Sugeily Villa
Hartsdale,NY
Summary
Compassionate and detailed oriented Registered Nurse with three years of clinical experience and a strong focus on patient care coordination. Known for reliability in dynamic healthcare environments, adapting to changing needs while prioritizing patient well-being. Eager to transition into a prior authorization nurse role, leveraging my commitment to patient advocacy and optimizing outcomes with efficient, compliant care.
Overview
3
3
years of professional experience
Work History
Nurse Clinician / Home Infusion (PRN)
PromptCare Companies
41 Spring St, New Providence, NJ 07974
05.2025 - Current
- Coordinate and provide quality home infusion services to patients in the home care setting and communicating with providers, ensuring smooth transitions in care planning.
- Administered medications and treatments as prescribed by physicians such as IV Inotropes, intravenous immunoglobulin, Biologic, antibiotic, Total Parenteral Nutrition (TPN), and other IV therapies.
- Monitor patient response to infusion therapies, adjust therapies as needed, and report changes to prescribing physician to assessing clinical rationale in authorizations.
- Knowledge of PIV, Mid-Line, PICC Line, Tunneled Catheters, and Ports.
- Proficiency in IV insertion, vascular access devices, and infusion pumps.
- Strong pediatric peripheral IV skills, demonstrating adaptability to diverse patient needs.
- Delivered high-quality patient education on various topics related to disease management, self-care techniques, and preventative measures.
- Educate and counsel patients and families on infusion therapy, medications, side effects, and care at home.
- Ensured regulatory compliance, maintaining accurate documentation prior authorization submissions.
Staff Nurse
Montefiore Medical Center
Bronx, NY
11.2023 - Current
- Collaborate with healthcare providers to secure timely prior authorizations, ensuring patient access to prescribed care.
- Ensure accurate documentation aligned with payer requirements, supporting insurance submissions and approvals.
- Advocate for patient coverage by coordinating necessary clinical documentation for pre-approval processes.
- Delegate and supervise patient care technicians to maintained compliance for authorization documentation.
- Manage and implement patient care for cardio-thoracic needs such as rapid atrial fibrillation, angina, and myocardial infarction.
- Provide post operative care for the following: Lung and Heart transplant, Cardiac Cath, Coronary Artery Bypass Graft, TAVR Valve replacement, Pacemaker placement, and VADS.
- Manage wound vacs and chest tubes based on patient needs and physician orders.
- Performed EKG's.
- Performed post-mortem care.
- Administered medications via IV, G-tube and J-tube.
- Experienced nasopharyngeal and oral suctioning.
- Administered insertion of Foley and straight catheters.
UAS Clinical Eligibility Registered Nurse
Health-first
New York, NY
06.2023 - 12.2023
- Conducted initial nursing assessments to determine patient needs-building a foundation for evaluating medical necessity in authorization review.
- Assessed the impact of health conditions on daily life, refining skills in analyzing clinical information relevant to authorizations.
- Made recommendations on patient eligibility-directly parallel to determining whether requested services meet criteria for approval.
- Monitor delivery of services and follow up through in-person visits and Telehealth conferences.
- Performed care coordination and long-term care assessments-mirroring collaboration between teams during the authorization process.
- Reviewed assessments and medical notes to determine care plans-similar to reviewing clinical documentation for authorization decisions.
- Assisted with nursing home admissions, understanding transitions, which helps when coordinating care guidelines.
Education
Bachelor of Science - Nursing
Capella University
225 South 6th St, Minneapolis, MN 5540212.2023
Associate of Science - Nursing
Cochran School of Nursing
Yonkers, NY05.2022
Skills
- Bilingual in English and Spanish (great for communicating with diverse patients and providers)
- Documentation for insurance compliance and prior authorization
- Educating patients on the authorization process and coverage criteria
- Patient assessment for determining medical necessity in coverage reviews
- safety protocols ensuring compliance with payer guidelines
- Familiarity with EMR Epic medical system for payer-required documentation
- Microsoft Office/ Excel/ Outlook
Licenses/Certifications
• New York State Registered Nurse License # 887237
• Advanced Cardiac Life Support (ACLS) Certified
• Basic Life Support (BLS) American Heart Association Certified
• NIHSS
• PALS
• Infection Control Certification and OSHA Health & Safety
• Identification and reporting of child Abuse and Neglect Certified
Timeline
Nurse Clinician / Home Infusion (PRN)
PromptCare Companies
05.2025 - Current
Staff Nurse
Montefiore Medical Center
11.2023 - Current
UAS Clinical Eligibility Registered Nurse
Health-first
06.2023 - 12.2023
Associate of Science - Nursing
Cochran School of Nursing
Bachelor of Science - Nursing
Capella University