Jessica Shuman
Rio Rancho,NM
Overview
31
31
years of professional experience
Work History
Oncology Nurse
Presbyterian Rust Medical Center
Rio Rancho, NM
11.2018 - Current
- Certified Chemotherapy RN. Duties include care of patients on night shift from 1900 to 0730.
- Assessment of each patient, development of careplan, and implementation of careplan.
- Duties include monitoring of vital signs every 4 hours, medication administration, and bedside care.
- Notification to MD for any abnormal vitals signs including NEWS2 score 7 or above.
- Constant evaluation for signs or symptoms of sepsis.
- Chemotherapy administration via peripheral IV, PICC, Port-acath, subcutaneous or oral routes per orders and unit protocol.
- Emergency treatment for chemotherapy reactions.
- Monitoring of neurological status during and after chemotherapy administration.
- Frequent blood transfusions, antibiotic infusions, and administration of other medications.
- Oncology care extends from the physical to mental, psychological and social aspects of cancer treatment.
- Provide support of patient and family in stressful and difficult situations.
- Also includes end-of-life care when active treatment has stopped and patient is kept comfortable during the dying process.
- Team approach to assist all patients on unit to maintain safety and comfort during active treatment.
- Education of patient and families regarding medical condition, treatment plan and process.
- Documentation of all activities.
Utilization Review Nurse, Department of Case Management
Sandoval Regional Medical Center
Rio Rancho, NM
04.2015 - 07.2018
- Review clinical information for all patients admitted to facility utilizing Interqual Criteria to determine medical necessity of admission, appropriate status of admission i.e. Observation or Inpatient status, and appropriate level of care i.e. Acute, Intermediate or Critical.
- Communicate recommendations to physicians for admission status and level of care, with strong emphasis on Medicare's 2 Midnight Rule in order to maximize reimbursement and maintain compliance with Medicare Conditions of Participation.
- Submit clinical information timely to insurance companies for authorization and reimbursement.
- Arrange peer-to-peer discussions for appeals of denials.
- Trand and trend inefficiencies in care and delays in discharge.
- Establish strong working relationships with contacts at insurance companies.
- Act as a resource to physicians and discharge planning case managers for insurance issues.
- Assist with transfers of patients to other facilities for higher level of care.
Care Review Clinician III
Molina Healthcare
Albuquerque, NM
05.2013 - 04.2015
- Review clinical information for patients admitted to acute inpatient, long-term-acute care, and skilled nursing facilities for medical appropriateness by applying Interqual Care Criteria.
- Based on review results, issue admission or concurrent review authorization or denial.
- Communicate with case management staff at facilities, medical directors, and member regarding authorization, denial and appeal processes.
- Refer cases as needed to physician advisor, subrogation, quality, and legal departments for evaluation and addressing of complex insurance and patient care issues.
- All reviews done within required timeframe.
RN Admissions Intake Coordinator
Lovelace Rehab Hospital
Albuquerque, NM
05.2008 - 03.2013
- Responsible for obtaining prior authorization from insurance companies for admission to acute inpatient rehab facility.
- Review clinical information submitted by 5 rehab liasions for appropriateness of admission.
- Present and discuss referrals with Medical Director for clearance for admission.
- Coordinate admission process with field liasions, sending facility, transport drivers, dialysis providers and internal staff.
- Complete phone consultations for physicians, patients, family members, and other hospitals regarding admission criteria and process.
- Facilitate resolution of all barriers to insurance authorization and transport needs in order to maintain census in facility.
RN Rehab Nurse
Lovelace Rehab Hospital
Albuquerque, NM
10.2006 - 05.2008
- Development and initiation of nursing careplan.
- Nursing management of patients recovering from traumatic brain injuries, strokes, amputations, spinal cord injuries, neurological deficiencies, multiple-trauma injuries, and medically complex illnesses.
- Medication administration, pain control, bowel and bladder management, central line and intravenous catheter management, wound care.
- Communication with physician, physical, occupational, and speech therapists regarding patient status and progress.
- Participation in team conference to determine treatments, goals, length of stay, and discharge plan.
- Documentation of all nursing activities, interventions, and outcomes.
RN Case Manager
Easter New Mexico Medical Center
Roswell, NM
09.1999 - 05.2005
- Case Management for medical, surgical, psychiatric, and emergency room patients.
- Obtain initial and concurrent admission authorization for patients admitted for acute care.
- Daily clinical reviews for utilization management reporting, tracking and trending.
- Communication with physicians, nursing staff, therapists, and families regarding plan of care and discharge needs.
- Discharge arrangements for patients going to skilled nursing facilities, home health care services, durable medical equipment, IV antibiotics, and wound care.
- Coordination of transfers from acute hospital to acute hospital in emergency situations including contacting receiving facility and physician, ambulance or air transport.
- Relaying all information to patients, families, nurses, providers and transport companies.
RN Team Leader Orthopedic Unit
St Vincent's Hospital
Indianapolis, IN
07.1998 - 07.1999
- Direct nursing care of inpatient medical, surgical, orthopedic, and post-operative patients.
- This includes the admission process, physical assessment, post-op monitoring, pain control, wound care, medication management, and teaching patients and families.
- Development of nursing careplan and documentation of all assessments, activities, interventions, and outcomes.
- Communication with team members, patients and families.
- This facility had a hand specialist that often replaced missing thumbs with transplanted big toes.
- We would apply leeches to the transplants to manage swelling.
- Constant evaluation of circulation, sensation and movement to all involved digits and extremities.
- Address any abnormalities or complications with MD.
- As a team leader, I was responsible for supervising and directing other RNs, LPNs and Patient Care Techs.
Relief Charge RN Orthopedic Unit
Memorial Medical Center
Las Cruces, NM
04.1995 - 05.1998
- Relief Charge RN 3-11 shift on orthopedic unit.
- Make assignments for all staff on shift, assist other staff and address any patient or staff issues that arise.
- Direct hands-on patient care of inpatient medical, surgical, orthopedic, and post-operative patients.
- This includes the admission process, physical assessment, post-op management, pain control, wound care, medication management and teaching of patients and families.
- Address any abnormal labs, vital signs or physical conditions directly with MD.
- Development of nursing careplan and documentation of all interventions, activities and outcomes of care provided.
- Communication with team members, patients and families.
- Discharge planning and implementation.
- Report of shift events and activities to Unit Director.
Timeline
Oncology Nurse
Presbyterian Rust Medical Center
11.2018 - Current
Utilization Review Nurse, Department of Case Management
Sandoval Regional Medical Center
04.2015 - 07.2018
Care Review Clinician III
Molina Healthcare
05.2013 - 04.2015
RN Admissions Intake Coordinator
Lovelace Rehab Hospital
05.2008 - 03.2013
RN Rehab Nurse
Lovelace Rehab Hospital
10.2006 - 05.2008
RN Case Manager
Easter New Mexico Medical Center
09.1999 - 05.2005
RN Team Leader Orthopedic Unit
St Vincent's Hospital
07.1998 - 07.1999
Relief Charge RN Orthopedic Unit
Memorial Medical Center
04.1995 - 05.1998