Abrille Gore

•Performed comprehensive needs assessments, addressing social determinants and aligning patients with benefits and support services.

•Developed and executed individualized care plans featuring targeted goals, monitoring, and structured outreach.

•Managed panels of high-risk and complex patients to reduce avoidable admissions and support safe transitions post-discharge.

•Conducted medication reconciliation and taught adherence techniques, including teach-back strategies.

•Utilized motivational interviewing to empower patient engagement in chronic disease self-management.

•Coordinated timely care transitions, referrals, and access to specialty services.

•Led advance care planning discussions and facilitated palliative care consultations when needed.

•Routinely analyzed data on care utilization to inform plan modifications and improve outcomes.

•Ensured documentation accuracy in EMR for interdisciplinary visibility and standardized care communication.

• Administered nursing care to cardiac patients undergoing diagnostic, therapeutic or emergency services.
• Assisted in diagnosis and treatment of conditions such as unstable angina, cardiomyopathy, coronary artery disease and cardiac dysrhythmia.
• Conducted initial assessments, documented findings in patient records and notified physicians of abnormal findings.
• Administered medication, pain management and analysis of patient responses to interventions to improve individual performance.
• Acted as a liaison between patients, families, and healthcare providers to ensure clear communication and understanding of treatment plans.
• Implemented individualized nursing interventions based on thorough assessments, resulting in increased patient satisfaction and overall wellbeing.

• Help patients by supervising care and treatments, leading patient assessments, creating personalized plans of care, targeting patient concerns, and offering the best solutions.
• View each patient with a strong sense of empathy, listen closely to their personal stories, and get to know each one’s physical, mental and emotional needs.
• See patients' progress and build rewarding relationships with them during stays that last from two to four weeks.
• Spend each day helping someone to regain control of their lives with the goal of being discharged from the hospital and back to their community, families, and friends.

• Coordinate patient-centered care plans to ensure medically appropriate, cost-effective care
• Perform comprehensive needs assessments, identifying barriers to care and addressing social determinants of health
• Collaborate with PCPs, specialists, and hospitalists to facilitate care transitions and chronic disease management
• Conduct medication reviews and patient education to improve adherence and prevent complications
• Document all communications and interventions in the electronic medical record (EMR)
• Assist patients with advanced care planning, including Advanced Directives

• Performed venipunctures, IV infusions, and port access procedures
• Conducted medication reviews and patient teach-back for proper regimen adherence
• Coordinated insurance authorizations and referrals to ensure timely access to treatment

• Provided comprehensive patient assessments and care coordination for diverse patient populations
• Educated patients and families on medication management and chronic disease self-care

• Managed patient triage and care coordination to ensure timely and appropriate treatment
• Assisted patients with understanding and accessing available healthcare resources