Ma Jerika Ann Visaya
501 S Blairstone Rd Apt 2902 Tallahassee,FL
Summary
Healthcare professional with specialization in Cardiac Progressive Care. Offers valuable experience in managing cardiac patients and ensuring high standards of care. Focuses on team collaboration and adaptability, consistently delivering reliable patient outcomes. Known for strong clinical skills and patient-centered approach.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Registered Nurse, Cardiac Progressive Care
Tallahassee Memorial Healthcare
01.2024 - Current
- Demonstrated strong leadership skills during critical situations such as Code Blue events, coordinating team efforts to stabilize patients and initiate appropriate interventions.
- Provided emotional support to patients and families coping with challenging cardiac diagnoses, helping them navigate difficult decisions regarding treatment options and end-of-life care.
- Promoted a culture of safety in the cardiac unit by consistently adhering to best practices for infection control and risk management.
- Advanced quality improvement initiatives within the Cardiac Progressive Care unit through regular participation in process evaluation meetings and offering constructive feedback on areas for growth.
- Expanded clinical knowledge base by attending continuing education courses focused on advancements in cardiac nursing practice.
- Managed complex medication regimens for cardiac patients, ensuring proper dosing, timely administration, and monitoring for potential drug interactions or side effects.
- Expedited patient recovery times through careful implementation of evidence-based care plans tailored to individual needs and preferences.
- Utilized advanced critical thinking skills to promptly identify early warning signs of patient deterioration or complications, initiating appropriate interventions to prevent adverse outcomes.
- Evaluated patient histories, complaints, and current symptoms.
- Recorded details regarding therapies to keep patient charts updated.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Rehabilitation Nurse (PRN)
Encompass Health Rehabilitation Hospital of Tallahassee
09.2023 - Current
- Responsible for helping patients who are suffering from illnesses, disabilities, and injuries
- Establish goals and treatment plans, educate patients, and perform daily care tasks
- Continued care for cardiac, orthopedic and pulmonary clients out of the hospital
- Used Suctioning trachs, infusion therapy, Gtube feeding, wound care, lab draws, medication and treatment administration, assessment of outcomes and tailored changes to that individuals needs
- Coordinated nursing care activities in collaboration with other members of the interdisciplinary rehabilitation team to facilitate achievement of overall goals
- Demonstrated effective oral and written communication skills to develop a rapport with clients, their families, and health team members and to ensure the fulfillment of requirements for legal documentation and reimbursement
- Monitored, recorded, and communicated patient condition as appropriate to care team, physician, patient, and family
- Promoted patient independence by teaching self-care techniques and providing adaptive equipment recommendations.
- Supported patients'' emotional well-being, providing compassionate listening during difficult times in their healing journey.
- Enhanced the quality of patient care through effective communication with interdisciplinary team members.
- Managed complex wound care cases, utilizing advanced dressing techniques to promote timely healing while preventing complications such as infection or skin breakdowns.
Registered Nurse, Behavioral Health
Tallahassee Memorial Healthcare
10.2022 - 01.2024
- Served as an advocate for patients during treatment planning sessions with psychiatrists, therapists, social workers, and other healthcare professionals.
- Coordinated multidisciplinary team meetings to discuss individual patient progress and adjust treatment plans accordingly.
- Participated in quality improvement initiatives aimed at enhancing the overall standard of care provided to behavioral health clients within the facility.
- Assisted patients with developing coping strategies for managing stressors related to their mental health conditions.
- Collaborated with physicians to ensure accurate diagnosis, treatment, and proper medication administration for mental health clients.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Established strong rapport with patients and families by listening empathetically, providing emotional support, and addressing concerns promptly.
- Maintained timely, accurate, and confidential documentation of patient care, progress, and responses to treatment plans.
