Robert Gomez Jr
El Paso
Summary
Experienced healthcare professional with a strong focus on patient care, critical thinking, and communication. Skilled in team collaboration and achieving optimal patient outcomes. Reliable and adaptable, ensuring efficient and compassionate care in dynamic environments. Equipped with expertise in medical procedures, patient assessments, and care coordination. Experienced in developing and delivering clinical education to healthcare professionals, utilizing innovative teaching methods to enhance student learning and practical skills. Demonstrated knowledge in creating supportive and effective learning environments that foster student success. Diligent and experienced nurse with a robust background in clinical instruction, guiding students through complex medical scenarios to ensure comprehensive understanding and application of clinical practices. Exhibiting effective communication and mentorship skills, fostering a collaborative learning environment. Healthcare professional with a track record of training and mentoring future medical practitioners, showcasing a proven ability to design and implement educational programs that enhance clinical competencies. Reliable team player with a focus on collaboration and adaptability to evolving educational needs. Exhibits excellent instructional skills and a patient-centered approach.
Overview
25
25
years of professional experience
1
1
Certification
Work History
Clinical Instructor
Western Technical College
09.2024 - Current
- Work with nursing students in the simulation lab, supervising and advising students as they develop their nursing skills
- Plan and coordinate academic clinical classroom instruction
- Serve as a clinical instructor at off-campus sites while students are performing their clinicals
- Assessing student performance, evaluating their clinical reasoning and competence
- Orient students to the clinical setting and provide proper demonstration of procedures
- Provide timely and honest feedback to the students regarding their strengths and weaknesses
Nursing Supervisor / Administrator on Duty
Del Sol Medical Center
04.2024 - Current
- Utilize professional leadership and management skills to facilitate hospital throughput and resolve issues
- Supervise over 80 RNs and 40 CNAs of a busy 221-bed hospital
- Promptly report acute issues and daily hospital events to leadership
- Serve as a resource for all staff and physicians including facilitating equipment and procedural issue resolution
Quality Practice Consultant RN
Anthem-Amerigroup
02.2020 - Current
- Create project plans with physician's offices that establishes goals and objectives for HEDIS and CAHPS improvement
- Assess current practice patterns to ascertain both assets and challenges to meeting established goals for HEDIS and CAHPS
- Provide ongoing support to physician's offices to maintain and improve partnership
- Provide clinical documentation improvement education and guidance to ensure physician compliance with CMS ICD-10 guidelines
- Abstract clinical data from provider records to assist in closing HEDIS gaps
- Analyze and identify patterns in documentation to provide timely and effective feedback to enact change for improvement
- Collect data from various electronic systems to assist with closure of HEDIS measure gap closure
- Perform quality audits of ICD-10 coding documentation and identify areas of need and education
- Create training and education materials for providers to improve ICD-10 coding compliance
- Actively train both providers unfamiliar with ICD-10 Risk Adjust coding and providers who are struggling to maintain compliance
Emergency Room RN
Del Sol Medical Center
10.2022 - 04.2024
- Accurately assessing patient conditions and prioritizing appropriately
- Fully capable of working in a fast-paced environment that requires critical thinking skills
- Provide life support techniques when appropriate
- Effectively communicate with leadership and fellow nurses, becoming an integral part of the emergency department team
Quality Practice RN
WellCare Medical Management
08.2017 - 12.2019
- Provide HEDIS/STAR reports and guidance on closing care gaps for physicians who are contracted with the managed care healthplan
- Audited patient charts to identify areas of growth and develop unique plans specific to each provider's office to increase Star ratings
- Ensured capture of HCC Risk codes to increase PMPM reimbursements which in turn increases incentive dollars paid to contracted physicians
- Worked closely with physician office staff educating staff on the risk adjustment process system, Part D medication compliance, HEDIS quality metrics, CMS documentation guidelines, and STAR measure processes
- Perform clinical documentation improvement processes and guidance to ensure physician compliance with CMS
