Monica Hernandez
Chicago
Summary
Compassionate Registered Nurse with experience offering comprehensive patient care in inpatient and or outpatient environments. Works well with diverse patient populations and fosters trusting relationships to improve outcomes. Efficiently coordinate with healthcare professionals to advance patient care.
Overview
13
13
years of professional experience
Work History
Prior Authorization Representative
Cook County Health Hospital Systems
12.2023 - Current
- Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Processed new medication and refill requests for authorization.
- Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.
- Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for approvals.
- Reduced claim denials by thoroughly reviewing and analyzing medical necessity documentation before submitting for approval, ensuring all criteria were met.
- Supported continuous improvement initiatives by actively participating in meetings, providing feedback, and suggesting areas for improvement.
- Contacted insurance companies to obtain prior authorization for medications.
- Created and maintained spreadsheets detailing medical procedures and insurance denials and approvals.
Registered Nurse, Labor and Delivery
Saint Anthony Hospital
05.2015 - Current
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
- Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
- Provided direct patient care, stabilized patients and determined next course of action.
- Administered medications via oral, IV and intramuscular injections and monitored responses.
- Managed care from admission to discharge.
- Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
- Collected blood, tissue and other laboratory specimens and prepared for lab testing.
- Updated patient charts with data such as medications to keep records current and support accurate treatments.
- Monitored patient reactions to drugs and carefully documented findings.
- Reviewed post-operative orders and continuously monitored patients' post-operative vitals, set up PCA and fluids and oriented patients to unit.
- Provided emotional support and guidance to new mothers and families during labor, delivery and postpartum.
- Responded to emergency situations such as pre-eclampsia, early labor, and fetal distress.
- Assisted physician during delivery, examination and surgical procedures by anticipating needs, encouraging patient, and attending to baby after birth.
- Supported physicians in both planned and emergency Cesarean section procedures.
Home Health Nurse
United Caregivers
07.2017 - 05.2022
- Provided physical assessments, medication and chronic disease management to home health patients.
- Advised and coached patients progressing from hospitals, rehab facilities and other medical organizations to at-home treatment settings.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
- Monitored vital signs, developed and implemented care plans, and documented patient progress
Licensed Practical Nurse, Post Partum
Saint Anthony Hospital
06.2012 - 05.2015
- Documented accurate and complete patient information to address patient problems and expected outcomes.
- Performed routine evaluations of each patient's status, needs and preferences.
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Obtained patient vital signs and input/output measurements from inpatients.
- Coordinated postnatal follow-up appointments for both mother and infant to monitor ongoing recovery from childbirth and track growth milestones in the weeks following delivery.
- Streamlined documentation processes by maintaining accurate and detailed electronic health records for each patient.
Education
Associate of Science - Nursing
05.2014
General Studies - General Studies
09.2010
Skills
- Highly skilled career professional since 2011 with practical experience in hospital setting providing excellent patient care
- Able to identify complex patient problems and review related evidence based research to develop and evaluate options and implement solutions
- Ensure that patients received appropriate quality of care to improve practice process and outcomes
- Deep knowledge of medical terminologies and critical thinking skills regarding labor and delivery nursing
- Interpretation of fetal heart tracing and nursing resuscitation interventions
- Foley Catheter Insertion and Removal
- Blood Draw and Sample Collection
- Operational Procedures
- Circulating Nursing
- Patient Intervention Companionship and Emotional Support
- Administering Medicines
- Clinical Documentation and Reporting
- High Blood Pressure Management
Timeline
Prior Authorization Representative - Cook County Health Hospital Systems
12.2023 - Current
Home Health Nurse - United Caregivers
07.2017 - 05.2022
Registered Nurse, Labor and Delivery - Saint Anthony Hospital
05.2015 - Current
Licensed Practical Nurse, Post Partum - Saint Anthony Hospital
06.2012 - 05.2015
Wilburt Wright College - Associate of Science, Nursing
Richard J Daley College - General Studies, General Studies
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