Utilization Management Nurse Reviewer
Shearwater Health Advisors
02.2022 - 09.2022
- Responsible for reviewing proposed hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiency in accordance with client’s-specific contract rules and guidelines and with company’s policies, practices and procedures to facilitate quality and cost effective care for the injured employee
- Complete short stay work queue reviews and track and trend results for reporting and education purposes
- Identify opportunities for process and system improvement and initiate and lead performance initiatives as indicated
- Identify and facilitate resolution of system process problems impeding UM functions
- Identify and resolve delays and obstacles as appropriate
- Collaborate with nursing, physicians, admissions, fiscal, legal, compliance, coding, and billing staff to answer clinical questions related to medical necessity and patient status
- Maintain current status determination tools and other UM tools and distribute to staff as needed
- Ensure that RN CMs are consistently recommending the appropriate admission status and provide education as needed
- Complete short stay work queue reviews within5 business days, including referrals to UR physician advisors
- Perform other concurrent and retrospective reviews within5 business days, or earlier as directed by UR Program Manager
- Prepare succinct, written clinical case summaries that include rationale for the recommended billing status as directed by UR Program Manager
- Serve as a resource person for RN CMs and others to ensure consistent and accurate patient status determinations for appropriate claim submission
- Effectively and efficiently create clinical case summaries from a variety of medical record documentation for internal and external audiences, including for commercial payers and Medicare and Medicaid contractors
- Document UM, quality, and risk concerns and refer to appropriate departments as applicable for follow up
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
Personal Care Assistance
The Social Service of Methodist Church Macau
02.2020 - 01.2022
- Delivered skilled personal care assistance such as bathing, grooming, dressing, toileting support which enhanced hygiene levels for patients.
- Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
- Supported a diverse range of clientele with varying physical abilities by employing adaptive techniques during personal care assistance.
- Improved patient well-being by providing compassionate and attentive personal care assistance during the COVID-19 pandemic.
- Enhanced patient comfort by providing compassionate personal care and assistance with daily activities.
- Improved patient satisfaction with personalized care and attention to detail.
- Collaborated with nurses to plan personalized patient care interventions, promoting recovery and overall wellbeing.
- Promoted a culture of self-care among staff and participants, recognizing the importance of maintaining personal well-being in a high-stress work environment.
- Strengthened interpersonal skills through effective communication with patients, families, colleagues, and other healthcare professionals.
- Increased patient mobility through careful assistance with exercises as prescribed by physical therapists or occupational therapists.
Preservice Review Nurse
Optum Global Solutions (United Health Care)
04.2018 - 01.2020
- Responsible for reviewing requests received from providers, using approved protocols and criteria
- (Milliman Care Guidelines or Healthcare Operations Protocols)
- The RN is expected to approve those requests that meet medical necessity, along with benefit level, and the contractual status of the provider/facility as appropriate for all fully - funded lines of business
- Evaluate and assess each request verifying eligibility and specific product
- Determine benefit level based on site of service
- Utilize written criteria to approve, pend, or send the case to the medical director for review
- Pend cases by documenting in the claim's payment system, contact the provider for the necessary information via fax and/or phone, and sending a letter to the member to alert them of the pending decision
- Maintain100% accuracy of clinical review case notes in Facets
- Maintain productivity standards and maintain compliance with all regulatory agencies including NCQA, DOL, DOI for each state, Medicaid, CMS, and OPM
- Maintain100% accuracy in summarizing cases for the Medical Director to review using appropriate protocols based on members clinical and benefit information
- Maintain compliance with turnaround times based on the member's product, the type of request, and the specific regulatory agency
- Reduced healthcare costs through efficient utilization of resources and identification of unnecessary treatments or procedures.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Maintained professional competence by staying current on industry trends, best practices, and regulatory requirements specific to utilization review nursing.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
Telephonic Triage Nurse (Cigna)
Hinduja Global Solutions Inc.
05.2017 - 01.2018
- Enhanced patient satisfaction through compassionate communication and timely triage responses.
- Reduced hospital readmissions by providing effective discharge instructions and follow-up care advice to patients.
- Demonstrated adaptability during periods of high call volume or staffing shortages while maintaining consistent quality of care.
- Increased efficiency within the triage team through regular collaboration on best practices for phone-based nursing interventions.
- Maintained compliance with regulatory standards by adhering to established protocols for telephonic nurse triage services.
- Facilitated continuity of care by maintaining detailed records of patient interactions, symptoms, and treatment recommendations.
