Experienced nursing professional bringing demonstrated clinical expertise, leadership skills and technical knowledge. Proficient in updating charts, monitoring medications and working with multidisciplinary teams to optimize patient care. Quality-driven and efficient with strong interpersonal abilities.
Overview
7
7
years of professional experience
Work History
Utilization Review Nurse
AdventHealth
Maitland, FL
05.2021 - Current
Assessed patient medical records to determine the appropriateness of requested services and procedures.
Determined medical necessity and cost-effectiveness of services through utilization review processes.
Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
Conducted reviews of inpatient utilization for compliance with admission criteria and concurrent review requirements.
Care Manager
AdventHealth
02.2020 - 05.2021
Advent Health Care Manager Acts as resource and provides staff and physician education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
Performs initial case management assessment to determine care coordination and discharge planning needs.
Negotiating for patients, and coordinating resources with payers, agencies and vendors during inpatient and transition phases.
Created customized care plans, working with hospital staff and families to assess and meet individual needs.
Registered Nurse
Advent Health Celebration Thoracic surgical/ CV
03.2017 - 07.2020
Developed strategy to target nursing and patient satisfaction issues, improve response and patient care quality and suggest actionable improvements to promote hospital-wide quality and safety initiatives .
Supervised professional and paraprofessional nursing staff and delegated tasks to maintain continuum of care.
Collaborated with leadership to devise initiatives for improving nursing satisfaction, retention and morale.
Collaborated with interdisciplinary healthcare personnel to meet patients' personal, physical, psychological and cognitive needs.
Education
Advance Cardiac Life Support (2022) American Heart Association CPR Certification (2021 -
AdventHealth Hospital
01.2023
Bachelor's Science - Nursing
JACKSONVILLE UNIVERSITY
01.2019
Associate Degree - Nursing
Louisiana State University Alexandria
12.2016
Massage Therapy Certification -
Everest University - Tampa
Tampa, FL
01.2008
Master of Science -
CRNA ADU
Skills
Attentive to details, strong work ethic, highly motivated, work well with
others, manage multiple priorities and strong time management skills
Develop and apply individualized care plan based on patient's needs,
and evaluation of care plan as defined by policy
Proficient in speaking multiple languages such as: English, Portuguese and Spanish
Excellent professional rapport with physicians and other departmental
personnel
Earned Daisy Awards based on patient's nomination for outstanding
care
HIPAA Compliance
Additional Information
Performs assessments as per policy, and when there is a change in the plan of care, or when an intervention is performed. Execute duties in accordance with unit specific standards. Provide leadership when executing a preceptor role for entry level nurses. Incorporates factors related to safety, effectiveness, cost, and impact on practice in
Languages
Spanish
Professional
Portuguese
Professional
References
References available upon request.
Timeline
Utilization Review Nurse
AdventHealth
05.2021 - Current
Care Manager
AdventHealth
02.2020 - 05.2021
Registered Nurse
Advent Health Celebration Thoracic surgical/ CV
03.2017 - 07.2020
Advance Cardiac Life Support (2022) American Heart Association CPR Certification (2021 -
TELEPHONIC NURSE CASE MANAGER/UTILIZATION REVIEW/MEDICAL AFFAIRS REVIEW NURSE at AIG DALLAS/HEALTH DIRECT INC.TELEPHONIC NURSE CASE MANAGER/UTILIZATION REVIEW/MEDICAL AFFAIRS REVIEW NURSE at AIG DALLAS/HEALTH DIRECT INC.