Dominique Nichole Dela Cruz
Miami,FL
Summary
Compassionate and resourceful Nurse with over nine years of clinical experience, from taking care of patients from underserved communities with limited resources. Proficient in delivering prompt solutions for patients behind a desktop computer miles away from the vulnerable patients with complex needs. Expertise in pre and post-operative care for orthopedic and spine surgeries aiding them to have the best quality of life while in recovery. Committed to collaborating with healthcare teams and adhering to facility specific protocols and polices to enhance patient standards of care.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Staff Nurse/Staff Relief Charge Nurse
Jackson Memorial Hospital
Miami, Florida
06.2022 - Current
- Utilizes the nursing process (assessment, planning, implementation, and evaluation) in applying nursing knowledge
- Documents all pertinent information regarding nursing care, care plans and observations
- Maintains a working knowledge of facility infection control procedures
- Recognizes, questions and reports significant patient findings and/or inconsistencies in medical/nursing orders/treatment regime
- Selects and individualizes/updates and adheres to clinical procedures/ protocols/standards/ clinical pathways, plans of care/narcotics policies and discharge/teaching plans
- Collaborates with different individuals of the healthcare team to ensure patient safety
- Recognizes/prioritizes overt/convert unit needs/problems/implements corrective action independently
- Acts as a preceptor to newly hired nurses in the unit
- Assumes charge nurse role when assigned/supervises designated personnel/takes action as needed
- Applies the use of logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions and approaches to problems
- Maintains HIPAA compliance at all times
- Follows and performs all related unit specific policies and procedures, as detailed on the unit specific competency check-list
- Utilizes job and unit specific equipment as required
- Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise)
- Provides care for different patient population but mostly the elderlies and adult patients with existing complex comorbidities, patients that has been in unfortunate situations requiring Orthopedic and Neurosurgical interventions
Covering Supervisor for OptumRx (Medicare Part D Plan)
United Health Group (Optum, UMR, OptumRx)
Manila, Philippines
01.2021 - 05.2022
- Managing a team, answer queries and concerns, monitor team’s adherence to daily schedule or any staffing concerns
- Provide timely coaching and opportunities in performance and behavior
- Data gathering and reporting; in terms of improvement opportunities, productivity, quality and perform internal audits
- Escalate critical information such as issues or challenges encountered
- Work side by side with different departments
- Perform any other administrative or non-administrative duties as assigned by any representative of the Company from time to time either through direct written order or by oral assignment
- Attend and participate in learning and development
Subject Matter Expert for OptumRx (Commercial Plan and Medicare Part D Plan)
United Health Group (Optum, UMR, OptumRx)
Manila, Philippines
01.2021 - 05.2022
- Overall team support and point person with anything related to: Interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases under the Pharmacy Benefits
- Conform with and supports department quality assurance and improvement guidelines
- Ensure that all team members are calibrated within the process
Case Management Utilization Nurse for UMR
United Health Group (Optum, UMR, OptumRx)
Manila, Philippines
12.2019 - 01.2021
- Consult physicians/providers with questions, interpret clinical guideline criteria, and render/review coverage determination for prior authorization cases
- Gather complex clinical information, coverage policy and criteria information and work within regulatory guidelines to make coverage determinations
- Organize workload, set priorities, complete assignments in a timely manner and utilize resources appropriately while complying with department program standards
- Perform all duties and functions in compliance with state and federal pharmacy laws and regulations
- Awarded the Sages of Clinical Services, amongst 120,000 Clinicians of UnitedHealth Group
Nurse Case Manager (DHN Level III and Heart Failure Program for Special Needs Plan for Medicare)
United Health Group (Optum, UMR, OptumRx)
Manila, Philippines
06.2018 - 12.2019
- Through telephonic interaction and use of the nursing process specifically to patients with Diabetes and Heart Failure with its co-morbidities
- Worked with members to ensure they make informed decisions using evidenced based care guideline and clinical judgement
- Helps members reform self-care, reduce cost, and improve quality of life through education, empowerment, support, and advocacy
- Coordinate with providers and various resources to help the member navigate the healthcare system better
Staff Nurse
Kabacan Medical Specialists Inc.
Kabacan, Philippines
06.2015 - 06.2018
- Provided professional nursing care in assigned unit
- Performed frequent patient evaluations including monitoring and tracking vital signs, performing procedures such as IV placement and administering medications
- Advocated and educated patients and their families on treatment plans to promote independence
- Administered medication, changes in wound dressings, and provided care for other treatment options
- Developed the day-to-day nursing care plans both in hospital, and to a discharge patient with proper discharge instructions and health teachings
- Assessed patient condition and relay pertinent patient information for any necessity of referral for a higher level of care
- Interdisciplinary communication within the health care team to achieve optimal health for the patients we served
- Cared for indigent people of the community with different spiritual background, including the vulnerable patient population with existing multiple comorbidities
Education
Bachelor of Science - Nursing
Trinity University of Asia-St Luke’s College of Nursing
Quezon City, Philippines03.2010
Skills
- Care plan implementation and care coordination
- Clinical documentation
- HIPAA protocol adherence
- Leadership
- Nursing assessment
- Medication administration
- Compassion
- Patient and family education
- Policy and procedure compliance
- Patient safety monitoring
- Clinical judgment
- Time management
- Communication
- Computer literacy
- Central line care, drain management, tracheostomy care
- Pain management
Certification
- Registered Nurse, California, 95348894
- Registered Nurse, Florida, RN9599945
- Registered Nurse, Texas, 933259
Certifications
- BLS, 05/31/26
- ACLS, 05/01/26
Languages
English
Professional
Tagalog
Professional
References
References available upon request.
Timeline
Staff Nurse/Staff Relief Charge Nurse
Jackson Memorial Hospital
06.2022 - Current
Covering Supervisor for OptumRx (Medicare Part D Plan)
United Health Group (Optum, UMR, OptumRx)
01.2021 - 05.2022
Subject Matter Expert for OptumRx (Commercial Plan and Medicare Part D Plan)
United Health Group (Optum, UMR, OptumRx)
01.2021 - 05.2022
Case Management Utilization Nurse for UMR
United Health Group (Optum, UMR, OptumRx)
12.2019 - 01.2021
Nurse Case Manager (DHN Level III and Heart Failure Program for Special Needs Plan for Medicare)
United Health Group (Optum, UMR, OptumRx)
06.2018 - 12.2019
Staff Nurse
Kabacan Medical Specialists Inc.
06.2015 - 06.2018
Bachelor of Science - Nursing
Trinity University of Asia-St Luke’s College of Nursing