Hands-on professional proudly offering more than 13 years of expertise in nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight and performance improvement.
Overview
4
4
Certifications
5
5
years of post-secondary education
17
17
years of professional experience
Work History
Remote Concurrent Review Nurse
Wellmed Medical Management
01.2016 - Current
Performed admission reviews for medical necessity based upon Interqual/Milliman specification.
Submitted cases to Medical Director for criteria failures and helped facilitate resolutions and approvals.
Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Supervised and maintained all utilization review documentation through Trucare EMR.
Participate in continuing training and education to improve processes.
Team Lead for Market Pod-Analyzing quality metrics, auditing documentation for process improvement, onboarding new hires
Post-surgical Nurse
Eminent Medical Center
12.2016 - Current
Managed patients recovering from medical or surgical procedures.
Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
Communicated medical information and discharge instructions to patients and families to reduce return visits.
Assessed patients immediately following surgery to identify and resolve potential complications.
Connected with patients and families from variety of cultural and economic backgrounds to establish and maintain open communication for improved patient outcomes.
Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
Explained course of care and medications, including side effects to patients and caregivers in easy-to-understand terms.
Provided skilled, timely and level-headed emergency response to critically-ill patients.
Inpatient Nurse
Texas Institute for Surgery
01.2011 - 01.2015
Observe and monitor the overnight day surgery patient.
Provide discharge teaching on home medications, wound care, dressing changes, etc per surgeon’s instructions, as well as blood pressure, diabetes and cholesterol maintenance and education.
Provide appropriate triage and care for emergency room patient-including assessing, stabilizing and transferring the emergent patient to a higher level facility, such as cardiac emergencies, illnesses, post-surgical complications and occasional employee injuries and sicknesses.
Acting Charge Nurse and support person for night shift staff and agency personnel.
Preceptor for new hires on night shift.
Staff Nurse
Baylor University Medical Center
Dallas, TX
01.2008 - 06.2010
Administer medications safely and accurately according to Five Rights.
Assist Doctors with bedside procedures.
Educate patients and family on disease process and medications.
Provide accurate and concise documentation for care provided.
Day Shift Representative for Skin and Wound Assessment Team.
Floor Representative for Medical Service Line Quality Improvement Committee.
Recipient of Service of Excellence Award in 1/2009.
Recipient of Service of Excellence Award in 2/2010.
Patient Care Coordinator at Wellmed at Flamingo / Wellmed Medical ManagementPatient Care Coordinator at Wellmed at Flamingo / Wellmed Medical Management
Patient Care Coordinator at WellMed Medical Management - United Health GroupPatient Care Coordinator at WellMed Medical Management - United Health Group