Professional nurse with extensive experience in utilization review. Skilled in analyzing patient care and ensuring compliance with healthcare regulations. Strong focus on team collaboration and achieving optimal patient outcomes. Adaptable and reliable, excelling in dynamic environments requiring precise decision-making and effective communication.
Diligent [Desired Position] with solid background in utilization review and patient care coordination. Proven ability to streamline processes and enhance patient outcomes through efficient resource management. Demonstrated expertise in case management and regulatory compliance.
Overview
14
14
years of professional experience
Work History
Utilization Review Nurse
Evicore
Melbourne, FL
03.2019 - 05.2025
Conducted comprehensive reviews of patient care plans for compliance with established guidelines.
Collaborated with healthcare teams to assess necessity and appropriateness of services provided.
Evaluated clinical documentation for accuracy, ensuring adherence to regulatory requirements.
Implemented process improvements to enhance efficiency in utilization review operations.
Registered Nurse
Holmes Regional Medical Center
Melbourne, FL
11.2018 - 03.2019
Demonstrating effective, safe clinical practice as well as medication administration
Delegating of patient care activities appropriately.
Effective communication with other members of the healthcare team for care continuity
Utilization of effective evidence-based practice approach
Documents all nursing care, change in condition, response to therapy, treatments, procedures
Provides patient, family and/or caregiver education as
Provides service to patients and families with sensitivity and respect for their needs, expectations, age, cultural, and individual needs.
Promoting a safe and positive environment for my coworkers as well as myself, the patient and their family/friends
Proactive in the needs of the patients and the unit
Extending help to all coworkers
Educating certified nursing assistant in situations where it is needed
Registered Nurse
The Brennity at Melbourne
Viera, FL
01.2015 - 11.2018
Administer medications through PEG tube
Supervise CNAs and medication technician
Document all assessments, observations and reports
Report to physicians and ARNPs for conclusive decision regarding healthcare of resident
Sound, ethical and independent decision making
Perform head to toe assessments
Administer medications prescribed by physician
Administered enema treatments, nebulizer treatments, intramuscular and subcutaneously injections, ophthalmic, gastrointestinal and intravenous medications as prescribed by physician.
Monitored blood glucose levels in diabetic patients through use of glucometer and interfaced with laboratories to obtain results of analysis and follow-up on STAT orders.
Transmitted pharmaceutical prescriptions for dispensing and interfaced with pharmacist on dosages and refills.
Assessed at-risk patients, interfaced with physicians, implemented prescribed protocols and formulated patient care plans as prescribed.
Medication Technician
The Brennity at Melbourne
Viera, FL
01.2015 - 07.2017
Administer medications or treatments, such as catheterizations, suppositories, irrigations, enemas, massages, or douches, as directed by a physician or nurse.
Answer patient call signals, signal lights, bells, or intercom systems to determine patients' needs.
Change bed linens or make beds.
Collect specimens, such as urine, feces, or sputum.
Communicate with patients to ascertain feelings or need for assistance or social and emotional support.
Document or otherwise report observations of patient behavior, complaints, or physical symptoms to nurses.
Feed patients or assist patients to eat or drink.
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical or nursing staff.
Prepare or serve food trays.
Record height or weight of patients.
Record vital signs, such as temperature, blood pressure, pulse, or respiration rate, as directed by medical or nursing staff.
Remind patients to take medications or nutritional supplements.
Turn or reposition bedridden patients.
Undress, wash, and dress patients who are unable to do so for themselves.
Medication Technician
Emeritus at Port Orange Assisted Living Facility
Port Orange, FL
01.2013 - 01.2015
Administer medications or treatments, such as catheterizations, suppositories, irrigations, enemas, massages, or douches, as directed by a physician or nurse.
Answer patient call signals, signal lights, bells, or intercom systems to determine patients' needs.
Change bed linens or make beds.
Collect specimens, such as urine, feces, or sputum.
Communicate with patients to ascertain feelings or need for assistance or social and emotional support.
Feed patients or assist patients to eat or drink.
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical or nursing staff.
Prepare or serve food trays.
Provide physical support to assist patients to perform daily living activities, such as getting out of bed, bathing, dressing, using the toilet, standing, walking, or exercising.
Record height or weight of patients.
Record vital signs, such as temperature, blood pressure, pulse, or respiration rate, as directed by medical or nursing staff.
Remind patients to take medications or nutritional supplements.
Turn or reposition bedridden patients.
Undress, wash, and dress patients who are unable to do so for themselves.
Certified Nursing Assistant
Emeritus at Melbourne Assisted Living
Melbourne, FL
01.2012 - 01.2013
Answer patient call signals, signal lights, bells, or intercom systems to determine patients' needs.
Change bed linens or make beds.
Collect specimens, such as urine, feces, or sputum.
Communicate with patients to ascertain feelings or need for assistance or social and emotional support.
Feed patients or assist patients to eat or drink.
Document or otherwise report observations of patient behavior, complaints, or physical symptoms to nurses.
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical or nursing staff.
Prepare or serve food trays.
Provide physical support to assist patients to perform daily living activities, such as getting out of bed, bathing, dressing, using the toilet, standing, walking, or exercising.
Turn or reposition bedridden patients.
Undress, wash, and dress patients who are unable to do so for themselves.
Certified Nursing Assistant
Melbourne Terrace Rehab Center
Melbourne, FL
01.2011 - 01.2012
Answer patient call signals, signal lights, bells, or intercom systems to determine patients' needs.
Change bed linens or make beds.
Collect specimens, such as urine, feces, or sputum.
Feed patients or assist patients to eat or drink.
Measure and record food and liquid intake or urinary and fecal output, reporting changes to medical or nursing staff.
Prepare or serve food trays.
Provide physical support to assist patients to perform daily living activities, such as getting out of bed, bathing, dressing, using the toilet, standing, walking, or exercising.
Record vital signs, such as temperature, blood pressure, pulse, or respiration rate, as directed by medical or nursing staff.
Turn or reposition bedridden patients.
Undress, wash, and dress patients who are unable to do so for themselves.
Education
Bachelor of Science - Nursing
Bethune Cookman University
Daytona Beach, FL
05.2017
Associate of Arts - undefined
Brevard Community College
Palm Bay, FL
12.2012
High School Diploma - undefined
Bayside High School
Palm Bay, FL
05.2010
Skills
Documentation and reporting
InterQual criteria
Utilization review
Records analysis
Clinical assessment
Interpersonal and written communication
Prior authorization
ADDITIONAL
BCLS/ CPR : American Heart Association January 2019
Utilization Review Nurse at Cedar Crest Hospital & Residential Treatment CenterUtilization Review Nurse at Cedar Crest Hospital & Residential Treatment Center