Jennifer Bravo
Porterville,CA
Summary
Highly motivated employee with 23 years of experience in the medical field. Skilled in both LVN and RN roles, with a proven track record of delivering exceptional patient care. Well-rounded nurse with extensive knowledge across various fields. Strong work ethic, adaptability, and exceptional interpersonal skills enable effective unsupervised work and quick mastery of new skills.
Overview
16
16
years of professional experience
Work History
Grievance and Appeals RN
Elevance Health
Remote, CA
06.2024 - Current
- Pre/Post/Expedited Appeals for medication, procedure, and inpatient stay authorization.
- Reviewed patient medical records to determine if requested services are medically necessary and appropriate for the diagnosis.
- Analyzed clinical data submitted by physician offices in order to approve or deny prior authorization requests.
- Researched complex cases that require additional information before determining approval and denial status.
- Prepared detailed reports related to utilization management activities such as pre-authorization reviews, appeals, denials.
- Assessed the appropriateness of requesting provider's treatment plans based on clinical review criteria set forth by the payer or regulatory bodies.
- Adhered strictly to HIPAA regulations pertaining to protected health information when handling confidential documents related to patient care.
Appeals RN
Elevance Health/ Contracted w/ BCForward
Remote, CA
05.2023 - 02.2024
- Reviewed Post Service appeals submitted by providers to ensure accuracy and compliance with policies.
- Ensured all documents are stored securely according to HIPAA standards.
- Worked closely with internal teams such as Medical Directors, Customer Service Representatives, Provider Relations staff., in order to facilitate successful resolution of appealed claims.
- Analyzed medical records to determine if further information was needed in order to process appeals.
- Coordinated with internal departments to ensure timely resolution of appeals.
- Write up summaries for appeal review
Clinical Quality Improvement/ Covid Call Center
Optum/ Contracted w/ Iconma&Ivory
Remote, CA
11.2020 - 04.2023
- Investigated medical and surgical potential quality issues, patient saftety events, and sentinel/serious reportable saftey events.
- Conducted timely reviews of electronic medical records.
- Preparation of written case summaries with recommendations for further actions as necessary.
- Collaborated with Medical Directors on complex care identified in PQIs/SEs/SREs as needed
- With Covid quality, monitored workplace activities to determine compliance with safety regulation and standards. Investigated incidents, determining root causes, and implementing corrective actions and conducted safety audits and inspections. Oversight nurse for Covid testing and vaccine sites.
RN Staff Nurse/PRN
Sierra at the Lake
Springville , CA
04.2019 - 12.2019
- Assessed, monitored and documented patient vital signs, medical history and physical condition.
- Provided direct patient care, including administering medications and treatments according to physician orders.
- Assessed patient needs, developed individualized plans of care, and implemented treatments accordingly.
- Monitored and evaluated the effectiveness of medications and treatments administered to patients.
- Performed wound dressing changes, catheterizations, tube feedings, assessments of physical condition, and other nursing interventions as required.
- Collaborated with physicians to develop treatment plans that addressed the medical needs of each resident.
Wound Care Nurse
Sierra View Medical Center
Porterville, CA
04.2015 - 11.2017
- Assessed and monitored patient's wound healing progress.
- Conducted wound care treatments such as debridement, dressing changes, irrigation and application of topical medications.
- Provided education to patients and families on wound care management techniques.
- Administered topical treatments such as topical antibiotics, hydrogels, alginates, foams dressings., as prescribed by physicians.
- Reported any changes or abnormalities in a patient's wound status to attending physician or other healthcare staff members.
- Assisted with surgical procedures related to wound care such as skin grafts or flap closures.
- Consulted with physicians regarding appropriate dressing materials for various types of wounds.
Medical-Surgical RN
Sierra View Medical Center
Porterville, CA
06.2008 - 04.2015
- Provided patient education on disease processes, medications, treatment plans, diet and lifestyle modifications.
- Monitored vital signs, administered intravenous fluids, medications, blood transfusions and other treatments according to physician orders.
- Performed wound care including dressing changes, debridement and irrigation; monitored healing progress.
- Provided emotional support to patients and families by listening to their concerns.
- Ensured that all safety protocols were followed when providing patient care services.
- Evaluated effectiveness of interventions through observation of clinical indicators such as pain level, breathing rate or laboratory values.
Education
Associate of Science - Nursing
Porterville College
Porterville, CA06-2008
Porterville College
Porterville, CASkills
- Quality Improvement
- Wound Care
- Investigate/Chart abstraction
- Clinical Guidelines(MCGs)
- Nurse Assessments
- Patient Safety
- Telephone Etiquette
- Patient Education
- Critical Thinking
- Computer Skills
- EMR Systems
- Care Plan Development
- Clinical best practice
- Case Management
Languages
Spanish
Elementary
Timeline
Grievance and Appeals RN
Elevance Health
06.2024 - Current
Appeals RN
Elevance Health/ Contracted w/ BCForward
05.2023 - 02.2024
Clinical Quality Improvement/ Covid Call Center
Optum/ Contracted w/ Iconma&Ivory
11.2020 - 04.2023
RN Staff Nurse/PRN
Sierra at the Lake
04.2019 - 12.2019
Wound Care Nurse
Sierra View Medical Center
04.2015 - 11.2017
Medical-Surgical RN
Sierra View Medical Center
06.2008 - 04.2015
Associate of Science - Nursing
Porterville College
Porterville College