Darlene Somoza
Kaiser Permanente
Fontana,CA
1
Certification
10
years of professional experience
Registered Nurse with 10+ years of experience in medical-surgical and surgical telemetry patient care. Seeking to transition clinical expertise
into appeals and medical necessity reviews. Experienced in assessing clinical documentation against care standards, identifying quality-of-care concerns, and triaging complex cases to ensure timely and appropriate resolution. Strong advocate for patients by coordinating with primary care providers, outside agencies, and multidisciplinary teams to support continuity of care and compliance with regulatory protocols.
Work History
Registered Nurse
4 Years 1 Month- Review patient charts and clinical documentation to assess care needs, identify risk factors, and determine appropriate care.
- Triage and prioritize patient care needs across a full caseload each shift, ensuring timely, appropriate response to urgent and escalating cases.
- Advocate for patients and families, ensuring understanding of diagnoses, treatment options, and rights within the care process.
- Coordinated with primary care providers and multidisciplinary teams to resolve complex patient care issues and escalate cases per established protocols.
- Trained and function as Relief Charge Nurse (Team Leader), directing shift-to-shift departmental operations and coordinating patient care while assessing complex situations and applying clinical judgment to determine appropriate action.
Registered Nurse
6 Years 11 Months- Conducted comprehensive patient assessments and chart reviews to plan, implement, and evaluate individualized care in accordance with regulatory standards.
- Advocated for patients throughout hospital stays, coordinating discharge planning and ensuring member rights and needs were addressed.
- Advised patients and caregivers on post-surgical management, discharge plan objectives, and safe medication use.
- Reviewed clinical documentation and care standards to train new nurses and ensure compliance with safety protocols.
Education
Bachelor of Science - Nursing
Skills
Bilingual — fluent
effective verbal and written clinical communication in English and Spanish
Medical necessity and clinical documentation review
Quality-of-care and risk identification
Case triage and prioritization
Patient and provider advocacy
Care coordination with Primary Care Physicians and care teams
Discharge planning
Complex case assessment and escalation
Interdisciplinary and interagency collaboration
Strong clinical judgment
Electronic Health Record proficiency / charting documentation on Epic
Accomplishments
- Rated exceptional in communication, adaptability, patient advocacy, and clinical judgment on annual evaluations
Certification
- Team Leader Training (Kaiser Permanente)
- American Heart Association (AHA) Basic Life Support (BLS)
- Just Culture Training
- Management of Assaultive Behavior (MAB)
Timeline
Registered Nurse
Kaiser Permanente
08.2022 - CurrentRead More
Registered Nurse
Huntington Hospital
08.2016 - 07.2023Read More
Azusa Pacific University
Bachelor of Science from Nursing
Read More