- Improved patient outcomes by conducting thorough telephonic assessments and promptly addressing medical concerns.
- Ensured patient safety during crisis situations by rapidly assessing symptoms over the phone and guiding individuals toward appropriate emergency resources.
- Delivered quality nursing care remotely, utilizing clinical knowledge and strong communication skills to assess and advise patients effectively.
- Performed additional clinic and non-triage nurse duties such as instructing patients in general and specific medical care and health issues and administering or dispensing medication and injections.
HEDIS Review Nurse (Cigna)
Hinduja Global Solutions Inc.
01.2017 - 05.2017
- Maintains current knowledge base of applicable HEDIS measures
- Requests and abstracts appropriate medical records
- Monitors reports and logs to assess accuracy of abstraction, compliance with standards/workflows
- Duties and Responsibilities
- Reviewing medical records and documents to abstract clinical data for HEDIS reporting
- Documenting findings in applicable HEDIS databases and on prescribed cloud-based platforms
- Meeting daily abstraction goals and maintaining a high abstraction accuracy percentage
- Maintaining HIPAA standards and immediately reporting any critical findings to designated authorities
- Contributed to the development of training materials for new HEDIS reviewers, promoting a consistent approach to data collection.
- Demonstrated flexibility in adapting to changes in project scope or requirements, maintaining high standards of performance and accuracy at all times.
- Identified potential barriers to care through careful analysis of medical records, facilitating targeted interventions for at-risk populations.
- Evaluated effectiveness of interventions implemented based on HEDIS findings, driving continuous quality improvement efforts.
- Assisted in achieving compliance with NCQA standards by identifying areas for improvement in healthcare delivery.
- Participated in ongoing professional development opportunities to stay current with industry best practices for HEDIS review and reporting.
- Collaborated with healthcare providers to ensure timely submission of required documentation for HEDIS review.
- Utilized advanced analytical skills to identify and resolve discrepancies in reported HEDIS measure results.
- Prepared comprehensive reports on HEDIS findings for presentation to senior leadership, highlighting key areas of improvement and recommending action steps for future success.
- Enhanced accuracy of HEDIS reporting through meticulous documentation and validation of collected data.
- Improved HEDIS performance by conducting thorough medical record reviews and data extraction.
- Evaluated and optimized clinical software, applying established and end-user feedback.
- Used advanced health informatics knowledge and judgment to promote colleague involvement in planning, decision-making and evaluating outcomes.
- Supported continuous quality improvement initiatives by analyzing trends and patterns in HEDIS measures.
Private Duty Nurse
Private Client
04.2015 - 12.2015
- Provided compassionate care for patients, resulting in positive feedback from families.
- Administered medications accurately and efficiently, ensuring proper dosages and timely treatments.
- Promoted proper nutrition by preparing balanced meals tailored specifically to individual dietary needs.
- Monitored vital signs regularly to detect and address potential health concerns promptly.
- Scheduled appointments and transported patients to medical facilities using personal transportation.
- Developed strong rapport with patients and families, providing emotional support during difficult times.
- Managed wound care meticulously, preventing infections and promoting healing effectively.
- Assessed patient needs routinely, adjusting care plans as necessary for the best results.
- Safeguarded patient privacy by adhering strictly to HIPAA regulations during all interactions.
- Assisted patients with daily living activities, promoting dignity and independence.
- Documented patient assessment, evaluation and responses to therapy to facilitate therapeutic intervention.
Opthalmology Nurse
Laguna Holy Family Hospital
06.2014 - 03.2015
- Educated patients on various eye conditions, empowering them to make informed decisions about their treatment plans.
- Contributed to efficient clinic operations, managing appointments and updating patient records diligently.
- Achieved high levels of accuracy in medication administration, minimizing adverse drug reactions or interactions among patients.
- Enhanced patient comfort by providing thorough preoperative and postoperative care.
- Exhibited exceptional attention to detail while conducting preoperative assessments that enabled early detection and resolution of potential issues before surgery took place.
- Ensured timely interventions during emergencies, applying critical thinking skills to assess situations promptly.
- Implemented effective pain management strategies for post-surgical patients, promoting faster healing times and improved comfort levels.
