 45 which consisted of Case Managers, Care Managers Referral and Data Coordinators.

Prior to FPA Ms. Mitchell worked at HIP of NEW YORK where she was the Director of Utilization Review. . She was responsible for the development and implementation of both an Inpatient and Outpatient Utilization Program for Manhattan, Bronx and Westchester.  The program consisted of both telephonic and on-site hospital nurses.  She was an active member in the development of an Asthma Intervention program, CHF and joint replacement programs.  During her tenure at HIP there were educational outreaches established with the NYC hospitals to help foster the concept of early discharge planning and the role of the UM nurse.

In addition to her Utilization Management background Ms. Mitchell has held Senior Nursing Administrative positions in several Acute Care Hospitals within the New York City area.

Ms. Mitchell is a member of the American Nurses Association, and the American Organization of Nurse Executives.  She is a Certified Professional in Utilization Review (CPUR) and in addition to her RN, she received an MS. in Health Administration from Long Island University.