Experienced healthcare leader in the managed care market adept at training and leading successful teams focused on delivering exceptional service to all members and staff. Talented problem-solver with excellent clinical, scheduling and compliance administration skills.
Overview
34
34
years of professional experience
8
8
years of post-secondary education
Work History
Sr. Manager, Clinical Health Services
Aetna/CVS Health
Woonsocket, RI
10.2017 - Current
Assisted with regulatory issues such as compliance, participating in NCQO and state audits
Developed proposals and presentations for internal and external audiences.
Provided strong leadership to enhance team productivity and morale.
Recruited, oriented and trained healthcare staff members.
Analyzed current programs to determine effectiveness.
Consulted with healthcare professionals on business decisions.
Maintained frequent interaction with senior management to measure goal achievement and determine areas of improvement.
Conducted performance evaluations, compensations and hiring to maintain appropriate staffing requirements.
Created and implemented organizational policies and procedures, desktops and job aides
Staff Nurse, Neonatal Intensive Care Unit
St. Elizabeth Health Care
Edgewood, KY
10.2015 - Current
Assessed, evaluated and cared for neonate and pediatric patients.
Performed various nursing interventions such as wound dressing, vital sign monitoring and specimen collection.
Gathered patient health data through interviews and observation, documenting data in electronic records.
Formulated plans for nursing measures to restore, maintain and promote patients' physical and mental health.
Implemented medication and IV administration, catheter insertion and airway management.
Identified patient care requirements by establishing personal rapport with patients and families.
Collected blood, tissue and other laboratory specimens and prepared for lab testing.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Identified learning needs of patients and families and responded with advocacy and health education.
Managed elements of patient care from admission to discharge or transfer to other units.
Monitored patients' conditions and reported changes in physical presentation, appearance and behavior to discuss treatment with physicians.
Directed patient care by initiating and following through with plan of care, continuing care and discharge instructions.
Clinical Care Manager
Aetna/CVS Heatlh
Woonsocket, RI
05.2014 - Current
Coordinated implementation of health programs and initiatives in collaboration with professionals and technical personnel.
Worked with providers to define quality metrics and outcome reporting process.
Provide ongoing case management to patients to implement appropriate treatment plan, adhere to quality models and maximize utilization of services needed to achieve optimal outcomes.
Practiced high level of professionalism to safeguard patient information and maintain data integrity.
Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing and other enabling services for patients.
Arranged transportation and documented details of discharge transition plans.
Staff Nurse, Neonatal Intensive Care Unit
Cincinnati Children's Hospital Burnet Campus
Cincinnati, OH
06.2004 - 05.2014
Assessed, evaluated and cared for neonate and pediatric patients.
Gathered patient health data through interviews and observation, documenting data in electronic records.
Performed various nursing interventions such as wound dressing, vital sign monitoring and specimen collection.
Reported patients' status and delegated nurse assignments to achieve optimal outcomes.
Directed patient care by initiating and following through with plan of care, continuing care and discharge instructions.
Coordinated with physicians to perform bedside procedures such as intravenous injections, vascular line insertions and bronchoscopies.
Collected blood, tissue and other laboratory specimens and prepared for lab testing.
Precepted student nurses and oriented new hires, providing guidance and mentorship when teaching on hospital policies, emergency procedures and nursing best practices.
Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
Assessed medical status of patients pre- and post-operation by checking vital parameters and supervising food intake.
Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process and management and lifestyle options.
Identified learning needs of patients and families and responded with advocacy and health education.
Monitored patients' conditions and reported changes in physical presentation, appearance and behavior to discuss treatment with physicians.
Implemented medication and IV administration, catheter insertion and airway management.
Identified patient care requirements by establishing personal rapport with patients and families.
Managed elements of patient care from admission to discharge or transfer to other units.
Registered Nurse, Licensed Practical Nurse
Shady Nook Care Center
Lawrenceburg, IN
08.2002 - 04.2006
Managed patient care through closely monitoring respiration, blood pressure and blood glucose levels.
Provided direct patient care, stabilized patients and determined next course of action.
Cared for wounds, provided treatments and assisted with procedures.
Managed care from admission to discharge.
Monitored and tracked patient vitals in [Software] to keep team informed of changing conditions.
Administered controlled narcotics, inserted IVs and performed catheterizations.
Collaborated with interdisciplinary team of healthcare and social service providers to address patients' needs through effective intervention and care planning.