Maribel Santiago

• Determined and authorized patient services in compliance with guidelines and regulations.
• Review initial and recurrent request for authorizations based on information received and determine an appropriate outcome to either approve or elevated via MRIOA / Internal Medical Director based on medical necessity and Medicare guidelines
• Proficient in Intake 98, InterQual, EPIC, Home Provider Portal, MRIOA
• Knowledge in DME, THH Commercial
• Transferred between departments when needed
• Work on rotating weekends

• Assist residents in Memory Care unit with daily medication reminder
• Observer and monitor residents condition and communicating with Doctors and family members of progress or decline in residents health conditions
• Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.

Triage LPN

• Triaged all hospital calls and all patient vitals

Intake Nurse Specialist

• Worked alongside liaisons, hospitals, medical offices, nursing & mental health facilities, clients and families to determine their needs weather medical, physical or mental and direct them to the services they may require
• Called and verified provider qualification and policy benefits, and set up initial assessments with Nursing staff

On Call Weekend Nurse

• Called hospitals, nursing/ mental health facilities and checked on clients discharge to assure that they will have the care needed when they arrived to their homes
• Monitored the tele-health program and called clients accordingly to their BP, pulse ox and weight readings

• Provide routine care and follow up visits
• Responsible for providing med pre pours as per medication files and per Dr
• Orders, wound care, obtaining patients vitals, and updating clients files accordingly
• Help clients with follow up MD appointments, patient and family teaching and reporting any updates to RN supervisor
• Managed wound care effectively, preventing infection and promoting proper healing techniques.
• Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.