Monina S. Fernando
Summary
Experienced in conducting thorough utilization reviews to ensure effective resource use and patient care. Utilizing clinical judgment to assess and recommend appropriate treatment plans, with a track record of ensuring compliance with healthcare regulations and improving patient outcomes. Strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
32
32
years of professional experience
Work History
RN Field Visiting Nurse
Sacred Heart Home Health Services
01.2022 - 01.2024
- Performs initial assessment and evaluation of patient’s condition and the need for home health services
- Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Developed strong relationships with patients'' families, providing emotional support while addressing concerns or questions about care plans.
- Improved patient outcomes by providing high-quality nursing care and implementing evidence-based practices.
- Educated patients on disease management and self-care techniques, promoting lifestyle changes for improved health.
- Managed care from admission to discharge.
- Served as a liaison between physicians and patients'' families to facilitate clear communication regarding treatment options and progress updates.
- Assessed patient conditions promptly upon admission to determine appropriate interventions and prioritize care needs.
- Provided direct patient care, stabilized patients, and determined next course of action.
- Provided emotional support to patients during challenging times, fostering a sense of trust and rapport that contributed to better overall wellbeing.
- Managed patient caseloads effectively, ensuring timely interventions and thorough follow-ups to mitigate potential complications.
- Participated in professional development opportunities regularly to stay current on best practices in the field of nursing.
- Devised individualized care plans tailored to each patient''s unique situation, optimizing clinical outcomes.
- Utilized advanced clinical skills such as wound care management or IV therapy administration, leading to faster recovery times for patients treated under my supervision.
- Streamlined documentation processes to ensure accurate record-keeping and compliance with regulatory standards.
- Aligned nursing goals with department objectives to enhance overall performance metrics within the healthcare facility.
Independent Consultant
Home Health Consultant
01.2017 - 01.2022
- Assists home health agencies in operational processes
- Assists with ADR’s (Audits by Medicare) and surveys
- Assists with start up agencies including application to CMS and DHS
- Fostered strong relationships with clients through consistent communication and collaboration.
- Conducted meetings with clients to determine project intent, requirements and budgets.
- Streamlined business processes for clients by identifying inefficiencies and implementing effective solutions.
- Reviewed internal systems and organized training plans to address areas in need of improvement.
Administrator/Director of Patient Care Services/CEO/Owner
EMC Home Health Providers, Inc.
01.2007 - 01.2017
- In charge of day to day clinical and administrative operations of the agency
- Involved in Case management/Utilization Review/Performance Improvement/Discharge Planning
- Served as a Board of Director and member of Professional Advisory Committee
- In charge of ongoing staff development and education and orientation
- Responsible for maintaining and ensuring compliance with Federal (CMS) and State (DHS) including other State and local laws and requirements and CHAP
- Handled clinical audit review, appeals, ADR’s and ICD-10 coding
- Handled business development
- Coordinated and communicated with all disciplines including physicians
- Maintained accurate documentation of company policies and procedures for easy reference by all employees.
- Participated in direct client care, supervisory visits, and initial assessments
- Supervised administrative support staff members, offering guidance, feedback, and mentorship that contributed to their professional growth and development.
- Managed human resources functions, including hiring, onboarding, and employee evaluations for optimal team performance.
- Coordinated company events and meetings to foster teamwork and boost employee morale.
- Reduced overhead costs through careful budget management and resource allocation.
Utilization Review Nurse
Molina Health Care
01.2007 - 01.2008
- Responsible for prior authorizations, outpatient medical necessity/utilization review, and/or other utilization management activities, case management of health care members
- Performed outbound phone calls to members for assessment of their home situation to determine their needs to prevent hospitalization
- 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.
Administrator/Director of Patient Care Services/CEO
Monina Home Health, Inc.
01.2002 - 01.2007
- In charge of day to day clinical and administrative operations of the agency
- Involved in Case management/Utilization Review/Performance Improvement/Discharge Planning
- Serves as a Board of Director and member of Professional Advisory Committee
- In charge of ongoing staff development and education and orientation
- Responsible for maintaining and ensuring compliance with Federal (CMS) and State (DHS) including other State and local laws and requirements and CHAP
- Handles clinical audit review, appeals, ADR’s and ICD-9 coding
- Handles business development
- Supervises and in charge of all employees and contracted employees
- Coordinates and communicates with all disciplines including physicians
- Participates in direct client care, supervisory visits, and initial assessments
Director of Patient Care Services
Ace Health Systems, Inc.
