SUMMARY

• Experienced Nurse with an in - depth knowledge of total & skilled patient care including medication and treatment administration. Possess excellent interpersonal and highly effective communication skills to communicate effectively, verbally and in writing, with all levels of management and staff. Able to communicate with people of diverse socioeconomic and ethnic origins; speak before groups; exercise independent judgment in medical emergencies; demonstrate tact, diplomacy, patience, and compassion; establish and maintain working relationships with co-workers, other agencies, and organizations; comply with nursing policies, protocols, and program regulations; understand and follow instructions; a keen Learner and effective Collaborator.

TECHNICAL SKILLS

SOFTWARE: Milliman Care Guidelines, InterQual Criteria, Windows XP, MS Office, WordPerfect 6.0, Microsoft Windows NT,. Typing Speed 65-70 wpm.

PROFESSIONAL EXPERIENCE

Confidential, Plainfield, IN

Registered Nurse

Responsibilities:

• Provide and coordinate direct care to patients;
• Identify patient needs, develop and revise standards of practice to meet changing patient needs;
• Actively participate with all level of staff during patient emergencies and in planning care for complex patients;
• Work with the multidisciplinary team in monitoring patient progress, identifying problems and facilitating changes in treatment approach to meet patient care objectives.
• Advocate for the patient/family during their acute illness and admission.
• Conduct review of requested services using established guidelines and standards that are set •Identifies patient care requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand care requirements.
• Patient care goals; teaching patient, friends, and family to understand condition, medications, and self-care skills; answering questions.
• Maintains safe and clean working environment by complying with procedures, rules, and regulations; calling for assistance from health care support personnel.
• Protects patients and employees by adhering to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.

Confidential, Houston, TX

RN-Prior Authorization Nurse-Telecommuter

Responsibilities:

• Receive requests for authorization of services, including inpatient hospital admissions, inpatient rehabilitation services, ssilled nursing, home care, home care infusion services, outpatient and /or inpatient elective surgery, and referrals for physician consultation with nonparticipating physician offices. .
• Reviews and Provides authorizations and/or denials based on clinical documentation review and medical necessity.
• Conduct review of requested services using established guidelines and standards that are set forth in the policies and procedure to ensure that the level of care, length of stay, or services requested are medically appropriate, and the determination is rendered in a timely manner as required by state regulations.
• Refer Prior Authorization requests to Medical Director for review as needed and follow up to complete the prior authorization. .
• Collaborates closely with the Medical Director for complex cases.

Confidential, Houston, TX

RN-Complex Case Manager

Responsibilities:

• Provide care management and/or disease management services to members, with Complex/chronic illnesses as identified by the health plan.
• Identifies high risk members with potential for complications, and coordinates the appropriate member-focused treatment plan with appropriate health care disciplines Obtain and document accurate member history and document per NCQA Standards.
• Develop Care plans and establish member-focused short and long term goals in collaboration with the Member’s PCP and other Specialists..
• Perform Pre Certification duties and Conduct field visits as required.

Confidential, Arlington, TX

RN-In house Per Diem Nurse

Responsibilities:

• Independently provide and coordinate direct care to patients;
• Identify patient needs, develop and revise standards of practice to meet changing patient needs;
• Effectively sets priorities for patient care and unit needs
• Actively participate with all level of staff during patient emergencies and in planning care for complex patients;
• Facilitate collaboration among health team members;
• Work with the multidisciplinary team in monitoring patient progress, identifying problems and facilitating changes in treatment approach to meet patient care objectives.
• Function as an advocate for the patient/family during their acute illness and admission.

Confidential, Rockville, MD

RN Product Support Nurse-Case Manager

Responsibilities:

• Handles inbound, outbound, and after hour patient calls for pharmaceutical companies.
• Provides patient education and telephonic patient support, using the nursing process to assess caller needs and respond to inquiries.
• Provides health information, education, direction and support to callers/patients while participating in the department's multiple projects, priorities, daily operations..
• Participates as a team member including the on-call After Hours service, by being on call after hours and on weekends every 8 weeks as needed.
• Effectively incorporates standards of care, procedures, and policies into daily work. Under the direction of the Manager, the RN Telehealth Nurse provides telephone information and education to patients regarding their disease and prescribed therapy.

Confidential, Annapolis, MD

RN Charge Nurse, (PRN)

Responsibilities:

• Administer patient medications and treatments to geriatric, post-op and mentally ill patients as ordered;
• Interface with other providers-Doctors and Pharmacists to obtain and verify new orders, and transcribe them;
• Supervise and assign duties to Nursing Assistants, and other support staff;
• Participate in Care-planning meetings, patient assessments, appropriate planning and documentation of nursing interventions.
• Applying and changing dressings & Inserting, Irrigating and changing Catheters
• Collect lab specimens for lab tests.

Confidential, Medical Centers, MD

RN-Staff Nurse

Responsibilities:

• Independently provide and coordinate direct care to patients;
• Identify patient needs, develop and revise standards of practice to meet changing patient needs;
• Effectively sets priorities for patient care and unit needs
• Actively participate with all level of staff during patient emergencies and in planning care for complex patients;
• Facilitate collaboration among health team members;
• Work with the multidisciplinary team in monitoring patient progress, identifying problems and facilitating changes in treatment approach to meet patient care objectives.
• Function as an advocate for the patient/family during their acute illness and admission.

Confidential, Rockville, MD

Nursing Coordinator

Responsibilities:

• Coordinates home care visits for injection training of patients either by a qualified home care agency nurse or by a qualified clinic nurse;
• Serve as a generalist/nurse providing information and direction to patients. Provide appropriate patient counseling in regards to the management of (RRMS) Relapsing-Remitting Multiple Sclerosis and treatment with MS drug-Rebif.
• Request verbal orders from the patient’s doctor’s office for incomplete prescriptions, and liaise with the Pharmacy to ensure appropriate transcription of Verbal Orders.