Summary
Overview
Work History
Education
Timeline
Generic

Kathleen Valentino

South Kingstown,Rhode Island

Summary

Organized and knowledgeable Registered Nurse experienced in treating and caring for patients. Successful in providing fast and accurate assessments and working calmly under pressure. Recognized for collaborating well with doctors to maintain top-notch healthcare practices. Caring, hardworking and service-oriented Registered Nurse with more than [Number] years of experience. Well-versed in offering evidence-based, therapeutic care. Collaborative and motivational leader with expertise in training new nursing staff while providing top-notch service to patient populations. Patient-oriented Nurse with 40+ years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with [Area of expertise] specialty. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Talented Team Leader experienced and dedicated to enhancing employee satisfaction and business success. Diplomatic and friendly with proven commitment to employee training. Hardworking team player bringing necessary experience and knowledge to tackle any operational demand. Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, triage and care coordination in fast-paced environment. Proven to remain calm under pressure and skillfully handle difficult patients and high-stress situations. Consistently developing strong relationships with patients and families through empathetic communication, respectful attitude and excellent customer service. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader. Reliable business professional with experience in project management, process improvement and financial analysis. Proven track record of successfully streamlining business operations and reducing costs. Adept at analyzing data to identify trends and developing strategies to improve efficiency. Hardworking Registered Nurse with success providing individualized patient care. Committed to delivering best-in-class patient care through effective education and counseling. Proven leadership focused on increasing and enhancing patient care and satisfaction. Streamline safety protocols for comprehensive patient care. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level [Job Title] position. Ready to help team achieve company goals. Compassionate Registered Nurse with experience offering comprehensive patient care in outpatient environments. Works well with diverse patient populations and fosters trusting relationships to improve outcomes. Efficiently coordinate with healthcare professionals to advance patient care. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Forward-thinking Operations Specialist bringing [Number] years of expertise in [Area of expertise] for [Industry] sector businesses. Cultivates rapport with individuals to optimize project goals and output, resolve complex problems and deliver innovative improvement strategies. Proficient in [Software] and [Software]. Multi-tasking Team Leader well-known for executing successful, new [Type] initiatives. Creates dynamic and positive workplace culture to align with organizational mission and values. Trains new hires and mentors struggling workers to achieve overall team success. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Supportive Team Lead with [Number] years of experience leading teams. Expert in following detailed production schedules with distinguished history of maximizing productivity. Committed to proactive reorganization for optimized safety and efficiency. Team Leader experienced in directing activities of workgroups. Develops strategies, provides training, sets goals and obtains team feedback. Excellent interpersonal and communication skills. Big picture focus with excellence in communicating goals and vision to succeed. Problem solver, networker, and consensus builder. Highly adaptable team leader with excellent background of quick and effective performance. Safely lifts [Number] pounds. Highly experienced in performing quality inspections and machinery operations. Patient-oriented Nurse with [Number] years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with [Area of expertise] specialty. Organized Team Leader builds positive rapport, inspire trust and guide teams toward achievement of organizational goals. Strong facilitator adept at working cross-departmentally with co-management and top-level leadership. Excellent trainer and mentor.

Overview

28
28
years of professional experience

Work History

RN Utilization Review Team Lead

Neighborhood Health Plan
Providence, RI
03.2011 - 04.2013
  • Assessed patient medical records to determine the appropriateness of requested services and procedures.
  • Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
  • Analyzed data from patient surveys, interviews and other sources to assess healthcare service quality.
  • Provided education to providers regarding utilization management processes and protocols.
  • Collaborated with multidisciplinary teams on developing strategies for improving care quality and controlling costs.
  • Evaluated clinical documentation for accuracy and completeness in order to make decisions about coverage determinations.
  • Monitored pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
  • Maintained up-to-date knowledge of health plan benefits, policies, procedures, regulations, coding guidelines.
  • Generated reports related to utilization management activities such as length of stay trends, denials rates.
  • Investigated complaints related to denied claims or treatment plans.
  • Participated in provider meetings to discuss cases involving complex medical conditions or difficult authorization decisions.
  • Identified opportunities for improvement within the utilization review process through data analysis.
  • Facilitated communication between payers, providers and patients concerning authorization issues or concerns.
  • Coordinated with other departments within the organization regarding changes in policy or procedure implementation.
  • Attended conferences and training sessions related to utilization review topics such as best practices or new technologies.
  • Served as a resource for staff members seeking guidance on utilization review matters.
  • Determined medical necessity and cost-effectiveness of services through utilization review processes.
  • Reviewed patient admissions to determine medical necessity as directed by [Type] criteria.
  • Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
  • Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
  • Remained up-to-date on various benefit plans, medical policies and state-specific clinical guidelines or criteria.
  • Collaborated with [Job title]s in group meetings to identify issues and find cost-effective solutions.
  • Kept detailed documentation on all utilization reviews by using [Type of Software].
  • Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
  • Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
  • Interpreted and evaluated diagnostic tests to identify and assess patient's condition.