01.2001 - 01.2003
- Assisted in planning overall development and administration of the agency under the direction of the Administrator and Board of Directors
- In charge of all clinical aspects of the daily operation of the agency
- Involved in Case management/Utilization Review/Performance Improvement
- Establishes methods for coordination of care by all disciplines
- Supervises and trains staff in order to improve practice within the agency
- Acts as the Administrator in his/her absence
- Participates in direct client care activities e.g. initial evaluation, followup, IV’s, wound care etc..
Community Liaison Nurse/Clinical Nurse Liaison/Public Relations and Marketing
Rancho Los Amigos Rehab Center
01.2000 - 01.2001
- Acted in an administrative capacity to evaluate/accept patients that are appropriate for rehabilitation
- Performed advanced physical assessment on potential rehabilitation patients utilizing Functional Independent Measures
- Provided requested consultative services to a particular county facility regarding referral and transfer process
- Coordinated transfers from acute county facility to the rehabilitation facility
- Provided in services and orientation to physicians, interdisciplinary team, patients, and patient’s family regarding rehabilitation and services provided by Rancho Los Amigos.
Critical Care Nurse
Rancho Los Amigos Rehab Center
01.1998 - 01.2000
- Performed direct care of critically ill clients (medical/surgical) which involved decision making and critical thinking skills
- Acted as preceptor to new employees and/or student workers which involved completion of employee unit orientation checklist, acting as a resource person, and reporting feedback to Nurse Manager
- Unit Collaborative Team Member responsible for Unit Performance Improvement monitoring which involved data collection, preparation of results of monitors and reporting results to Nurse Managers and Clinical Director
- Unit charge nurse in the absence of the Nurse Manager and Assistant Nurse Manager
- Performed special assignments allocated by the Nurse Manager or Assistant Nurse Manager such as Quality Assurance, chart review/audit, preparation and organization of unit manuals, reviewing policies and procedures and unit competencies
Staff Nurse
LAC/USC Medical Center
01.1992 - 01.1998
- Direct patient care of patients (medical, surgical, neuro)
- Acted as unit charge nurse in the absence of the Nurse Manager and Assistant Nurse Manager
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Assessed physical, psychological, physiologic, and cognitive status of patients.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Collaborated with physicians, pharmacists and therapists to deliver quality, evidence-based care.
Education
Bachelors of Science Degree - Nursing
California State University Dominguez Hills
Carson, CA01.2006
Critical Care Nursing Program Certificate - undefined
LAC/USC Medical Center
Los Angeles, CA01.1992
Associate in Arts Degree - Nursing
Cerritos College
Norwalk, CA01.1992
Skills
- Clinical judgment
- Compassion and empathy
- Discharge planning
- Geriatric care
- Team coordination
- Patient education and counseling
- Strong clinical judgment
- Staff supervision
- Care planning
- Patient management
- Professional bedside manner
- Case management
- High level of autonomy
Timeline
RN Field Visiting Nurse
Sacred Heart Home Health Services
01.2022 - 01.2024
Independent Consultant
Home Health Consultant
01.2017 - 01.2022
Administrator/Director of Patient Care Services/CEO/Owner
EMC Home Health Providers, Inc.
01.2007 - 01.2017
Utilization Review Nurse
Molina Health Care
01.2007 - 01.2008
Administrator/Director of Patient Care Services/CEO
Monina Home Health, Inc.
01.2002 - 01.2007
Director of Patient Care Services
Ace Health Systems, Inc.
01.2001 - 01.2003
Community Liaison Nurse/Clinical Nurse Liaison/Public Relations and Marketing
Rancho Los Amigos Rehab Center
01.2000 - 01.2001
Critical Care Nurse
Rancho Los Amigos Rehab Center
01.1998 - 01.2000
Staff Nurse
LAC/USC Medical Center
01.1992 - 01.1998
Critical Care Nursing Program Certificate - undefined
LAC/USC Medical Center
Associate in Arts Degree - Nursing
Cerritos College
Bachelors of Science Degree - Nursing
California State University Dominguez Hills
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