Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Registered Nurse
Aya Healthcare
01.2022 - Current
Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations, managing care from admission to discharge.
Effectively communicated with physicians regarding patient needs, performance, medications and changes.
Completed initial assessments of patients and family to determine and address individual discharge needs. ·
Monitor the use of healthcare resources to achieve desired patient outcomes and decrease length of stay and resource utilization.
Utilized electronic medical record systems to store, retrieve and process patient data.
Case Manager
Paradigm Complex Care Solutions
08.2021 - 01.2022
Worked directly with medical professionals, using clinical expertise and proprietary data insights to facilitate care.
Maintain vital communication with everyone involved in a case: employers, insurers, and the injured worker.
Attend MD appointments to obtain medical updates, ongoing treatment plan and work on timeline for anticipated dates for release and return to work utilizing ODG.
Audited charts and reviewed clinical documents to verify accuracy.
Case Manager
Coventry Health Care
09.2012 - 08.2021
Worked directly with medical professionals, using clinical expertise and proprietary data insights to facilitate care.
Maintain vital communication with everyone involved in a case: employers, insurers, and the injured worker.
Attend MD appointments to obtain medical updates, ongoing treatment plan and work on timeline for anticipated dates for release and return to work utilizing ODG.
Audited charts and reviewed clinical documents to verify accuracy.
Denials Management Coordinator-Case Management
St. Vincent Heart Center Of Indiana
09.2006 - 02.2012
Reviewed all denial and concurrent accounts for categorization and level of appeal.
Maintained a clinical appeal process for all inpatient denials assuring that proper documentation is provided to support appeals of unauthorized inpatient days or days denied for lack of documentation.
Analyzed trends and data to inform decision-making and program development.
Assisted with development and implementation of training programs for staff.
Generated and maintained statistical data related to medical records.
Care Resource Coordinator-Case Management
Heart Institute Of Indiana
11.2004 - 09.2006
Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
Effectively communicated with physicians regarding patient needs, performance, medications and changes.
Completed initial assessments of patients and family to determine and address individual discharge needs. ·
Clinical Research Nurse Coordinator
Eli Lilly & Company
03.2004 - 11.2004
Worked with principal investigator and sponsors to facilitate daily trial activities and comply with research protocols.
Screened patient records, databases, and physician referrals to identify prospective candidates for research studies.
Collected data and followed research protocols, operations manuals, and case report form requirements.
Followed informed consent processes and maintained records.
Maintained compliance with protocols covering patient care and clinical trial operations.
Collected, evaluated, and modeled collected data.
Clinical Research Nurse
Kelly HealthCare
04.2001 - 03.2004
Completed OASIS assessments and implemented care plans for patient treatment based on physician medical regimens.
Educated family members and caregivers on patient care instructions.
Sustained quality standards by performing routine medication audits and upholding internal and industry best practices.
Communicated with healthcare team members to plan, implement and enhance treatment strategies.
Utilized electronic medical record systems to store, retrieve and process patient data.
Contract Certified Pharmacy Technician at Aya Healthcare (Broward Healthcare North)Contract Certified Pharmacy Technician at Aya Healthcare (Broward Healthcare North)
Travel Registered Nurse, Labor and Delivery at AMN Healthcare & AYA HealthcareTravel Registered Nurse, Labor and Delivery at AMN Healthcare & AYA Healthcare