RN Case Manager

Windham Group
Manchester, NH
02.2002 - 03.2010
  • Provided emotional support and counseling to patients dealing with chronic illness or end-of-life issues.
  • Assessed patient's physical, mental, and psychosocial health status to develop individualized care plans.
  • Monitored and evaluated effectiveness of treatment plans and interventions.
  • Collaborated with physicians, nurses and other healthcare professionals to ensure optimal patient outcomes.
  • Maintained accurate documentation of patient progress in the electronic health record.
  • Conducted weekly interdisciplinary team meetings to review case management activities for assigned caseloads.
  • Educated patients on disease prevention strategies, wellness promotion techniques and lifestyle modifications.
  • Reviewed clinical data including lab results, radiology reports and vital signs to assess appropriateness of treatments.
  • Participated in quality improvement initiatives related to case management processes.
  • Actively participated in multidisciplinary rounds discussing complex cases with members of the healthcare team.
  • Ensured compliance with regulatory standards concerning utilization review, ethical decision making and legal aspects of case management practice.
  • Analyzed financial information related to insurance coverage eligibility prior to initiating services.
  • Attended continuing education seminars relevant to case management practices.
  • Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
  • Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
  • Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
  • Coordinated with healthcare team to establish, enact and evaluate patient care plans.
  • Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
  • Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
  • Referred patients to specialized health resources or community agencies to furnish additional assistance.

Cardiac ICU Registered Nurse

South County Hospital Healthcare System
Wakefield, RI
02.1985 - 03.1990
  • Provided direct patient care and monitoring of vital signs, oxygen saturation levels, and cardiac rhythms.
  • Assessed patients for potential complications due to medications or interventions.
  • Performed venipuncture, intravenous therapy administration, and arterial blood gas draws.
  • Administered medications as ordered by physician according to hospital policy and procedure.
  • Coordinated with physicians and other healthcare professionals to develop individualized treatment plans for each patient.
  • Collaborated with multidisciplinary team members in providing quality patient care.
  • Responded quickly to changes in a patient's condition and reported them to the physician immediately.
  • Facilitated communication between family members, nurses, physicians, social workers, physical therapists, dieticians, pharmacists and other healthcare personnel involved in the care of the patient.
  • Educated patients on their disease process and treatment plan while ensuring they understand all instructions given by medical staff.
  • Participated in daily rounds with attending physicians discussing progress of assigned patients.
  • Maintained accurate documentation of assessments, treatments, medications administered and any changes in the patient's condition.
  • Initiated lifesaving measures such as CPR when needed during code blue situations.
  • Evaluated laboratory results for abnormal values and took appropriate action based on findings.
  • Identified opportunities for improvement in clinical practice standards and processes.
  • Supported the development of new protocols that would improve clinical outcomes.
  • Provided guidance and support to less experienced nursing staff.
  • Attended continuing education courses related to cardiac ICU nursing practices.
  • Supervised cardiac monitors, mechanical ventilators and alarms and oxygen delivery devices.
  • Kept track of patients' changing pain levels and proactively worked to minimize excess pain or discomfort.
  • Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
  • Evaluated patient vital signs and laboratory data to assess needs and provide emergency interventions.
  • Observed strict safety measures, including checking medication dosages before administration to patients.
  • Checked on patients regularly to track progress with treatments, changes in symptoms and need for emergency interventions.
  • Identified abnormal and critical respiratory patterns through direct pulmonary assessments.
  • Detected emerging problems by monitoring patients' behavior, vital signs and fluid intake and output.
  • Delivered information regarding care and medications to patients and caregivers in comprehendible terminology.

Education

Master of Science - Health Care Administration

Salve Regina University
Newport, RI
05-2000

Bachelor of Science - Health Administration

Roger Williams University
Bristol, RI
05-1998

Associate of Science - Nursing

CCRI
Warwick, RI
06-1981

Timeline

RN Utilization Review Team Lead

Neighborhood Health Plan
03.2011 - 04.2013

RN Case Manager

Windham Group
02.2002 - 03.2010

Cardiac ICU Registered Nurse

South County Hospital Healthcare System
02.1985 - 03.1990

Master of Science - Health Care Administration

Salve Regina University

Bachelor of Science - Health Administration

Roger Williams University

Associate of Science - Nursing

CCRI
Kathleen Valentino