Sheila Ricafrente
Stafford,VA
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate with strong organizational skills eager to secure this position to expand and grow as a professional. Ready to help the team achieve company goals.
Overview
15
15
years of professional experience
Work History
Clinical Appeals Nurse
Sentara Health Revenue Cycle
03.2022 - Current
- Functions as an Integrated Care Manager in the Clinical Appeals Department
- Collaborates with other health professionals, such as physicians, nurses, and social workers to ensure patient safety and quality of care
- Maintain accurate records on all clients according to policies and procedures
- Analyzes the denials of insurance claims or of coverage for medical treatments or procedures at a healthcare facility
- Ensures that case reviews meet contractual, regulatory, and business goals and that appeals and grievances are resolved timely to meet regulatory timeframes
- Helps ensure that patients get the care needed
- Mentors new nursing staff members, fostering teamwork and improving unit efficiency.
Registered Nurse
The New Hope Center for Reproductive Medicine
06.2021 - 06.2022
- Responsible for pre-op and post-op/recovery of patients undergoing surgical procedures
- Direct patient and clinical care to patients with lab/testing results, pre and post-surgical care, and performing medical treatment plans as prescribed by the physician
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
Registered Nurse, Labor and Delivery
Sentara Leigh Hospital
02.2018 - 03.2022
- Functions primarily as a Labor & Delivery Nurse
- Responsible for managing pregnant patients during labor, obstetrical emergencies, and other obstetric conditions
- Provided education, support, medical care, and constant monitoring of expectant mother and fetus through labor and birth
- Pre-op, peri-op, and post-op recovery of patients following surgical procedures
- Circulated in the operating room for cesarean sections, providing assistance to the surgical team and providing reassurance to the patient
- On occasion, functioned as a Postpartum Nurse providing immediate postpartum care by monitoring fundal height, bleeding, and vital signs following a vaginal or postoperative cesarean section deliveries
- Assisted with initial stabilization of newborn, administered newborn medications, helped with newborn procedures, and monitored early newborn vital signs
- Recorded newborn feeding schedule
- Assisted with breastfeeding, if possible, or referred to a lactation consultant
- Provided emotional support and guidance to new mothers and families during labor, delivery, and postpartum.
Registered Nurse
WIC Overseas Program
05.2013 - 05.2017
- Served as the Site Manager and WIC Nurse on Marine Corps Air Station Iwakuni, Japan
- Provided services to ensure optimal nutrition and health during the critical stages of fetal and early childhood growth
- Directly responsible for health screening and assessment to determine WIC eligibility
- Provided nutrition education, immunization checks, nutritional counseling, and medical and social service referrals
- Worked very closely with all base community agencies that interface with the WIC Overseas Program to promote the health and well-being of pregnant/breastfeeding/postpartum mothers, their infants and children.
Volunteer
Cub Scout Pack 77
08.2012 - 03.2014
- Possessed the working knowledge of the Cub Scout advancement plan
- Helped plan and conduct induction and advancement recognition ceremonies, coordinating with the den leaders and Scoutmaster
- Responsible for maintaining inventory of all scouting awards.
Registered Nurse
Navy-Marine Corps Relief Society
10.2012 - 08.2013
- Pioneered the first ever Home Visiting Nurse Program on Marine Corps Air Station Iwakuni, Japan
- Provided free in-home visits to active duty or retired Sailors, Marines and their families, focusing mainly on new mothers and their newborns
- Answered questions and provided information on a wide range of health topics ranging from breastfeeding, lactation, weight checks to healthcare education
- Worked closely with Base Clinic for referrals.
Volunteer
MC Perry Elementary School
08.2011 - 06.2013
- Built strong relationships among parents, teachers, and community leaders in support of students
- Partnered with the school brainstorming and organizing various fundraisers to raise money for school activities
- Also functioned as a helper and the Committee Chairperson for the Teacher Workroom taking charge of scheduling volunteers to assist teachers in their crafting and administrative needs.
Volunteer
Headquarters & Headquarters Squadron
08.2011 - 06.2013
- Partnered with a team of spouses and active duty servicemembers organizing unit functions and family events to boost morale and promote camaraderie
- Served a one-year term as the Vice President of the command’s spouses group.
Registered Nurse, Labor and Delivery
CarolinaEast Medical Center
09.2009 - 05.2011
- Experienced in the care of the patient during ante partum, labor and post partum
- Cared for patients requiring fetal assessment and fetal monitoring in both complicated and uncomplicated deliveries
- Monitored, recorded and communicated patient condition as appropriate utilizing computerized documentation systems
- Educated patient and families and provided age and culturally appropriate care
- Modified patient treatment plans as indicated by patients’ responses and conditions
- Occasionally floated to Maternity and Nursery when the need arose.
Education
Master of Science Degree in Nursing -
Liberty University
Lynchburg, Virginia10.2023
Bachelor of Science Degree in Nursing -
Hawaii Pacific University
Honolulu, Hawaii05.2003
Skills
- Possess RN licensure for the states of Virginia, California, and Hawaii
- BLS – Health Care Provider
- High level of autonomy
- Relationship building
- Data collection
- Strong Clinical Judgement
Accomplishments
- Collaborated with the previous Team Lead in the development of New Hire Orientation processes for our department to provide a more streamlined orientation plan.
- Successfully assisted in precepting two team members on our team last year while still maintaining my assigned timely accounts, meeting strict "timely" guidelines and adherence to organizational standards.
- Participated in the department's efforts toward process improvement by working closely with the consulting group to identify any barriers and promote best practices to support effective and efficient work processes.
Phone
(808) 375-8423
Timeline
Clinical Appeals Nurse
Sentara Health Revenue Cycle
03.2022 - Current
Registered Nurse
The New Hope Center for Reproductive Medicine
06.2021 - 06.2022
Registered Nurse, Labor and Delivery
Sentara Leigh Hospital
02.2018 - 03.2022
Registered Nurse
WIC Overseas Program
05.2013 - 05.2017
Registered Nurse
Navy-Marine Corps Relief Society
10.2012 - 08.2013
Volunteer
Cub Scout Pack 77
08.2012 - 03.2014
Volunteer
MC Perry Elementary School
08.2011 - 06.2013
Volunteer
Headquarters & Headquarters Squadron
08.2011 - 06.2013
Registered Nurse, Labor and Delivery
CarolinaEast Medical Center
09.2009 - 05.2011
Master of Science Degree in Nursing -
Liberty University
Bachelor of Science Degree in Nursing -
Hawaii Pacific University
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