Nicole Silva
Maplewood,NJ
Summary
Dynamic RN Case Manager with extensive oncology nursing experience at Memorial Sloan Kettering Cancer Center. Expert in patient advocacy and insurance authorization, successfully facilitating access to complex treatments. Proven ability to collaborate with interdisciplinary teams, enhancing patient care and outcomes through effective communication and strategic case management.
Overview
16
16
years of professional experience
1
1
Certification
Work History
RN Case Manager, Patient Financial Services
Memorial Sloan Kettering Cancer Center
New York, NY
09.2020 - Current
- Review an assigned caseload of oncologic/non-oncologic treatment plans requiring insurance authorizations and oversee the financial clearance process
- Supporting our Cellular Therapy Services team with insurance authorization of CarT products, TILs therapy, Gene Therapy, Auto/Allo SCT, and Clinical Trials
- Facilitate patient access to care by drawing upon Oncology nursing knowledge and an understanding of complex insurance landscapes—particularly patients who are out of network without out of network benefits
- Utilize clinical nursing expertise to evaluate treatment orders and serve as the liaison between the clinical team, insurance carrier, and billing department.
- Assisting the clinical team with overturning denials for medically necessary care
- Assisting with navigating complex system to achieve mutual goals, advocate for patients, while recognizing personal dignity, autonomy, and the right to self-determination
- Understanding the importance of utilization management by reviewing and evaluating the medical necessity, appropriateness, and effectiveness of complex oncological treatment plans
- Reviewing NCCN, CMS, and FDA guidelines for approval of chemotherapy regimens for Medicare AB patients
- Collaborating with Payor Access Team from pharmaceutical companies when necessary for challenging cases
Outpatient Chemotherapy Infusion RN, Clinical Nurse III
Memorial Sloan Kettering Cancer Center
Basking Ridge, NJ
01.2017 - 09.2020
- Promoted to Clinical Nurse III, the proficient nurse who possesses in-depth knowledge, skills, and abilities of nursing practice, after successfully completing the promotional requirements.
- Served as 1 of 2 charge nurses during the COVID-19 pandemic, managing a team of 30 nurses during an unprecedented time. Adapting to new facility protocols paired with split-second decision-making skills to ensure continuity of care for our oncology patients who were COVID + but required treatment for their cancer diagnosis.
- Fulfill infusion charge nurse role by managing daily operations of a high-volume outpatient regional site. Working closely with the nurse leader in assessing nurses’ performance while also guiding and motivating the staff. Completing administrative tasks and collaborating with the interdisciplinary team to improve the patient experience and workflow by participating in weekly meetings.
- Provide care to oncology patients by evaluating the appropriateness of treatment based on the patient’s condition, pre-treatment tests, lab values and following policy and procedure to administer chemotherapy, biotherapy, and/or immunotherapy.
- Assess patient’s response to treatment, provide patient education regarding treatment and symptom management, and appropriately escalate symptoms and concerns to the multidisciplinary team to optimize the patient’s treatment plan and enhance the patient experience.
- Provide care to patients via alternative methods including CADD pumps, Hepatic Arterial Infusion Pump (Codman & SynchroMedII), intraperitoneal ports, and intravesical access.
- Manage care for patients receiving investigational treatments by reviewing the protocol and collaborating with the research team to confirm medication dosages, pre-treatment lab work, premedications, and relevant testing.
- Orient and precept experienced nurses to the chemotherapy infusion unit by engaging in effective communication, critical thinking, and providing constructive feedback.
- Fulfill verification nurse role to ensure that orders entered by the physician are correct for the patient, diagnosis, and treatment.
- Fulfill lab inject nurse role by assessing patients need for injections and administering as prescribed by LIP as well as accessing central venous catheters and drawing blood work. Providing discharge instructions to patients as indicated.
Part–time Building Float RN, Clinical Nurse II
Memorial Sloan Kettering Cancer Center
Basking Ridge, NJ
02.2016 - 01.2017
- Provided clinical support to Radiology, Medical-Oncology, and Lab Inject departments as needed.
- Prepped patients for MRI, CT scan, and PET scan by educating patients on procedure and discharge instructions as well as obtaining vascular access and administering IV contrast.
- Managed patients with contrast reactions by working with Radiologist and initiating hypersensitivity order set.
- Worked collaboratively with the Medical-Oncology team in the Triage Department by assessing patients over the phone and clinically determining if the patient needed emergency medical assistance. Also provided patient education and symptom management via telephone.
Outpatient Infusion Center RN
New York Presbyterian Hospital
New York, NY
08.2012 - 02.2016
- Provided care to oncology, hematology, and BMT patients by administering chemotherapy, biotherapy, blood products, and antibiotics.
