Scarlet Blanco
Miami Lakes,FL
Summary
Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, triage and care coordination in fast-paced environment. Proven to remain calm under pressure and skillfully handle difficult patients and high-stress situations. Consistently developing strong relationships with patients and families through empathetic communication, respectful attitude and excellent customer service.
Overview
15
15
years of professional experience
Work History
RN Specialty II- Neurology Clinic Nurse
Memorial Physician Group
10.2021 - Current
- Triage Seizure, MS, ADHD and Headache calls, provide guidance based on MD recommendations
- Provide Seizure and Headache health education to parents/guardians and patient
- Prior authorization for specialty Seizure medications and MS medications
- Coordinate delivery between specialty pharmacy to hospital for IVIG infusions
- Triage patient for clinic visit- vital signs, documenting medical history
- Coordinate infusion admissions for Pediatric MS patients
- Coordinate MS patient/Families to community sources
- Coordinate Neuroimmunolgy clinic appointments
- Call parents with results for genetic testing, labs, EEG and MRIs
- Genetic testing via buccal swabs
- Compose diagnosis letters for Autism, Seizure and Headache
- Assist with coordination of direct admissions.
RN Specialty II- Cardiac Clinic Nurse
Memorial Physician Group
08.2019 - 10.2021
- Schedule and enter orders for Electrophysiology study/Ablation procedure/Pacemaker/ICD Implantation
- Health education for patients and parents for EPS/Ablation/Pacemaker/ICD pre/post procedure
- Assist parents with medication refills and medical questions
- Call patients/parents to provide lab, genetic and Holter/cardiac monitor results
- Compose medical/dental clearance and school notes for patients
- Assist in clinic triaging/rooming patients
- Complete genetic testing for EP and cardiomyopathy clinic
- Complete Stress Test and Tilt Table
- Assist with scheduling direct admissions to hospital for sick clinic visits needing admission and admissions for Flecainide Challenge test
- Enter orders for clinic (Echo, EKG, Stress Test, Tilt Table, Holter/Cardiac Monitor and Fetal Echo)
- Prior Authorizations for Medications
- Assist doctor with daily SICD/ICD/Pacemaker reports of EP patient for Medtronic, St
- Jude and Boston Scientific.
RN- Utilization Review Specialist
Memorial Healthcare Systems
05.2018 - 08.2019
- Review clinical medical information for pediatric and adult population to determine medical necessity and appropriateness of hospital services
- Use Interqual Criteria for appropriate patient status for Admissions, Continued Stay, and Discharge
- Collaborate with Doctors and case management team to coordinate member care and establish discharge planning when inpatient status is no longer appropriate
- Refer to Physician advisor or EHR when requested services do not meet interqual criteria
- Request clinical information from healthcare providers/hospitals to complete medical necessity and level of care reviews for requested services.
RN-Case Manager/Specialist-Clinical Effectiveness
Joe DiMaggio Children’s Hospital
02.2018 - 05.2018
- Regularly meet with multidisciplinary team to evaluate pediatric patient’s health status and appropriateness of medical care being provided, including but not limited to admission, length of stay and assisting with discharge coordination and transfers
- Participate in NICU rounds with multidisciplinary team, assist in expediting transfers and assist SW with DME issues for discharge if needed
- Review NICU/Pediatric patient charts and assist in completing orders for Certification and Re-Certification of Hospital stay for Medicaid patients
- Review patient admissions daily and use InterQual criteria to review service requests for medical necessity and compliance with reimbursement policy criteria
- Assist in setting up Peer to Peer reviews between Hospital MD and Plan MD for denials.
RN- Supervisor Case Management
Molina Healthcare
08.2016 - 09.2017
- Provided guidance to care management team that consisted of 12 Registered Nurse Case Managers and 3 Social Workers to ensure Model of Care implementation and NCQA requirements/standards were met
- Managed staff caseloads and assigned cases appropriately with regards to complexity of medical or psychosocial needs and line of business (Medicaid/Medicare)
- Ensured documentation was in compliance with standard processes and turn-around times set by department
- Coached and evaluated Case Management team performance and provided employee development and recognition
- Assisted with selection, orientation and mentoring of new staff
- Managed Specialty program for health plan (ER Diversion program)- consisted of Registered Nurse Case Managers specializing in reducing unnecessary ER visits and connecting members to appropriate level of care.
Registered Nurse- Case Manager
Molina Healthcare
06.2015 - 08.2016
- Provided case management services to approximately 100+ Pediatric patients with chronic/complex conditions (medically fragile)
- Case management for Obstetric patient for post-partum HEDIS measures
- Conducted assessment of member needs by collecting in-depth information from member, member’s family/caregiver, hospital staff, physicians and other providers
- Developed and implemented case management plan in collaboration with member, caregiver, physician and/or other appropriate healthcare professionals to address member's needs
- Performed ongoing monitoring of Plan of Cares to evaluate effectiveness
- Documented care plan progress in Molina’s information system (CCA, member 360, UMK2 and QNXT).
Registered Nurse- Clinic
Institute for Child and Family Health
04.2009 - 06.2015
- Supervised medical assistants
- Provided nursing care services daily to approximately 20-30 pediatrics patients
- Administered medications ordered by pediatric physicians including but not limited to Diabetes and ADHD medications
- Administered Influenza Immunizations during H1N1 season
- Performed Vision and BMI screenings yearly to pediatric patients
- Liaison for families in need of health services provided through community resources
- Provided health education to parents, pediatric patients and staff
- Evaluated chronic conditions of each patient and applied care plans as needed.
Registered Nurse-Telemetry
Palm Springs General Hospital
06.2009 - 12.2009
- Assessed, evaluated and cared for approximately 7-8 adult patients
- Provided specialized nursing care by obtaining vital signs, EKG placement, supplying supplemental oxygen, and insertion of catheters, feeding tubes, IV and central lines
- Administered medications as directed/ordered by physician
- Planned and implemented individualized nursing care for cardiac patients
- Educated patients and their family members regarding diet, exercise and medication
- Developed and maintained caring and safe environments for patients.
Education
Associate of Science in Nursing -
Miami Dade College
Miami, FL12.2008
Skills
- Procedure preparations
- Patient and family education and counseling
- Care Plan Development
- Team Coordination
- Nursing staff leadership
- Strong Clinical Judgment
- Excellent interpersonal skills
- Quality Improvement
Licensure and Certifications
- Registered Nurse, State of Florida
- CPR/Basic Life Support
Volunteer Experience
Department of Health-2010
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
RN Specialty II- Neurology Clinic Nurse
Memorial Physician Group
10.2021 - Current
RN Specialty II- Cardiac Clinic Nurse
Memorial Physician Group
08.2019 - 10.2021
RN- Utilization Review Specialist
Memorial Healthcare Systems
05.2018 - 08.2019
RN-Case Manager/Specialist-Clinical Effectiveness
Joe DiMaggio Children’s Hospital
02.2018 - 05.2018
RN- Supervisor Case Management
Molina Healthcare
08.2016 - 09.2017
Registered Nurse- Case Manager
Molina Healthcare
06.2015 - 08.2016
Registered Nurse-Telemetry
Palm Springs General Hospital
06.2009 - 12.2009
Registered Nurse- Clinic
Institute for Child and Family Health
04.2009 - 06.2015
Associate of Science in Nursing -
Miami Dade College
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