Emergency Room RN, PRN
Foundations Hospital
04.2016 - 09.2019
- Provide nursing care for all emergency room patients including but not limited to handling of defibrillations, transfusion, IV start and maintenance, medication administration, procedure set up
- Assist in the care of traumas, cardiac arrests, strokes, and conscious sedations
- Assess, plan, implement, collaborate, and coordinate the needs of patients with acute and/or chronic mental illness
- Quickly and appropriately triage incoming patients to ensure the more critical of patients are seen expediently
- Provide accurate rundown to ER physician to coordinate care for the multitude of patients in the ER
- Provide education to patient and family members regarding ER flow process, disease process, and treatment plan
- Serve as a resource for other critical care nurses and emergency room staff, especially regarding critically ill patients
- Delivered evidence-based care for all patients especially those identified with emotional or psychiatric problems
RN Clinical Coding Consultant
Wellmed Medical Management
01.2011 - 10.2017
- Performed both concurrent and retrospective audits for Medicare risk adjustment, HEDIS, and quality measures for a large managed care health plan
- Led project for Risk Adjustment Turnaround Initiative for the El Paso market
- After analyzing the current status and strategies I led a team that formulated new goals, initiatives, and guidelines for implementation and support
- Performed both concurrent and retrospective audits of member medical records for Medicare risk adjustment purposes
- Utilized clinical and coding knowledge to determine validity of physician documentation adherence to CMS/Medicare guidelines
- Educated providers on the CMS risk adjustment process system and CMS documentation guidelines and formulated processes and ways to improve scores
- Developed business solutions to include action plans, training materials, and workflow enhancement strategies based on root cause analysis studies I performed at provider offices
- Was actively engaged with performance improvement activities and any committees as assigned
- Managed and mentored a Risk Adjustment team that consisted of 4 RNs and 1 coder
- Consistently improved provider's Risk Adjusted Factor and HEDIS Star ratings year over year
Clinical Documentation Improvement Coordinator
Del Sol Medical Center
11.2009 - 01.2011
- Analyzed and interpreted medical record documentation to ensure accuracy and specificity of documented illnesses and clinical treatment
- Utilized the 3M clinical documentation system to made appropriate DRG queries to physicians so that documentation can genuinely reflect the patient's severity of illness
- Adhered to CMS medical coding guidelines and private payer regulations related to inpatient retrospective payment systems
- Coordinated with Case Managers to prevent inpatient cases from exceeding LOS based on DRG assignment
- Maintained consistent follow up with physicians and provided them with education and updates to enhance performance improvement
- Identified and validated missing diagnoses to ensure protection against RAC audits
Administrator On Duty/Nursing Supervisor
Sierra Providence East Medical
07.2008 - 01.2010
- Provided administrative (CNO) level supervision for a busy 110 bed hospital during the twelve-hour shift
- Supervised a staff of over 50 RNs, 20 CNAs, and numerous other support staff at any given time
- Acted as a resource for all physicians, nursing staff, and ancillary staff
- Helped to resolve difficult problems in the care of critically ill patients
- Consistently had positive interactions with physicians, hospital staff, and hospital guests by applying strong communication skills and the ability to relate to people
- Utilized strong problem-solving skills to resolve numerous issues all in an effective, appropriate, and timely manner
- Reported to supervisors to include the CEO, CNO, COO, and CFO accurate and appropriate information of daily hospital census, staffing, and productivity numbers
- Used clinical knowledge and leadership based experience to make critical decisions with regard to personnel logistics as well as patient safety and disposition
- Managed the life-saving measures team in the event of a life-threatening event
- Ensured the team properly executed life-saving measures to include CPR, defibrillation, and/or cardioversion, and administering the appropriate medications as needed
RN ICU
Thomason Hospital
07.2008 - 09.2009
- Provided nursing care to a variety of ICU and Trauma ICU level patients
- Appropriately reported changes in patient conditions to physicians and charge nurse
- Document thoroughly all patient care information in Cerner to include vitals, assessments, physician notifications, and patient status changes