- Supported patients with visual impairments, recommending appropriate low vision aids and resources for better quality of life.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Educated family members and caregivers on patient care instructions.
Registered Nurse, Medical-Surgical Unit
Gen. J. Cailles Memorial District Hospital
03.2013 - 05.2014
- Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
- Developed strong rapport with patients through active listening skills, empathetic communication, and genuine concern for their wellbeing.
- Performed comprehensive physical assessments on newly admitted patients to establish baseline data for ongoing care planning.
- Enhanced patient safety through vigilant monitoring and assessment of vital signs, lab values, and symptoms.
- Recognized early warning signs of deteriorating patient conditions, initiating rapid response measures to prevent further complications or emergencies.
- Provided compassionate emotional support to patients and families during challenging health experiences.
- Participated in multidisciplinary rounds, contributing valuable insights from a nursing perspective to improve overall patient management strategies.
- Educated patients on disease processes, treatment options, self-care techniques, and medications to promote informed decisionmaking.
- Started intravenous fluids, administered medications, and documented patient charts by recording food and fluid output and intake.
- Administered medications and treatment to patients and monitored responses.
- Managed patients' pain by implementing pharmacological and non-pharmacological pain management interventions.
- Managed patient pain relief and sedation by providing non-pharmacological and pharmacological interventions.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
Education
Bachelor of Science - Nursing
Perpetual Help College of Manila
Manila, Philippines03-2012
Skills
- Proficient in Microsoft Word, Excel, PowerPoint Presentation, MCG, and CMS
- Clinical judgment
- Medical record review
- HIPAA Compliance
- Teamwork and collaboration
- Clinical process knowledge
- Utilization review
- Records analysis
- Clinical assessment
- Documentation and reporting
- Compassionate care
- Telemetry interpretation
- Clinical documentation
- Advanced life support
- Cardiac monitoring
Certification
- Registered US Nurse License: Florida RN9612563
- Registered US Nurse License: Texas891444
Timeline
Registered Nurse, Cardiac Progressive Care
Tallahassee Memorial Healthcare
01.2024 - Current
Rehabilitation Nurse (PRN)
Encompass Health Rehabilitation Hospital of Tallahassee
09.2023 - Current
Registered Nurse, Behavioral Health
Tallahassee Memorial Healthcare
10.2022 - 01.2024
Utilization Management Nurse Reviewer
Shearwater Health Advisors
02.2022 - 09.2022
Personal Care Assistance
The Social Service of Methodist Church Macau
02.2020 - 01.2022
Preservice Review Nurse
Optum Global Solutions (United Health Care)
04.2018 - 01.2020
Telephonic Triage Nurse (Cigna)
Hinduja Global Solutions Inc.
05.2017 - 01.2018
HEDIS Review Nurse (Cigna)
Hinduja Global Solutions Inc.
01.2017 - 05.2017
Private Duty Nurse
Private Client
04.2015 - 12.2015
Opthalmology Nurse
Laguna Holy Family Hospital
06.2014 - 03.2015
Registered Nurse, Medical-Surgical Unit
Gen. J. Cailles Memorial District Hospital
03.2013 - 05.2014
- Registered US Nurse License: Florida RN9612563
- Registered US Nurse License: Texas891444
Bachelor of Science - Nursing
Perpetual Help College of Manila
Training
- Advance Cardiovascular Life Support
- American Heart Association
- Southeastern School of Heart Sciences, Professional Safety Educators
- January17,2024
- Basic Life Support
- Tallahassee Memorial Healthcare
- October2,2024
- CPI-Nonviolent Crisis Intervention
- Tallahassee Memorial Healthcare Auditorium
- November4,2022
- 3 Days Basic Intravenous Therapy Training Program
- February20 –22,2013
- Martinez Memorial Hospital
- Maypajo, Caloocan City, Philippines
- Digital Retinal Camera, The Canon Model CX-1, and Retinal Imaging Control Software – RICS Training
- May21-24,28, and30,2014
- Laguna Holy Family Hospital
- Sta. Cruz, Laguna, Philippines
- Haag-Streit Octopus600 Basic Orientation and Training
- December11,2014
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