- Performed venipuncture, accessed ports, and maintained central catheter devices.
- Proficiently executed chemotherapy and biotherapy treatment safely and as per policy as well as the safe administration of blood products.
- Educated patients and their families on various chemotherapy treatments, blood transfusions, and symptom management.
Staff RN on Amenities Unit/Medicine/Post-Surgical
New York Presbyterian Hospital
New York, NY
12.2010 - 08.2012
- Worked effectively with an interdisciplinary team to implement care for a wide variety of patients, including international patients. These patients ranged in level of acuity, some of them required telemetry or step-down monitoring with an arterial line.
- Educated patients and their families on disease process, medical-surgical procedures, and broad aspects of therapeutic regimen including medications, pain management techniques, and post-op instructions.
- Demonstrated leadership skills by having an active role in the Unit Practice Council as well as fulfilling the charge nurse role and precepting new hires.
Multi-System Progressive Care Unit RN
Florida Hospital South Campus
Orlando, FL
10.2009 - 11.2010
- Managing care for and coordinating care with physicians, therapists, dietitians, and other disciplines to deliver nursing care for several patients on a multi-system progressive care unit utilizing critical care thinking skills.
- Assisting nursing students in performing basic care for patients, training graduate nurses, and teaching and orienting experienced nurses to the unit and hospital.
Education
Master of Science - Nursing, Leadership in Healthcare Systems Management
Drexel University
Philadelphia, PA05.2025
Bachelor of Science - Nursing
Fairleigh Dickinson University
Teaneck, NJ05.2009
Skills
- Patient advocacy
- Oncology nursing
- Communication skills
- Case management
- Care coordination
- Team collaboration
- Utilization review
- Health insurance navigation
- Project management
- Insurance authorization
Credentials
- MSN
- RN
- OCN
Certification
- New Jersey State Registered Professional Nurse, 08/2013, 05/2025, 26NR16908900
- New York State Registered Professional Nurse, 11/2010, 03/2028, 637711
- Oncology Certified Nurse (OCN), Oncology Nursing Certification Corporation, 12/2016, 12/2027
- Basic Life Support (BLS), American Heart Association, 09/2009, 08/2026
Professional Organizations
- Magnet Champion, Support and help sustain nursing excellence by promoting Magnet principles and best practice within my department., 11/2020, present
- MSKCC Outpatient Nursing Informatics Council, Integration of nursing practice and technology, served as taskforce member for Tip of the Month subcommittee., 11/2020, present
- Basking Ridge Infusion Unit Based Council, Served as Chair and Chair Elect., 01/2019, 09/2020
- MSKCC Outpatient Quality and Safety Council, Collaborated with a team of nurses from the institution to assess, monitor, and make recommendations to improve professional nursing practice., 01/2018, 11/2020
- Blood Transfusion Auditor, Monitored nursing practice quarterly to ensure compliance with policy., 02/2018, 09/2020
- Blood Transfusion Super User, Selected to train the nursing staff on the administration of blood products as per policy and serve as a resource for any related questions or issues., 12/2017, 09/2020
- Scalp cooling machine Super User, Managed and implemented care for patients utilizing the Dignitana and Paxman scalp cooling systems by providing first line support in my facility., 02/2017, 09/2020
- MSKCC GreenReps/NJ Regional Sustainability Task Force, 01/2017, 01/2018
- MSKCC Mentorship Program, Established a collaborative partnership with an APN in my organization for professional growth and development., 08/2016, 10/2016
Presentations
- Overview of Chemotherapy Induced Peripheral Neuropathy and the Use of Complementary Therapies to Relieve Symptoms, 10/2020
- Use of Medication Screening Tools in the Geriatric Oncology Population, 06/2019
- Advances in Immunotherapy Treatment with the use of Checkpoint Inhibitors, 07/2017
Timeline
RN Case Manager, Patient Financial Services
Memorial Sloan Kettering Cancer Center
09.2020 - Current
Outpatient Chemotherapy Infusion RN, Clinical Nurse III
Memorial Sloan Kettering Cancer Center
01.2017 - 09.2020
Part–time Building Float RN, Clinical Nurse II
Memorial Sloan Kettering Cancer Center
02.2016 - 01.2017
Outpatient Infusion Center RN
New York Presbyterian Hospital
08.2012 - 02.2016
Staff RN on Amenities Unit/Medicine/Post-Surgical
New York Presbyterian Hospital
12.2010 - 08.2012
Multi-System Progressive Care Unit RN
Florida Hospital South Campus
10.2009 - 11.2010
Master of Science - Nursing, Leadership in Healthcare Systems Management
Drexel University
Bachelor of Science - Nursing
Fairleigh Dickinson University