Maria Flanigan
Fultondale
Summary
Experienced, versatile, and purposeful professional Registered Nurse with expertise in various areas of healthcare. Strong leader who motivates staff and encourages department growth. Possesses broad knowledge of state and federal regulations and effectively communicates with patients, families/caretakers, and professional staff. A collaborative individual who leads by sharing knowledge, utilizing effective communication strategies, and fostering a team-oriented culture. Comprehensive understanding of the healthcare system from direct care provider, transitional care provider, and insurance representative roles, making patient care and placement decisions seamless for providers and patients. Outgoing, friendly, and people-oriented personality allows for effective connection with diverse groups and individuals. Strong organizational skills and solid communication abilities greatly contribute to efficient support of upper management.
Overview
10
10
years of professional experience
Work History
Staff Registered Nurse
University of Alabama Birmingham
03.2021 - Current
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Participated in staff meetings and continuing education programs to stay current on best practices and maintain licensure requirements.
- Precepted student nurses and oriented new hires, providing guidance and mentorship when teaching on hospital policies, emergency procedures, and nursing best practices.
Network Integrity - Investigator II
Blue Cross and Blue Shield of Alabama
03.2021 - 08.2024
- Developed and implemented strategies to minimize costs and maximize savings
- Analyzed claims data to identify trends and potential areas of improvement
- Developed and maintained relationships with insurance companies and policyholders
- Analyzed claims trends and identified opportunities for improvement
- Investigated fraudulent claims and reported suspicious activity to management
- Developed and implemented a successful claims process for a large insurance company, resulting in improved customer satisfaction and increased efficiency
Nurse Manager
Cooper Green Mercy Health Services Authority
06.2020 - 03.2021
- Ensured compliance with all regulatory requirements as established by The Joint Commission and other federal and state agencies
- Collaborated with other healthcare professionals to ensure quality of care and increase patient satisfaction
- Coordinated with physicians and other healthcare providers to ensure optimal patient care ensuring medical necessity is met
- Educated physicians and ancillary staff on proper documentation establishing medical necessity to prevent insurance denials
- Oversaw the utilization review process for three departments and developed ways of improving performance in each department
- Monitored quality of care and patient outcomes to ensure compliance with standards
RN Case Manager
Encompass Health Lakeshore Rehabilitation Hospital
01.2019 - 06.2020
- Collaborated with physicians and other members of the healthcare team to assess, plan, implement, coordinate, monitor, and evaluate patient care
- Facilitated referrals to community resources and other healthcare services
- Identified and addressed patient/family psychosocial needs
- Participated in quality improvement initiatives to improve patient care and outcomes
- Coordinated care among multiple disciplines and providers
- Perform ongoing utilization review and function as a liaison to the payer while assuring the team provided cost-effective treatment while establishing medical necessity to receive top reimbursement for services
Regional Clinical Admissions Director - Case Management
Genesis HealthCare
07.2014 - 03.2019
- As part of the leadership team, supervised and trained Clinical Admission Directors (RNs, LPNs, and Social Workers), on ways to manage difficult referrals to ensure proper placement upon discharge in conjunction with outside facilities and insurance companies
- Collaborated with physicians and other healthcare professionals to improve patient care
- Participated in interdisciplinary team meetings to discuss patient care issues
- Served as a clinical expert in the development and implementation of clinical initiatives
- Led interdisciplinary teams to ensure the delivery of safe and effective patient care
- Identified barriers affecting patient discharges and placement and found ways of collaborating with outside facilities to safely discharge patients
Education
Master of Science - Healthcare Executive
Chamberlain College of Nursing
Addison, IL10.2022
Bachelor of Science - Healthcare Management
Chamberlain College of Nursing
Addison, IL12.2019
Nursing Diploma - Nursing
Allen School of Nursing
Waterloo, IA05.1997
Skills
- Effective communication
- Multi-tasking
- Prioritization
- Organization
- Time management
- Knowledge of healthcare regulations
- Computer proficiency
- MS Excel
- HIS
- EMRs
- Critical thinking
- Decision-making
- Risk anticipation
- Spanish proficiency
- Medication and IV administration
- Patient Education
- Wound Care
- Care Plan Development
- Geriatric Nursing
- Infection control measures
- EMR / EHR
- Oncology Nursing
- Family Education
- Intake and discharge
- Case Management
Languages
Spanish
Native or Bilingual
Timeline
Staff Registered Nurse
University of Alabama Birmingham
03.2021 - Current
Network Integrity - Investigator II
Blue Cross and Blue Shield of Alabama
03.2021 - 08.2024
Nurse Manager
Cooper Green Mercy Health Services Authority
06.2020 - 03.2021
RN Case Manager
Encompass Health Lakeshore Rehabilitation Hospital
01.2019 - 06.2020
Regional Clinical Admissions Director - Case Management
Genesis HealthCare
07.2014 - 03.2019
Master of Science - Healthcare Executive
Chamberlain College of Nursing
Bachelor of Science - Healthcare Management
Chamberlain College of Nursing
Nursing Diploma - Nursing
Allen School of Nursing
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