Ricey Nunez, RN
Hollywood,Fl
Summary
To secure a position as Clinical Nurse for an Organization where my past experience and special skills can be of value and contribution. Allowing me to expand my learnings, knowledge, and skills. Extensive knowledge in Home Infusion dispensing and care coordination services. Extensive knowledge in patient care/Bed -side Nursing in an acute care facility. Proficient Lead Coordinator adept at managing projects with an efficient, hardworking approach.
Overview
22
22
years of professional experience
Work History
Utilization Management Nurse II
Humana
05.2023 - Current
- Utilized CMS Guidelines to conduct clinical reviews for Medical Necessity for DME and HH services and route cases accordingly to Medical Director when criteria is not met.
- Educated providers on Utilization Management and medical management processes.
- Collaborated with various staff members within provider network and case management team electronically or telephonically to coordinate member care.
Registered Nurse II Rehab/Med-Surg
Mount Sinai Health System
02.2022 - Current
- Acted as Charge Nurse on the floor 1 time per week and as needed based on department needs.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- 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.
- 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.
- Prevented the spread of infections by consistently adhering to strict infection control protocols and educating patients on proper hygiene practices.
- 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.
- Facilitated patient transitions between different levels of care, ensuring continuity of services and minimizing disruptions in treatment plans.
- Streamlined medication administration processes for increased safety and accuracy during busy shifts.
- Educated family members and caregivers on patient care instructions.
- Monitored patient reactions after administering medications and IV therapies.
POD Infusion Lead Coordinator
One Home Care
08.2014 - 02.2022
- Review referrals coming in for Home services ensuring patient diagnosis, medical order, and clinical notes are complete and accurate for processing to Pharmacy Department.
- Coordinates Home Health services for Infusion orders received.
- Perform timely prospective review for Infusion Services.
- Processing reauthorization as required by the servicing provider.
- Sorts requests by urgency of applicable turnaround time criteria.
- Demonstrates thorough knowledge of Medicare Regulations and Managed Care Contracts.
- Establishes and maintains positive communication and professional demeanor with internal and external staff, customers, providers, and enrollees fostering collaborative teamwork.
- Monitors staff work assignments and makes appropriate adjustments based on staffing levels, staff experience, and number/request types of authorizations received.
- Provide clinical knowledge and act as a clinical resource to non-clinical team staff.
- Collaborate with various staff within provider networks and case management team electronically or telephonically to coordinate member care.
- Acts as a liaison with outside entities, including, but not limited to, physicians, Health Plans, hospitals, health care vendors, social service agencies, patient advocates, and regulatory agencies.
- Coached employees through day-to-day work and complex problems.
Pharmacy Technician Coordinator
Univita Health
07.2013 - 08.2014
- Responsible for assisting pharmacists in daily dispensing and coordination of pharmacy services.
- Calling patients to monitor response to prescribed therapy and coordinating delivery of medications with currier services.
- Coordinating home infusion services upon the receival of a referral from Hospital, Skilled Nursing facilities, MD offices etc.
- Clinical monitoring and assessment of home infusion patients.
- Entering Labs results, monitoring Antibiotic therapy based on the Laboratory results under a supervision of a pharmacist.
- Receiving and Verifying Prescriptions.
- Compounded sterile admixtures and non-admixtures including but not limited to hydration, nutrition, TPN, antibiotic therapy using aseptic techniques and USP 797.
- Ensure clean room and related equipment was cleaned, sanitized, and maintained to compliance with company policies and procedures.
- Perform timely concurrent reviews of medication refills to ensure appropriateness and timelines of services.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
IV Technician/Dispensing Technician
Option Care Pharmacy
10.2002 - 07.2013
- Responsible for mixing TPN, Chemotherapy, Antibiotics and various other compounding using aseptic techniques and USP 797.
- Responsible for assisting equipment calibration and testing of Infusion pumps.
- Responsible for assisting drivers in checking and pulling supplies for Peripheral/Central Catheters.
- Called patients to coordinate deliveries of medications and supplies delivered.
- Assisted pharmacists in processing new referrals received.
- Performed after hours and weekend on call for Intake and Pharmacy.
- Assisted Home Infusion Nurses with Mal-functioning equipment (CADD/Curlin Pumps).
- Conducted drug product reviews and assisted Pharmacists and staff in drug inventory management.
- Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions and refill instructions.
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments.
IV Pharmacy Technician
Aventura Hospital
09.2002 - 09.2003
- Mixed in-house IV infusions including Antibiotics, Hydration, TPN’s.
- Attended rounds to various Nursing Units such as ICU and CCU.
- Prepared and delivered Medcarts-Crashcarts to designated Units.
- Communicated with hospital staff who continuously called the pharmacy for orders and requesting services for in-house patients.
- Ordered medicines daily to replenish stock and increase inventory in anticipation of need.
- Stocked, labeled and inventoried medication to keep accurate records.
- Performed various pharmacy operational activities with strong commitment to accuracy, efficiency and service quality.
- Calculated dosage, filled prescriptions and prepared prescription labels with absolute accuracy.
Education
Associate Degree in Nursing - Nursing
Florida National University
Miami, Fl08.2021
Pharmacy Technician Degree -
National School of Technology
Miami, Fl08.2002
Skills
- 19 years of experience working in Home Infusion Services, dispensing and care coordination
- 3 years of experience working bed-side care in an acute care setting
- 2 years of experience working in Utilization Management outpatient Home Health and DME
- Proven track record in leadership and technical support
- Ability to coordinate delivery of health services with variety of health service providers
- Proficient in Word, Power Point and Excel Platforms
- Strong critical thinking and problem- solving leader
- Proficient in EMR charting
- Strong Medical Ethics
- Culturally sensitive
- Work Planning and Prioritization
EDUCATION AND TRAINING
- LICENSES AND CERTIFICATES, Registered Nurse (Multistate License): RN 9583984 Registered Pharmacy Technician: RPT 1700
Languages
Spanish
Full Professional
English
Full Professional
References
References available upon Request
Timeline
Utilization Management Nurse II
Humana
05.2023 - Current
Registered Nurse II Rehab/Med-Surg
Mount Sinai Health System
02.2022 - Current
POD Infusion Lead Coordinator
One Home Care
08.2014 - 02.2022
Pharmacy Technician Coordinator
Univita Health
07.2013 - 08.2014
IV Technician/Dispensing Technician
Option Care Pharmacy
10.2002 - 07.2013
IV Pharmacy Technician
Aventura Hospital
09.2002 - 09.2003
Associate Degree in Nursing - Nursing
Florida National University
Pharmacy Technician Degree -
National School of Technology
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