- Evaluate current nursing interventions to determine their effectiveness and revise interventions as necessary
- Perform comprehensive assessment of critical patients
- Developed goals to assist critically ill patients to achieve as best as possible pre-illness level of function
- Educate both the patient and family members about the disease and recovery process
- Worked in conjunction with case management and the patient's family to optimize the recovery process of a critical illness post hospitalization discharge
PCM/Physician Support Coordinator
Las Palmas Del Sol Regional Health
07.2007 - 08.2008
- Provided IT support for physicians and their office staff with regard to Meditech and remote network access
- Participated in the design, testing, and support team for new or modified clinical applications, including HPF and Meditech
- Used clinical knowledge and experience to actively participate in the design of the new modules in Meditech
- As one of two RNs in the department, I was integral in the implementation and support to clinical staff during the Meditech upgrade
- Performed software and hardware installations and employed knowledge of computer systems to troubleshoot any problems
- Facilitated rollout of new and updated software to physicians and their respective offices
- Performed as the Remote Network Access Administrator to external customers
- These duties included creating and managing remote user accounts to their appropriate security level
- Applied thorough and effective teaching and communication skills to educate both physicians and their staff regarding network access, EHR usage, and problem-solving issues
- Developed and maintained excellent customer relationships to support the hospital system goals
Healthcare Coordinator
TriWest Healthcare Alliance
01.2006 - 07.2007
- Performed utilization and case management of both active duty and active duty family member services to civilian sector ensuring necessity, service, and length of stay
- Coordinated patient care with other facilities and civilian providers and assist the patient and their families with any barriers to care
- Adhered to Department of Defense and InterQual guidelines on all requests for medical services from Army Medical
- Reviewed medical referrals for appropriate use of healthcare services ensuring quality of care
- Reviewed questionable claims and worked to correct errors and omissions
- Quickly processed all claims appeals
- Performed as acting supervisor in the absence of the Nurse Manager to 3 area TriCare Service Centers to include WBAMC, Ft
- Bliss, and White Sands Missile Range
- Utilized knowledge of ICD 9, HCPS and CPT-4 codes to cross reference referrals with authorized care to verify accuracy
- Performed root cause analysis with regards to difficult claims, authorization, and payment issues
- Utilized clinical nursing knowledge to expedite Military Treatment Facility referrals to appropriate civilian specialty providers
- Performed as project manager for the Consult Tracking plan
- Instituted strategies and initiatives to revitalize the project resulting in an increase in the return rate of civilian consults to Army physicians from 30% to 60% within a 2 month period
- Promoted interdisciplinary collaboration across the difficult continuum of care between civilian and Army providers
- Managed all expedited, standard, and concurrent requests from providers in the appropriate manner
- Coordinated TriCare beneficiary referred care with the William Beaumont Army Medical Center's Referral Management Center, Case Managers, Discharge Planners, and TriWest corporate staff
Charge RN, Emergency Room
Physicians Hospital
01.2005 - 08.2006
- Utilized multitasking skills to perform as a triage, charge, and staff nurse during the 12 hour shift
- Worked as a highly motivated team member in the Emergency room providing direct patient care to a variety of individuals in accordance with the standards of nursing
- Used effective multi forms of communication with physicians, teammates, and patients
- Triaged and provided risk assessment services for patients seeking care for mental health conditions
- Provided skilled patient care to a variety of patient age groups and acuity levels
- Encouraged a fun yet professional work environment that centered on teamwork
Charge RN, Dialysis Unit
Renal Care Group
02.2004 - 08.2006
- Supervised Patient Care Technicians in the initiation and termination of dialysis for chronic renal failure patients in a 16 chair unit
- Provided patient education to chronic renal failure patients with regards to medication and fluid compliance, dietary restrictions, and dialysis access care
- Coordinated and provided effective patient care in conjunction with the Nephrologists
