Danny A. Sellers
Champlin,MN
Summary
Experienced Registered Nurse with a diverse professional background encompassing appeals review, utilization management, pediatric critical care, nursing supervision, leadership, education, military service, and business ownership. Proven ability to lead and serve effectively in high-pressure environments while maintaining a patient-centered approach. Extensive experience reviewing complex clinical cases, evaluating medical necessity, collaborating with interdisciplinary teams, and providing care to critically ill pediatric patients. Recognized for strong clinical judgment, attention to detail, decisive decision-making, and the ability to work independently while delivering high-quality outcomes.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Appeals Nurse Consultant
Aetna / CVS Health
06.2025 - Current
- Conduct comprehensive reviews of member appeals, reconsiderations, and grievance cases.
- Evaluate medical records, treatment plans, and supporting documentation to determine medical necessity and policy compliance.
- Apply evidence-based clinical guidelines, regulatory requirements, and company policies to support appeal determinations.
- Prepare detailed clinical summaries and recommendations for Medical Directors.
- Analyze complex clinical information and exercise sound clinical judgment in high-impact decisions.
- Work independently while maintaining productivity, quality, and turnaround standards.
- Advocate for appropriate patient care while balancing regulatory and organizational requirements.
Utilization Management Nurse Consultant
Aetna / CVS Health
05.2022 - 06.2025
- Reviewed individual medical cases to ensure patients received appropriate and effective care.
- Evaluated treatment plans against established guidelines and organizational policies.
- Balanced patient care needs with cost-effective healthcare delivery.
- Analyzed large volumes of clinical data and documentation to support authorization decisions.
- Collaborated with providers and interdisciplinary teams to optimize patient outcomes.
- Demonstrated strong analytical abilities, attention to detail, and independent decision-making skills.
Travel Registered Nurse – Pediatric Intensive Care Unit (PICU)
Cross Country Travel Corp
08.2019 - 02.2022
- Provided primary nursing care for critically ill pediatric patients at healthcare facilities throughout the United States.
- Collaborated with physicians, respiratory therapists, pharmacists, and interdisciplinary care teams.
- Performed comprehensive patient assessments and developed nursing interventions for complex patient conditions.
- Supported family-centered care initiatives through collaboration with patient support groups and families.
- Adapted quickly to new healthcare environments while maintaining exceptional standards of care.
Pediatric Intensive Care Unit (PICU) Registered Nurse
Children's Minnesota
05.2006 - 07.2019
- Delivered specialized care to critically ill pediatric patients in a high-acuity intensive care environment.
- Collaborated with physicians and interdisciplinary teams to develop and implement treatment plans.
- Served on the PICU Unit Council, contributing to operational improvements and unit leadership initiatives.
- Functioned as an American Heart Association Instructor teaching BLS, ACLS, PALS, and PEARS courses.
- Developed and implemented an in-unit Pediatric Advanced Life Support (PALS) curriculum for PICU nurses.
- Mentored and educated nursing staff to enhance clinical competency and improve patient outcomes.
- Participated in quality improvement and patient safety initiatives.
Education
Associate of Applied Science - Professional Nursing
Central Lakes College
Brainerd, MN01-1992
Skills
- Appeals & Grievance Review
- Utilization Management
- Leadership & Team Development
- Nursing Supervision
- Regulatory Compliance
- Healthcare Education & Training
- Critical Thinking & Analysis
- Independent Decision-Making
Certification
- Registered Nurse (RN)
- Licensed in:
- Minnesota (MN)
- California (CA)
- Texas (TX)
- Certifications
- Advanced Cardiac Life Support (ACLS)
- Pediatric Advanced Life Support (PALS)
- Basic Life Support (BLS)
- Pediatric Emergency Assessment, Recognition and Stabilization (PEARS)
- American Heart Association Instructor
Timeline
Appeals Nurse Consultant
Aetna / CVS Health
06.2025 - Current
Utilization Management Nurse Consultant
Aetna / CVS Health
05.2022 - 06.2025
Travel Registered Nurse – Pediatric Intensive Care Unit (PICU)
Cross Country Travel Corp
08.2019 - 02.2022
Pediatric Intensive Care Unit (PICU) Registered Nurse
Children's Minnesota
05.2006 - 07.2019
Associate of Applied Science - Professional Nursing
Central Lakes College
LEADERSHIP EXPERIENCE
- Throughout my career, I have served in a variety of roles including:
- Appeals Nurse Consultant
- Utilization Management Nurse Consultant
- Nursing Supervisor
- Pediatric Critical Care Nurse
- Charge Nurse
- Healthcare Educator
- American Heart Association Instructor
- Unit Council Member
- Military Service Member
- Business Owner and Operator
- Team Leader and Supervisor
- These experiences have strengthened my ability to lead teams, communicate effectively, mentor staff, solve problems under pressure, and deliver exceptional service in highly stressful environments.
PROFESSIONAL STRENGTHS
- Leadership
- Clinical Assessment
- Organization
- Decisiveness
- Empathy
- Attention to Detail
- Critical Thinking
- Independent Work Ethic
- Team Collaboration
- Communication
- Conflict Resolution
- Patient Advocacy
- Professional Motto:
- Dedicated to delivering exceptional patient-centered care, applying sound clinical judgment, and leading with integrity, compassion, and accountability.