Janeth Fernandez
About Janeth Fernandez
Janeth Fernandez is a Nurse Clinical Analyst with extensive experience in healthcare, currently serving as a SIU Lead Investigator at Molina Healthcare Inc. in Long Beach, California, and previously worked at Horizon Blue Cross Blue Shield of New Jersey for 18 years.
Work at Avalon Healthcare Solutions
Janeth Fernandez has been employed at Avalon Healthcare Solutions as a Nurse Clinical Analyst since 2019. In this role, she focuses on validating enforcement strategies to ensure compliance with medical policy intent and automated decision-making processes. Her responsibilities include providing clinical and coding expertise in analyzing lab claim trends, which helps identify potential root causes and recommend improvements.
Current Role at Molina Healthcare Inc
Since 2018, Janeth Fernandez has served as the Siu Lead Investigator at Molina Healthcare Inc in Long Beach, California. In this position, she has been responsible for investigating and analyzing claims to ensure compliance with healthcare regulations. Her experience in this role spans over six years, contributing to the organization's efforts in maintaining integrity in healthcare services.
Previous Experience at Horizon Blue Cross Blue Shield
Janeth Fernandez worked at Horizon Blue Cross Blue Shield of New Jersey as a Utilization Review Analyst III from 1996 to 2014. Over her 18-year tenure, she gained extensive experience in utilization review processes, contributing to the efficient management of healthcare services and ensuring that patients received appropriate care.
Educational Background in Nursing
Janeth Fernandez earned her Bachelor of Science degree in Nursing from Felician University. This educational foundation has equipped her with the necessary skills and knowledge to excel in her nursing and clinical analysis roles within the healthcare industry.
Health Care Administration Studies
Janeth also studied Health Care Administration at Seton Hall University from 2006 to 2008. This program provided her with insights into the administrative aspects of healthcare, complementing her clinical expertise and enhancing her ability to navigate complex healthcare environments.