MAUREEN VEJNOSKA
Nanuet
Summary
Registered Nurse skilled in clinical judgment and patient advocacy, adept at managing complex care regimens in acute settings. Experience in clinical review roles, supporting timely and quality care through meticulous documentation and collaborative team efforts.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Clinical Nurse Reviewer
Evolent Health
Arlington
09.2021 - 06.2026
- Performed clinical reviews of medical records to ensure accurate coding and compliance with Medicare regulations.
- Reviewed medical documentation for completeness, accuracy, and alignment with standards to provide medically necessary testing in a timely manner for the patient.
- Determined medical necessity using clinical guidelines such as MCG (Milliman Care Guidelines).
- Examined patient charts outpatient, and Urgent Care settings for completeness, accuracy, and adherence to clinical guidelines.
Registered Nurse
The Valley Hospital
Ridgewood
10.2002 - 09.2021
- Provided patient care on Cardiac/Medical-Surgical unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 5-7 patients per shift.
- Coordinated with multidisciplinary team to facilitate comprehensive patient care from admission to discharge.
- Educated patients and families on discharge care to promote recovery and prevent readmissions.
- Modified strategies to address evolving patient needs.
- Experience with various medical conditions including Parkinson's, Diabetes, Alzheimer's, Pulmonary, and Cardiac disease.
- Effective counseling in health maintenance and disease management.
- Excellent verbal and written communication
- Documented patient information obtained from interviews.
- Ability to work independently
Education
Bachelor of Science - Nursing
Dominican University
Orangeburg, NY01-2002
Bachelor of Arts - Biology
Dominican University
Orangeburg, NY01-1998
Skills
- Clinical quality assurance
- Clinical judgment
- Strong clinical judgment and documentation
- Patient assessment
- Care coordination
- Quality improvement
- Medicare compliance
- Time management
- Managing deadlines
- Problem solving
- Team collaboration
- Patient and family advocacy
- Clinical judgment
Certification
- Registered Nurse (RN), New York, 09/30/26
- Registered Nurse (RN), New Jersey, 05/31/2028
Timeline
Clinical Nurse Reviewer
Evolent Health
09.2021 - 06.2026
Registered Nurse
The Valley Hospital
10.2002 - 09.2021
Bachelor of Science - Nursing
Dominican University
Bachelor of Arts - Biology
Dominican University