SHELLEY BARRINEAU
Summary
Hardworking Registered Nurse with success providing individualized patient care. Committed to delivering best-in-class patient care through effective education and counseling. Proven leadership focused on increasing and enhancing patient care and satisfaction. Streamline safety protocols for comprehensive patient care.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Utilization Review Nurse
AmeriHealth Caritas Family of Companies
07.2020 - Current
- Supervised and maintained all utilization review documentation through Jiva.
- Facilitated workgroup meetings with medical personnel to find effective solutions to issues.
- Devise or identify solutions for irregular requests and issues.
- Performed admission reviews based for medical necessity based upon Medicaid or InterQual specification.
- Recorded details regarding therapies to keep patient charts updated.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- worked 12-16 cases in an 8hr shift.
Home Health Nurse
Bayada Home Health
02.2020 - 07.2020
- Provided physical assessments, medication, and chronic disease management to home health patients.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Administered different therapies and medications in line with physician orders and treatment plan.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
Utilization Review Nurse
Rady Children's Hospital
11.2018 - 01.2020
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed prior authorization review of services requiring notification.
- Supervised and maintained all utilization review documentation.
- Followed ever changing guidelines and kept up with all updated insurance agreements.
Inpatient Pediatric RN (General and Oncology)
The Aurora Group
03.2018 - 07.2018
Oncology Infusion Registered Nurse
Rady Children's Hospital (traveler)
07.2017 - 02.2018
- Access ports, start IVs, draw labs and monitor lab results for any blood products, nutrition needs, etc required due to effects of chemotherapy.
- Deliver chemotherapy, safely, after following procedures to pediatric individuals.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Educated family members and caregivers on patient care instructions.
Utilization Management Review RN
Blue Cross Blue Shield
09.2016 - 07.2017
- Knowledge of medical documentation, diagnosis, procedures and surgical outcomes. Using of this knowledge along with Medicaid guidelines, plan guidelines, Standard operating procedures and InterQual guidelines to make decisions regarding care to include hospital stays, therapies, surgical procedures, SNF and LTAC stays and DME.
- Coordinating with case management in helping out members with chronic diseases, frequent hospitalizations, need for rehabilitation, drug addiction and financial issues that arise.
- Working alongside Medical Director in making determinations including denials.
- Crafting and sending out of denial letters.
Outpatient Hematology Oncology clinic RN
Pro Link Staffing
11.2017 - 02.2018
Utilization Management Review Nurse (Contract)
Healthcare Support
07.2017 - 11.2017
06.2017 - 08.2017
Utilization Management Review Nurse
Valence Health
08.2015 - 08.2016
Hematology/Oncology and Diabetic RN
Dell Children's Medical Center
06.2014 - 08.2015
Radiology Registered Nurse
Children's Hospital of Orange County
01.2013 - 06.2014
Hematology/Oncology and Bone Marrow Transplant RN
Lucille Packard Children's Hospital
06.2012
Travel RN with Cross Country TravCorps
Day Surgery RN
Dell Children's Medical Centeer
02.2012 - 06.2012
Travel RN for Cross Country TravCorps
Hematology/Oncology and Bone Marrow Transplant R
Cardon Children's Hospital
- 02.2012
Travel RN for American Mobile Healthcare
Hematology/Oncology and Transplant RN
Phoenix Children's Hospital
08.2011 - 11.2011
Travel RN for Anerican Mobile Healthcare
Hematology/Oncology, Bone Marrow transplant, Endocrine and Large Organ transplant Registered Nurse
Medical University of South Carolina
- 08.2011
Worked from 07/03 to 01/04 as CAWorked from 01/04 to 12/04 as RN on Med Surg/Burn Unit
Education
Associates Degree - Nursing
Trident Technical College
North Charleston, SC2003
Skills
- Accomplished in management of radiology diagnostics(1yr)
- Proficient in EMRs including Cerner, McKesson, Meditech & Surginet
- Neurology experience(8yrs)
- Acute care (10yrs)
- Strong clinical judgment
- Diabetes and nutrition educator(5yrs)
- Tracheotomy care and resource nurse(5yrs)
- Patient and family advocacy
- Orthopedic Rehab (1yr)
- Medical Surgical (10yrs))
- Expertise in Oncology(6yrs)
- High level of autonomy
- Problem resolution capability
- Transplant patients (3yrs)
- Burns (1yrs)
- Float Pool (3yrs)
- Prior Authorizations (9yr)
- Care Manager
- V Care/InterQual/MCG
- Aerial and Jiva
Certification
South Carolina nursing license #94253
Timeline
Utilization Review Nurse
AmeriHealth Caritas Family of Companies
07.2020 - Current
Home Health Nurse
Bayada Home Health
02.2020 - 07.2020
Utilization Review Nurse
Rady Children's Hospital
11.2018 - 01.2020
Inpatient Pediatric RN (General and Oncology)
The Aurora Group
03.2018 - 07.2018
Outpatient Hematology Oncology clinic RN
Pro Link Staffing
11.2017 - 02.2018
Oncology Infusion Registered Nurse
Rady Children's Hospital (traveler)
07.2017 - 02.2018
Utilization Management Review Nurse (Contract)
Healthcare Support
07.2017 - 11.2017
06.2017 - 08.2017
Utilization Management Review RN
Blue Cross Blue Shield
09.2016 - 07.2017
Utilization Management Review Nurse
Valence Health
08.2015 - 08.2016
Hematology/Oncology and Diabetic RN
Dell Children's Medical Center
06.2014 - 08.2015
Radiology Registered Nurse
Children's Hospital of Orange County
01.2013 - 06.2014
Hematology/Oncology and Bone Marrow Transplant RN
Lucille Packard Children's Hospital
06.2012
Day Surgery RN
Dell Children's Medical Centeer
02.2012 - 06.2012
Hematology/Oncology and Transplant RN
Phoenix Children's Hospital
08.2011 - 11.2011
Hematology/Oncology and Bone Marrow Transplant R
Cardon Children's Hospital
- 02.2012
Hematology/Oncology, Bone Marrow transplant, Endocrine and Large Organ transplant Registered Nurse
Medical University of South Carolina
- 08.2011
Associates Degree - Nursing
Trident Technical College