Shelly Thees
Registered Nurse
Oxnard,CA
Summary
Driven, hardworking and veteran Registered Nurse bringing demonstrated patient care, medication monitoring and treatment management expertise. Adaptable and resilient with strong attention to detail, clinical expertise and emergency response experience. Bringing 32-year record of success in nursing and desiring a new and exciting position with St Johns Regional Medical Center
Overview
33
33
years of professional experience
3
3
years of post-secondary education
Work History
Staff Nurse ER
Dignity Health St Johns Regional Medical Center
Oxnard, CA
05.2015 - Current
- I currently work as part of a team with physicians, other nurses and healthcare professionals to provide care, monitor health conditions, plan long-term care needs, administer medicine, use medical equipment, and advise patients and their families on illness, care and continued care after a hospital stay.
ER CM RN
Dignity Health St John’s
Oxnard, CA
05.2013 - 07.2015
- ER CM night shift responsible for performing review for appropriateness of inpatient admission and continued stay
- Worked collaboratively with ER physicians and admitting physicians by providing education and information related to regulatory guidelines surrounding medical necessity
- Monitor patient's progress through ER to support appropriate level of care and transition patients across the continuum
- Admission reviews from ER and spoke with physicians to decide appropriate admission status for each individual patient based on InterQual criteria.
UR review, ACS
Oxnard, CA
07.2011 - 05.2013
- I was one of the startup RN's contracted to Gold Coast Health Plan to start up this company for Ventura Medicaid
- Review clinical information for concurrent reviews, extending the Length of Stay for inpatients as appropriate.
- Establish effective rapport with other employees, professional support service staff, customers, clients, patients, families, and physicians.
- Use effective relationship management, coordination of services, resource management, education, patient advocacy, and related interventions to:- promote improved quality of care and/or life- promote cost effective medical outcomes- prevent hospitalization when possible and appropriate- promote decreased lengths of hospital stays when appropriate- prevent complications in patients under our care when possible- provide for continuity of care- assure appropriate levels of care are received by patients
- Provide appropriate referrals to Case
- Management.
- Identify appropriate alternative and non-traditional resources and demonstrate creativity in managing each case to fully utilize all available resources.
- Maintain accurate records of all interventions.
- Performs utilization review for all members requiring services requiring authorization.
- Conducts assessment of medical necessity utilizing MCG online criteria.
- Gathers all pertinent information from providers and facilities to ensure GCHP physician reviewers have sufficient information to make a decision to approve or deny services.
- Coordinates with non-clinical staff to ensure all documentation is completed timely and in a professional manner.
- Interfaces with internal resources including Medical Directors and other Health Services staff to ensure members receive the right care at the right time in the right setting by the right provider.
CM RN
Ventura County Health Care Agency
Ventura, CA
01.2011 - 07.2011
- Utilizing nursing process, plans and participates in providing daily patient discharge management
- Follows prescribed doctors' orders concerning discharge plans
- Makes patient observations, records and reports all pertinent information
- Provides follow-through on judgment
- Provides unit organization and is responsible for completion of all delegated and indicated discharge planning duties by the end of the assigned shift
- Assists in training, supervision and evaluation of new and ancillary personnel.
Wellpoint
Camarillo, CA
06.2007 - 01.2011
- Concurrent stay review um rn, Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical issues
- Ensures medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources
- Works with medical directors in interpreting appropriateness of care and accurate claims payment
- May also manage appeals for services denied
- Primary duties may include, but are not limited to: Conducts pre-certification, concurrent, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts
- Ensures member access to medical necessary, quality healthcare in a cost-effective setting according to contract
- Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process
- Collaborates with providers to assess members' needs for early identification of and proactive planning for discharge planning
- Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications
- Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
RN
CMH
Ventura, CA
02.1998 - 10.2007
- Provided general nursing care to patients in this large community hospital
- Reviewed reports of patients' general physical condition, reactions to medications and medical histories
- Prepared equipment and aided physician during patient examinations and treatment
- Administered prescribed medications and treatments, and observed and reported patient reactions
- Examined instruments, equipment and surgical setup to ensure sterile environment
- Rotated among clinical specialties: emergency room, ICU/CCU, CRU and PACU
- Interpreted physician's instructions to patients
- Observed techniques of, and services rendered by, nursing staff to ensure adherence to hospital guidelines
- Assisted subordinates and supervisors in identifying and resolving problems
- Demonstrated techniques for nursing students and new personnel in order to provide training and direction
- Assigned duties to nursing staff in department for efficient use of personnel
- Provided direction and assistance to RN's, Emt's and secretaries for continuous flow through the emergency room
- Developed and implemented the Meditech computer system for on line documentation for nurses and physicians in the emergency room.
