Nina Sandate
Port Orchard,WA
Summary
Applied extensive experience in acute hospital settings and utilization management to advance nursing practice and patient care outcomes.
Overview
16
16
years of professional experience
Work History
RN Consultant
Aetna
01.2017 - Current
- Oversaw requests and evaluations of clinical information for initial, concurrent, or retro reviews, ensuring compliance with CMS and MCG guidelines.
- Oversaw pre-certification requests and reviews, ensuring strict compliance with MCG guidelines and Aetna’s clinical policy bulletins.
- Oversaw accurate CPT coding for all requested procedures and confirmed necessity for precertification or predetermination of codes.
- Facilitated preparation and submission of denial recommendations to medical director and plan liaison.
- Facilitated interdisciplinary teams by delivering comprehensive benefit information for in-network providers and facilities, including DME, home healthcare, acute and sub-acute rehab, and skilled nursing facilities.
- Facilitated regular communication with assigned case managers regarding unplanned admissions, inpatient status, and discharge plans with orders.
- Partnered with assigned case manager to analyze and address members' frequent hospital readmissions.
- Facilitated biweekly UM grand rounds with medical directors and direct supervisors to enhance proactive discharge planning.
RN
Methodist Texsan Hospital
01.2014 - 01.2017
- Responsible for the complete nursing process for both adult and geriatric patients.
- Managed and directed nursing care activities during the patients hospital stay.
- Identified short and long term goals based on patient care needs.
- Provided and documented nursing interventions based on assessed patient needs, and plan of care.
- Collaborated with appropriate health team members for coordination of the daily plan of care for assigned patients.
- Involved the family when providing care and in decision-making as appropriate.
- Documented the effectiveness of nursing care and modified plan of care as the patient progresses toward expected outcomes.
- Documented FIMS and which therapies were involved in patient care.
- Administer IV medications according to policy and procedures.
- Admit and discharge patients home, skilled nursing facility or LTAC.
- Implemented care plans for patient treatment after assessing physician medical regimens.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Monitored patient reactions after administering medications and IV therapies.
- Evaluated patient histories, complaints, and current symptoms.
- Educated family members and caregivers on patient care instructions.
- Collaborated with interdisciplinary teams to develop comprehensive care plans for complex cases.
- Contributed to interdisciplinary team meetings by presenting relevant clinical data about patients'' progress toward reaching established goals of care.
- Participated in ongoing professional development opportunities to stay current on best practices in nursing care and emerging trends in healthcare delivery.
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
- Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
RN
Methodist Metropolitan
01.2013 - 01.2014
- Assesses patient's status through interview, observation, and physical assessment.
- Communicated multi-disciplinary assessment data among team members.
- Identified and diagnosed alterations in conjunction with the patient's clinical presentation.
- Coordinated formation of interdisciplinary problem list.
- Developed a plan of care that included educational and discharge planning interventions.
- Implemented the patient's plan of care and evaluated the effectiveness of it.
RN
Christus Spohn Hospital
01.2011 - 01.2013
- Managed patient care as well as medication, orders and treatments.
- Assisted the physicians in performing special procedures.
- Monitored cardiac, neurological, and physical status of patients under care.
- Evaluated the nursing care provided in the area assigned.
- Maintained patient’s clinical records and assisted with execution of the physician’s orders.
- Administered treatments and sterile procedures.
- Administered medications and monitored patient vitals to ensure optimal care delivery.
- Collaborated with interdisciplinary teams to develop individualized care plans for patients.
- Educated patients and families on treatment plans, promoting adherence and understanding of care protocols.
- Assessed patient conditions and documented changes to inform clinical decision-making processes.
- Mentored junior nursing staff, fostering professional development and enhancing team performance.
- Implemented quality improvement initiatives to enhance patient safety and satisfaction measures.
- Led emergency response efforts, coordinating multidisciplinary teams during critical situations to optimize outcomes.
- Streamlined workflow processes, improving efficiency in patient admissions and discharge procedures.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
- Assisted in the training and mentorship of new nursing staff members, contributing to a positive work environment and high-quality patient care.
- Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
- Collaborated with interdisciplinary teams to develop comprehensive treatment plans for complex patients with multiple comorbidities.
- Served as a preceptor for nursing students during their clinical rotations, providing valuable real-world experience and guidance to foster professional growth.
- Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
- Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
- Participated in ongoing professional development opportunities to stay current on best practices in nursing care and emerging trends in healthcare delivery.
- Promoted a culture of safety within the healthcare facility by participating in quality improvement initiatives, identifying potential hazards, and advocating for best practices in nursing care delivery.
- Advised patients and caregivers of proper wound management, discharge plan objectives, safe medication use, and disease management.
- Contributed to interdisciplinary team meetings by presenting relevant clinical data about patients'' progress toward reaching established goals of care.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Managed patients recovering from medical or surgical procedures.
RN
Midland Memorial Hospital
01.2010 - 01.2011
- Responsible for the complete nursing process for both adult and geriatric patients.
- Managed and directed nursing care activities during the patients hospital stay.
- Identified short and long term goals based on patient care needs.
- Provided and documented nursing interventions based on assessed patient needs, and plan of care.
- Collaborated with appropriate health team members for coordination of the daily plan of care for assigned patients.
- Involved the family when providing care and in decision-making as appropriate.
- Documented the effectiveness of nursing care and modified plan of care as the patient progresses toward expected outcomes.
- Administer IV medications according to policy and procedures.
- Admit and discharge patients.
Education
BSN -
New Mexico Highlands University
Las Vegas, NM01.2019
ADN - Nursing
Odessa College
Odessa, TX01.2010
Skills
- Clinical information review
- CPT coding
- Pre-certification processes
- Case management collaboration
Timeline
RN Consultant
Aetna
01.2017 - Current
RN
Methodist Texsan Hospital
01.2014 - 01.2017
RN
Methodist Metropolitan
01.2013 - 01.2014
RN
Christus Spohn Hospital
01.2011 - 01.2013
RN
Midland Memorial Hospital
01.2010 - 01.2011
BSN -
New Mexico Highlands University
ADN - Nursing
Odessa College