Melissa Harper, BSN, RN, CCM, Case Management and UR Consultant, is currently Case Management Director at Taylor Regional Hospital in Campbellsville, Kentucky. She served as Director of Case Management and Utilization Review for another community hospital in Kentucky for eight years, with a total of fourteen years of progressive hands-on experience in Case Management & Utilization Review.

Melissa earned the designation of Certified Case Manager, capitalizing upon her skill sets, knowledge., corecompetencies and passion for Case Management and UR to lead her staff and department to achieve operational excellence. She prides herself on ensuring a strong collaborative working relationship between Case Management and Utilization Review and the practicing physicians in the hospital.

Melissa possesses a practical understanding of and ability to effectively interpret and apply Millman Care Guidelines and InterQual Guidelines to hospital cases, review the medical record and determine and recommend the most clinically relevant optimal level of care to the physician. She is a Certified InterQual instructor.

Given Melissa’s experience in Clinical Documentation Improvement and clinical validation, she can recognize opportunities for enhancing the physician’s documentation, working with physicians to seek additional relevant clinical information to be included in the record to better tell and describe the patient story, information that can be utilized to make a compelling case to the payer for inpatient level of care.