RN Staff Nurse
Boswell Memorial Hospital
Sun City, AZ
05.1994 - 01.1998
- Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
- Conferred with physicians to discuss diagnoses and devise well-coordinated treatment approaches.
- Effectively prioritized assignments, executing care based on each patient's relative condition and delegating tasks to available personnel deliver safe and efficient care.
- Updated patient charts with data such as medications to keep records current and support accurate treatments.
- rotations included orthopedics, telemetry, CCU/ICU, SICU
School Nurse
Buckeye Elementary School
Buckeye, AZ
08.1996 - 01.1997
- The School Nurse will treat students for medical issues, help prevent physical issues and disease, and coordinate routine health assessments.
- Developed care plans and made referrals as necessary for students with health concerns or injuries.
- Served as liaison between families, school personnel and other healthcare providers on behalf of students.
- Oversaw health services for school of 320 students and faculty.
- Responded to patient requests with appropriate clinical and personal assistance
- Responsible for professional, medical treatment of students.
- Responsible for early detection of physical problems and health evaluations.
- Responsible for disease prevention.
- Assists in promoting programs on health-education and immunization.
- Maintains clinical records.
- Coordinates vision, hearing, and orthopedic screening and health assessments.
- Provides emergency aid to students and school staff.
- Assists teachers in instructing students in health and nutrition education.
- Knowledge of community agencies to help students and their families.
- Knowledge of district policies and procedures.
Registered Nurse
Maricoppa Medical Center
Phoenix, AZ
07.1991 - 06.1994
- Created and implemented care plans for prisoners suffering from chronic conditions.
- Treated variety of illnesses affecting offenders in close quarters.
- Complied with all security regulations within prison system and administered care in safest possible environment.
- Interviewed inmate and consulted with employees of institution , such as supervisory personnel and psychologist
- Provided general and specialized nursing care to patient's in a locked hospital unit including post partum, chemotherapy infusion, post surgical patients
Registered Nurse Heart Transplant Step Down Unit
Ohio State University Hospital
Columbus, OH
10.1990 - 06.1991
- Heart, Kidney and Liver Step down unit
- -Specialize in care of solid organ transplant, with primary focus on patients who have received a heart , liver, kidney
- -Deliver care to patient's pre- and post- transplant w/management of patients in need of high flow oxygen
- -Trained in vasoactive drips, antiarrhythmic drips, anti-rejection medications and medical telemetry, including EPS and post-catheterization procedures, congestive heart failure and atrial fibrillation
- -Responsible for management of patients receiving common unit procedures eg chest tube insertion/removal, central line insertion, thoracentesis and paracentesis
Education
Associate of Applied Science - Nursing
Hocking College
Nelsonville, OH 06.1987 - 01.1990
Skills
ER
ICU
PACU
Telemetry
Chemotherapy infusion
ACLS
BLS
PALS
Milliman and Interqual guidelines
Utilization review
Staff performance evaluation
Supervising staff
Patient and family advocacy
Direct Patient Care
Additional Information
- LICENSES , Registered Nurse in the State of California, License number 541527
Timeline
Staff Nurse ER
Dignity Health St Johns Regional Medical Center
05.2015 - Current
ER CM RN
Dignity Health St John’s
05.2013 - 07.2015
UR review, ACS
07.2011 - 05.2013
CM RN
Ventura County Health Care Agency
01.2011 - 07.2011
Wellpoint
06.2007 - 01.2011
RN
CMH
02.1998 - 10.2007
School Nurse
Buckeye Elementary School
08.1996 - 01.1997
RN Staff Nurse
Boswell Memorial Hospital
05.1994 - 01.1998
Registered Nurse
Maricoppa Medical Center
07.1991 - 06.1994
Registered Nurse Heart Transplant Step Down Unit
Ohio State University Hospital
10.1990 - 06.1991
Associate of Applied Science - Nursing
Hocking College
06.1987 - 01.1990