Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kimberly Foley

Fort Myers

Summary

Experienced with analyzing and evaluating clinical documentation to ensure compliance and accuracy. Utilizes strong analytical skills to identify discrepancies and recommend necessary adjustments. Track record of maintaining high standards in clinical review processes, ensuring regulatory adherence and quality patient care.

Overview

8
8
years of professional experience
1
1
Certification

Work History

Clinical Reviewer

Evolent Health
02.2022 - Current
  • Reviews clinical authorization cases and approves imaging studies within guidelines
  • Examines patient's medical records including office visit notes
  • Adheres to HIPPA regulations and documents on cases appropriately
  • Uses clinical judgement and nursing knowledge to guide case work
  • Works quickly, efficiently and effectively to meet the needs of the company

Medical/Surgical Registered Nurse

Ascension Via Christi
Manhattan, KS
07.2020 - 02.2022
  • Administers medications using EMAR.
  • Collects, records, and maintains patient information.
  • Adheres to HIPPA regulations and works as a member of a multi-disciplinary team.

Travel RN: Float Pool

RN Network
Pensacola, FL
07.2020 - 03.2021
  • Counsels and educates patients and their families on treatment plans.
  • Consults with providers to assist in treatment planning
  • Cares for a variety of patients ranging from cardiac step-down unit 1:4 patient ratio to rehab patients 1:6 patient ratio.

Medical/Surgical/Telemetry RN: Intermediate Unit

Southcoast Hospital Group
New Bedford, MA
10.2019 - 06.2020

Previously employed 2015-2017 as a new graduate RN

  • Cares for patients on an intermediate care unit
  • Assists trauma, orthopedic, and surgical patients
  • Rounds as a multidisciplinary team member to improve patient health outcomes

RN: Float Pool

St. Vincent Hospital
Worcester, MA
09.2018 - 05.2020
  • Works on a variety of units, caring for patients with a wide range of illnesses including the psychiatric unit.
  • Performs an accurate physical assessment on admission and at specified intervals as necessary.
  • Develops an individualized nursing plan of care.

MedSurg/Telemetry RN

Hoag Memorial Presbyterian Hospital
Newport Beach, CA
10.2017 - 08.2018
  • Works closely with all health care providers to facilitate and coordinate efficient, effective, and quality healthcare
  • Initiates and maintains tubes, i.e. foley catheters, NG tube, etc.
  • Reports critical lab results to physicians and documents appropriately using Epic charting system.

Education

Master of Science - Nursing Education

University of Massachusetts Dartmouth
South Dartmouth, MA
05-2020

Bachelor of Science - Nursing

University of Massachusetts, Lowell
Lowell, MA

Skills

  • Clinical judgment
  • Clinical assessment
  • Teamwork and collaboration
  • Customer service
  • Problem-solving
  • Time management

Certification

  • Registered Nurse FL #9533950

Timeline

Clinical Reviewer

Evolent Health
02.2022 - Current

Medical/Surgical Registered Nurse

Ascension Via Christi
07.2020 - 02.2022

Travel RN: Float Pool

RN Network
07.2020 - 03.2021

Medical/Surgical/Telemetry RN: Intermediate Unit

Southcoast Hospital Group
10.2019 - 06.2020

RN: Float Pool

St. Vincent Hospital
09.2018 - 05.2020

MedSurg/Telemetry RN

Hoag Memorial Presbyterian Hospital
10.2017 - 08.2018

Master of Science - Nursing Education

University of Massachusetts Dartmouth

Bachelor of Science - Nursing

University of Massachusetts, Lowell