Gloria Marquez
Shippensburg,PA
Summary
Specialist in prior authorization and clinical utilization review, recognized for driving efficiency and compliance improvements via comprehensive clinical documentation evaluation. Adept at coordinating interactions among insurance companies, providers, and patients to promote timely healthcare access. Knowledgeable in complex insurance policy navigation to support patient care initiatives. Dedicated to advancing healthcare delivery through effective resource management strategies.
Compiles patient responses and relays vital information to provider
Maintains service continuity by stepping in to support during periods of coworker absence
Strengthens team dynamics by assisting in task coordination and promoting shared achievements.
Coordinate efforts with pharmacists and patients to relay crucial medication details and foster adherence
Proficient in patient data oversight, optimizing workflows for medication prior authorization and appeal processes.
Overview
2024
2024
years of professional experience
Work History
LPN Office Nurse
UPMC
- Administered medications and treatments as prescribed by healthcare providers.
- Monitored patient vital signs, documenting changes and reporting concerns to physicians.
- Assisted in patient assessments, contributing to individualized care plans.
- Educated patients on health management and medication adherence strategies.
- Collaborated with interdisciplinary teams to coordinate patient care effectively.
- Maintained accurate electronic health records and ensured compliance with regulations.
- Trained new staff on office protocols and best practices for patient interaction.
- Developed strong rapport with patients and their families, fostering trust and open communication during sensitive medical situations.
- Improved patient experience by providing compassionate and attentive nursing services in a busy office setting.
- Assisted in maintaining a clean and organized office environment by performing housekeeping tasks such as disposing of biohazardous waste, sanitizing exam rooms, and restocking supplies as needed.
- Supported new employees during orientation periods by serving as a knowledgeable resource on office policies, procedures, documentation requirements.
- Served as a liaison between patients and healthcare providers, facilitating clear communication regarding treatment plans and expectations.
- Promoted patient safety and comfort during office visits by attentively monitoring their condition and promptly addressing any concerns or discomforts expressed.
- Managed inventory of medical supplies within the office, ensuring adequate stock levels while minimizing waste through effective organization strategies.
- Demonstrated adaptability by efficiently managing unexpected changes in schedules or staffing situations without compromising patient care quality or timeliness of services rendered.
- Provided health education to patients on various topics such as medication management, disease prevention, and self-care strategies.
- Conducted thorough assessments of vital signs, lab results, and physical status to identify potential concerns and inform appropriate interventions.
- Maintained accurate medical records for over 100 patients, ensuring timely updates and efficient communication between healthcare providers.
- Collaborated with interdisciplinary team members to develop individualized care plans for each patient based on their specific needs.
- Implemented infection control measures throughout the office environment to maintain a safe atmosphere for both staff members and patients alike.
- Participated in continuing education opportunities for professional development purposes while staying apprised of industry best practices and emerging healthcare trends.
- Completed paperwork and prior authorizations and scheduled appointments for patients.
- Educated patients and families on disease processes, medications and treatments.
- Contributed to ongoing quality improvement initiatives within the practice by offering insights based on clinical expertise and patient feedback analysis.
- Prepared and administered vaccines and medications, collected specimens and performed other patient care tasks to assist physician with examinations and procedures.
- Tracked, reviewed and monitored diagnostic test results and assisted in management of patient care between visits.
- Administered medications and injections to patients.
- Evaluated patient histories, complaints, and current symptoms.
- Reviewed patient history to verify conditions and current medications.
- Responded to patient requests with appropriate clinical and personal assistance.
- Provided patient education on health care issues and prescribed medications.
- Delivered emotional support to patients and families during challenging times.
- Coordinated patient transfers to other facilities.
- Helped patients complete bathing, dressing and eating.
- Helped long-term care residents with bathing, dressing, feeding, and other daily living activities.
LPN Field Nurse
UPMC
01.2020 - 12.2023
- Administered medications and treatments per physician directives to ensure patient compliance.
- Monitored vital signs and medical history to assess patient conditions effectively.
- Collaborated with interdisciplinary teams to develop personalized care plans for patients.
- Educated patients and families on health management, medication adherence, and preventive measures.
- Documented patient progress and care activities in electronic health records accurately.
- Mentored junior nursing staff on best practices in patient care and safety protocols.
- Implemented quality improvement initiatives that enhanced patient satisfaction and outcomes.
- Administered medications safely and effectively, preventing adverse reactions or complications.
