Summary
Overview
Work History
Education
Skills
Timeline
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JOSETTE STANISLAS

Coral Springs,FL

Summary

Patient-focused Registered Nurse with years of experience in administering patient care, delivering excellent service and ensuring high standards of culturally competent care for wide variety of patients with diverse needs. Excellent problem-solver, clear communicator, detailed-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

21
21
years of professional experience

Work History

Utilization Management Department

United Healthcare
08.2021 - 03.2022
  • Supervise Contract Assistants.
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Performed prior authorization review of services requiring notification.
  • Submitted cases for criteria failures and helped facilitate resolutions and approvals.
  • Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.

Registered Nurse, Case Manager

OrthoNet
09.2014 - 08.2021
  • Analyzes patient records, and participates in interdisciplinary collaboration with professional staff.
  • Performs utilization review in accordance with all state mandated regulations.
  • Facilitates educational programs and inform physicians and other departments of regulations affecting utilization.
  • Utilize nationally recognized criteria to determine medical necessity of services requested.
  • Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.

Registered Nurse, Prior Authorization Nurse

Sunshine Health Centene
06.2010 - 08.2014
  • Managed and processed 30 or more cases daily.
  • Ensured compliance with medical and company standards.
  • Provided exceptional patient care; Educated providers on proper protocols for review process.
  • Reviewed requests for various departments utilizing Interqual or MCG.

Obstetric Case Manager

Coventry Health Care
03.2009 - 06.2010
  • Monitored clients' progress and tracked client services to provide crisis interventions.
  • Partnered with physicians, social workers, activity therapists, nutritionists, and case managers to develop and implement individualized care plans and documented patient interactions and interventions in electronic charting systems.
  • Collaborated with an interdisciplinary team to determine timely delivery of services.
  • Developed comprehensive discharge plans to transition clients to appropriate service providers in community.
  • Provided education on health and nutrition for patients to maintain healthy habits and wellbeing.
  • Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.

Supervisor, Licensed Practical Nurse

Miami Beach Community Health Center
10.2007 - 03.2008
  • Helped meet changing demands by recommending improvements to business systems or procedures.
  • Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
  • Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
  • Monitored workflow to improve employee time management and increase productivity.
  • Achieved results by working with staff to meet established targets.
  • Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.

LPN

Watercrest Care Center Nursing And Rehab
06.2001 - 10.2007
  • Performed routine evaluations of each patient's status, needs, and preferences.
  • Documented accurate and complete patient information to address patient problems and expected outcomes.
  • Cared for wounds, provided treatments, and assisted with procedures.
  • Monitored, tracked, and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.

Education

Bachelor of Science - Nursing

Chamberlain University
Downers Grove, IL
03.2024

Associates - Nursing

Excelsior College
Albany, NY
2009

Fort Myers Vocational Center
Fort Myers, FL
2001

Skills

  • Authorization Verification
  • Benefits Verifications
  • Team Leadership
  • Physician Assistance

Timeline

Utilization Management Department

United Healthcare
08.2021 - 03.2022

Registered Nurse, Case Manager

OrthoNet
09.2014 - 08.2021

Registered Nurse, Prior Authorization Nurse

Sunshine Health Centene
06.2010 - 08.2014

Obstetric Case Manager

Coventry Health Care
03.2009 - 06.2010

Supervisor, Licensed Practical Nurse

Miami Beach Community Health Center
10.2007 - 03.2008

LPN

Watercrest Care Center Nursing And Rehab
06.2001 - 10.2007

Bachelor of Science - Nursing

Chamberlain University

Associates - Nursing

Excelsior College

Fort Myers Vocational Center

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JOSETTE STANISLAS