Rofiat Adeniran
Parma,Ohio
Summary
●Experienced and reliable Utilization Review Nurse /Case Manager .
●Knowledgeable in admissions and stay reviews.
●Hardworking and proactive.
●Recognized consistently for performance excellence.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Registered Nurse, Medical-Surgical Unit (PRN)
Cleveland Clinic
02.2024 - Current
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
Utilization Review Nurse/RN Case Manager
Encompass Health Rehabilitation Hospital
08.2021 - 11.2023
- Conduct admission reviews, concurrent reviews and retrospective reviews around 15-30 per day. Report avoidable delays based on medical records review.
- Identify inappropriate utilization of services/settings through application of establish clinical criteria using InterQual and CMS guidelines for medical necessity.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Review if provided CPT codes for planned outpatient surgery are included in Medicare Inpatient list and if insurance authorization has been provided .
- Discuss with physician advisor if review criteria are met or not and if there is concern about level of care based on complexity of patient’s conditions or questions about quality of care.
- Communicate with payers in regards to clinical information to ensure support of medical necessity/level of care to successfully avoid or reverse denials.
- Completed initial assessments of patients and family to determine and address individual home care needs. ·
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
Psych Registered Nurse
Mediko (Richmond Justice Center) - Corrections
03.2021 - 10.2022
- Enhanced therapeutic communication skills by actively listening and empathizing with patients during their recovery process.
- Collaborated with community mental health resources to connect patients with long-term support services, improving their overall quality of life.
- Educated families about mental health conditions and coping strategies, strengthening support systems for long-term recovery.
- Facilitated group therapy sessions for patients, promoting emotional healing and personal growth.
- Decreased the risk of patient self-harm through continuous monitoring and creating a safe environment.
Education
Bachelor of Science - Nursing
Capella University
Minneapolis, MN06.2022
Associate of Science - Nursing
Capella University
Cleveland, OH12.2020
Skills
- Proficient in InterQual screening tool
- Point of Entry Utilization Review nurse
- Case Manager
- BSN with 4 years of experience working at different specialties like Medical Surgical/Tele, Stroke unit, Psychiatric,Step down Unit(float)
- Data Collection,Documentation and Charting
- Patient care planning
- Written and verbal communication skills
- Hospice Care
- Organizational skills
Additional Information
LICENSURE
●Registered Nurse
State of Virginia
License Number 0001302754
Expiration Date 05/31/2025
Compact Status Multistate
Certification
Basic Life Support (BLS).
Expiration:04/2025.
Advanced Cardiovascular Life Support (ACLS).
Expiration:04/2025.
NIH Stroke Certification (NIHSS).
Expiration:02/2025
Timeline
Registered Nurse, Medical-Surgical Unit (PRN)
Cleveland Clinic
02.2024 - Current
Utilization Review Nurse/RN Case Manager
Encompass Health Rehabilitation Hospital
08.2021 - 11.2023
Psych Registered Nurse
Mediko (Richmond Justice Center) - Corrections
03.2021 - 10.2022
Bachelor of Science - Nursing
Capella University
Associate of Science - Nursing
Capella University
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