- Quickly assessed deteriorating patients and instituted appropriate interventions such as fluid boluses, intravenous dextrose administration, and basic life support measures
- Safely administered medications through the intravenous, oral, and intramuscular routes
Charge RN, Dialysis Unit
Davita
03.2003 - 11.2005
- Worked in conjunction with the Nephrologists and provided on-time and on-target information regarding current patient statuses, thus improving patient outcomes
- Supervised a staff of five Patient Care Technicians in the safe initiation and termination of dialysis for renal failure patients
- Monitored patients and provided education and support influencing adherence to their treatment plans
- Appropriately triaged ill patients and instituted life saving measures when necessary
Charge Nurse, Emergency Room
University of Colorado Hospital
07.2001 - 03.2003
- Supervised a staff of 20 RNs and 4 ER Technicians in a busy Level II Trauma Unit
- Performed as a triage, trauma, and staff nurse when necessary
- Provided advanced level of specialized care to all patients, especially those critically ill
- Demonstrated experience, leadership, and creative approaches to the assessment and care planning of emergency room patients, especially those with complex mental health needs
- Monitored all incoming nursing calls to monitor potential emergencies and triage accordingly
- Facilitated and increased the working relationship between the nursing staff and the physicians
- Utilized effective nursing judgement skills to determine the patients' illness severity quickly
- Appropriately delegated duties to staff RNs and ancillary staff
- Oriented and precepted many new RN graduates and staff to the ER
Staff Nurse, Emergency Room
Del Sol Medical Center
08.2000 - 07.2001
- Provided safe and timely nursing care to all emergency room patients
- Functioned exceedingly well in all areas of the emergency room such as triage, trauma, fast track, and general medical surgical
- Discussed abnormal results with the providers and communicated normal lab results to the patient or caregiver
- Strived to create and foster an atmosphere of teamwork and brotherhood amongst all the staff
- Provided appropriate patient and family education with regard to diagnosis, treatment, and follow up care upon discharge from the ER
Education
Master of Science - Nursing
University of Phoenix
Phoenix, AZ07-2025
Bachelor of Science - Nursing
New Mexico State University
Las Cruces, NM01.2000
Skills
- Hardware Troubleshooting Expertise
- Software Problem Resolution
- Proficient in Software Packages
- Experience with OS Package Management
- Experienced in Installing Computer Components
- Software Installation
- System Software Deployment
- Typing at 40 wpm
- Experienced in MS Office Applications
- Operating knowledge of electronic medical records programs
- Meditech Proficiency
- Experience with Cerner Systems
- GE Centricity Proficiency
- EClinical Works
- Athena
- Amazing Charts
- Patient assessment
- Accurate Clinical Documentation
- Quality improvement
- Healthcare Regulatory Compliance
- Team leadership
- Patient Care Guidance
- Effective communication
- Completing physical assessments
- Leadership and mentoring
- Hands-on clinical instruction
- Instructing small groups
- Developing curriculum
- Health promotion strategies
- Classroom management
- Professional development planning
Certification
CPC - Certified Professional Coder
Affiliations
- The National Society of Leadership & Success
Languages
English
Native or Bilingual
Spanish
Full Professional
Timeline
Clinical Instructor
Western Technical College
09.2024 - Current
Nursing Supervisor / Administrator on Duty
Del Sol Medical Center
04.2024 - Current
Emergency Room RN
Del Sol Medical Center
10.2022 - 04.2024
Quality Practice Consultant RN
Anthem-Amerigroup
02.2020 - Current
Quality Practice RN
WellCare Medical Management
08.2017 - 12.2019
Emergency Room RN, PRN
Foundations Hospital
04.2016 - 09.2019
RN Clinical Coding Consultant
Wellmed Medical Management
01.2011 - 10.2017
Clinical Documentation Improvement Coordinator
Del Sol Medical Center
11.2009 - 01.2011
Administrator On Duty/Nursing Supervisor
Sierra Providence East Medical
07.2008 - 01.2010
RN ICU
Thomason Hospital
07.2008 - 09.2009
PCM/Physician Support Coordinator
Las Palmas Del Sol Regional Health
07.2007 - 08.2008
Healthcare Coordinator
TriWest Healthcare Alliance
01.2006 - 07.2007
Charge RN, Emergency Room
Physicians Hospital
01.2005 - 08.2006
Charge RN, Dialysis Unit
Renal Care Group
02.2004 - 08.2006
Charge RN, Dialysis Unit
Davita
03.2003 - 11.2005
Charge Nurse, Emergency Room
University of Colorado Hospital
07.2001 - 03.2003
Staff Nurse, Emergency Room
Del Sol Medical Center
08.2000 - 07.2001
Bachelor of Science - Nursing
New Mexico State University
Master of Science - Nursing
University of Phoenix
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