Nicole Ovalles
Cranston,RI
Summary
Compassionate and results-driven Licensed Practical Nurse with over 5 years of experience in telehealth, remote patient monitoring, and chronic care management. Expertise in virtual patient engagement, clinical documentation, and care coordination enhances the ability to deliver high-quality nursing care in technology-enabled environments. Recognized for strong assessment skills and adaptability, consistently achieving excellence in remote care delivery. Committed to improving patient outcomes through education, collaboration, and the application of evidence-based practices.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Licensed Practical Nurse – Travel/Agency
ESHYFT
Providence
10.2020 - Current
- Delivered skilled nursing care to medically complex patients across multiple facilities.
- Administered medications and treatments as per physician orders to ensure patient safety and comfort.
- Facilitated efficient communication between patients, families, and healthcare providers to promote continuity of care across settings.
Clinical Authorization Nurse (Contract)
CVS Specialty Pharmacy
Remote
10.2025 - 06.2026
- Reviewed and processed specialty medication authorization requests in alignment with payer policies and clinical criteria.
- Collaborated with pharmacists, providers, and insurance teams to ensure timely approvals and continuity of care.
- Ensured compliance with HIPAA, URAC standards, and organizational protocols.
Remote Patient Monitoring Nurse
HealthSnap
Remote
04.2025 - 10.2025
- Monitored patient vitals and trends through RPM platforms while maintaining strict HIPAA compliance.
- Identified escalation needs and collaborated with providers to adjust care plans.
- Educated patients and families on disease management and prevention strategies.
Clinical Nurse Reviewer – Medicare Appeals
Acentra Health
Remote
09.2023 - 03.2025
- Reviewed clinical documentation to determine medical necessity and authorize services per Medicare guidelines.
- Determined and authorized services for patients in accordance with guidelines and regulations.
- Improved patient care quality by conducting thorough clinical reviews and providing evidence-based recommendations.
Charge Nurse – Skilled Nursing
Golden Crest Nursing Centre
North Providence
10.2020 - 09.2023
- Supervised nursing staff and coordinated daily care operations.
- Monitored patient status, medications, and treatment outcomes.
- Provided education to staff, patients, and families to improve care quality,
Education
Licensed Practical Nurse - Nursing
Lincoln Technical Institute
Lincoln, RI10.2020
Certified Nursing Assistant -
Charter School AEP
Cranston, RI06.2012
High School Diploma -
Cranston High School East
Cranston, RI06.2012
Skills
- Telehealth & Remote Care: Remote Patient Monitoring, Chronic Care Management, Tele-triage, Virtual Consults, Care coordination, HIPAA Compliance, Patient Education, Care Plan Implementation
- Clinical & Case Management: Utilization Review BFCC QIO, Prior Authorizations, Specialty pharmacy medication authorizations Discharge Planning, Care Coordination
- Documentation & Quality: Clinical Documentation, Medical Record Review, Quality Improvement, Policy & Procedure Compliance, Electronic health records management
- Direct Patient Care: Diabetes Management, Medication Administration, IV Therapy, Wound Care, Catheter/Colostomy Care, Dementia & Behavioral Care, Disease prevention, Geriatric care, Community health
- Technical Skills: Matrix, Eclinical Works, PointClickCare, Epic, Symphony, Eboard, Jitzi, Genesys, RXclaims, AS400, CAS, MFT Managed, Microsoft Office, Teams, Google meets
- Professional Strengths: Communication, Critical Thinking, Leadership, Multitasking, Time Management, Problem-Solving, Self-Directed, Patient advocacyFirst Aid/CPR
Websites
Certification
- CPR – BLS (AHA)
- HIPAA Fundamentals for Business Associates
- Cyber Awareness
- Safeguarding Personal Information (PII)
- URAC 101 Organizational Training
- Dementia Care & Behavioral Health
- DHS Record Management
Timeline
Clinical Authorization Nurse (Contract)
CVS Specialty Pharmacy
10.2025 - 06.2026
Remote Patient Monitoring Nurse
HealthSnap
04.2025 - 10.2025
Clinical Nurse Reviewer – Medicare Appeals
Acentra Health
09.2023 - 03.2025
Licensed Practical Nurse – Travel/Agency
ESHYFT
10.2020 - Current
Charge Nurse – Skilled Nursing
Golden Crest Nursing Centre
10.2020 - 09.2023
Licensed Practical Nurse - Nursing
Lincoln Technical Institute
Certified Nursing Assistant -
Charter School AEP
High School Diploma -
Cranston High School East