- Maintained accurate documentation of patient assessments and treatments, ensuring compliance with regulatory standards.
- Dispensed and administered patients' medications following care plans and physician's orders.
- Educated patients and families on healthcare management strategies, promoting self-care and wellbeing.
- Delivered emotional support to patients facing challenging diagnoses or difficult treatments, fostering resilience during recovery processes.
- Coordinated with physicians to implement prescribed treatment plans, ensuring consistency in patient care delivery.
- Managed complex wound care for improved healing rates and reduced infection risk.
- Provided exceptional patient care by meeting physical, psychological, and overall care requirements to support daily living needs and independence.
- Improved patient outcomes by providing high-quality nursing care and timely interventions.
- Assessed patients by observing and recording vital signs, gathering specimens and reviewing lab test results.
- Reduced hospital readmission rates by closely monitoring patients'' progress and executing effective care plans.
- Implemented preventive measures that mitigated the spread of infections among vulnerable patient populations.
- Served as a liaison between patients and their healthcare providers, advocating for their needs while promoting informed decisionmaking.
- Organized and updated patient charts and records by reporting vitals, medical history, treatment plans, current medications, medication reactions, allergies and health status information.
- Enhanced patient satisfaction with compassionate, individualized nursing services tailored to their unique needs.
- Developed strong rapport with patients through clear communication skills that foster trust within the nurse-patient relationship.
- Utilized evidence-based practices in administering nursing care that aligned with industry best practices and promoted positive results.
- Complied with State Department of Health by completing required forms and entering in computer database.
- Contributed to interdisciplinary team collaboration for optimal patient care and treatment planning.
- Provided skilled nursing care for diverse populations, including geriatric, pediatric, and chronically ill patients.
- Collaborated with other nurses to provide seamless coverage during shift changes ensuring continuity of safe quality patient care.
- Worked closely with healthcare staff to devise personalized care plans adaptive to changing patient needs by detailing treatment methods, dosage and duration.
- Supervised and monitored LPNs and CNAs daily to provide essential training.
- Streamlined communication among healthcare team members, resulting in enhanced efficiency and collaboration.
- Complied with applicable legal requirements for HIPAA and documentation standards.
- Educated patients and caregivers on disease processes, medications, plans of care and individualized treatment plans.
- Observed confidentiality safeguards for all patient-related information.
- Reviewed all medicines to identify possible adverse reactions, significant side effects, drug allergies and contraindicated medications.
- Established realistic, measurable and observable goals consistent with patients' diagnosis.
- Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
- Supported diagnoses by taking blood samples from patients for laboratory testing.
- Administered medications and injections to patients.
- Responded to patient requests with appropriate clinical and personal assistance.
- Delivered emotional support to patients and families during challenging times.
- Helped patients complete bathing, dressing and eating.
LPN Charge Nurse
Fox Subacute
02.2016 - 01.2020
- Supervised daily nursing operations to ensure high-quality patient care.
- Coordinated staff assignments based on patient needs and skill levels.
- Administered medications and monitored patient responses effectively.
- Trained new nursing staff on protocols and best practices for patient safety.
- Conducted regular assessments to develop care plans in collaboration with healthcare teams.
LVN Floor Nurse
LifeCare
05.2016 - 06.2017
- Administered medications and treatments per physician orders, ensuring patient safety and compliance with protocols.
- Monitored vital signs and documented changes in patient conditions to inform care decisions.
- Collaborated with interdisciplinary teams to develop and implement individualized care plans for patients.
- Assisted in training new staff on proper nursing procedures and use of medical equipment.
- Streamlined documentation processes, improving efficiency in patient record-keeping systems.
- Led quality improvement initiatives focused on enhancing patient care standards and operational workflows.
- Participated in ongoing professional development opportunities to stay current on best practices in nursing care and maintain licensure requirements.
- Contributed to a safe working environment by following infection control protocols and accurately reporting incidents or concerns.
Education
No Degree - LVN
Rio Hondo College
Whittier, CASkills
Patient screening skills
Languages
Spanish
Native or Bilingual
Timeline
LPN Field Nurse
UPMC
01.2020 - 12.2023
LVN Floor Nurse
LifeCare
05.2016 - 06.2017
LPN Charge Nurse
Fox Subacute
02.2016 - 01.2020
LPN Office Nurse
UPMC
No Degree - LVN
Rio Hondo College