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hedis abstractor nurse resume example with 20+ years of experience

JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary
Nurse Case Manager with valid State of Ohio RN License. Solid clinical, utilization review and case management experience within a managed care environment.
Skills
  • Strong clinical judgment
  • Quick learner
  • Dependable
  • Previous HEDIS Abstractor 
Work History
2014 to 04/2015 HEDIS Abstractor-Nurse Encompass Health Corp. | Tucson, , Performed medical records review and abstraction in support of annual HEDIS project.  Applied structured auditing criteria to determine compliance standards.  Reviewed and abstracted paper and electronic medical records and completed audits to determine if the quality of care measures, as defined by NCQA for that years HEDIS audit had been met.  Entered findings into data base.
2013 to 03/2014 HEDIS Abstractor -Nurse Five Star Quality Care, Inc. | Albany, ,

Performed medical records review and abstraction in support of annual HEDIS project.  Applied structured auditing criteria to determine compliance standards.  Reviewed and abstracted paper and electronic medical records and completed audits to determine if the quality of care measures, as defined by NCQA for that years HEDIS audit had been met.  Entered findings into data base.


10/1997 to 06/2012 Certified Case Manager Papa Murphy's Holdings, Inc. | Ramsey, ,
  • Developed patient care plans, including assessments, evaluations and nursing diagnoses.
  • Documented patient information obtained from interviews.
  • Ensured efficacy of treatments through monitoring of treatment regimens.
  • Provided ongoing education to patient and family
I retired June 2012
09/1990 to 09/1997 Long Term Care Manager The Brooklyn Hospital Center | Brooklyn, NY,
  • Supervised Chronic patient care, adeptly handling all aspects of treatment from medication to wound care to monitoring for all patients per shift.
  • Oversaw and managed clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.
  • Completed staff performance evaluations
  • Effectively supervised RN's, LPNs, CNA's and non-clinical staff. Recruited, hired and improved annual employee retention rate.
  • Self-directed with astute judgment skills. High level of personal accountability​.
  • Processed monthly reports for department performance.
  • Closely monitored acute conditions.
  • Demonstrated ability to lead and motivate outstanding healthcare teams.
  • Participated in unit-based Quality Assurance Program.
  • Developed and implemented nursing care plans.
  • Developed patient care plans, including assessments, evaluations and nursing diagnoses.
  • Delegated staff nurse duties.
  • Established staff schedules and assignments based on facility needs for three 49 chronic care units and a 79 bed Alzheimer's unit.
03/1989 to 09/1990 Assistant Director of Nursing St Leonard Center | City, STATE,
  •  Supervised Chronic patient care, adeptly handling all aspects of treatment from medication to wound care to monitoring for all patients per shift
  • Oversaw and managed clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.
  • Completed staff performance evaluations.
  • Supervised RN's, LPNs, CNA's and non-clinical staff.
  • Recruited, hired and improved annual employee retention rate.
  • Self-directed with astute judgment skills. High level of personal accountability​.
  • Processed monthly reports for department performance.
  • Demonstrated ability to lead and motivate outstanding healthcare teams.
  • Participated in unit-based Quality Assurance Program.
  • Developed patient care plans, including assessments, evaluations and nursing diagnoses.
  • Delegated staff nurse duties.
  • Established staff schedules and assignments based on facility needs.
09/1987 to 03/1989 Evening Shift Supervisor Bethany Lutheran Village | City, STATE,
  • Supervised Chronic patient care, adeptly handling all aspects of treatment from medication to wound care to monitoring for all patients per shift.   
  • Oversaw and managed clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.   
  • Completed staff performance evaluations.   
  • Effectively supervised RN's, LPNs, CNA's.   
  • Closely monitored acute conditions.   
  • Delegated staff nurse duties.   
  • Established staff schedules and assignments based on facility needs.    Processed monthly reports for department performance.   
  • Closely monitored acute conditions.   
  • Demonstrated ability to lead and motivate outstanding healthcare teams.    Participated in unit-based Quality Assurance Program.   
  • Developed and implemented nursing care plans.   
  • Developed patient care plans, including assessments, evaluations and nursing diagnoses.   
  • Delegated staff nurse duties.
08/1986 to 07/1987 Staff Nurse Millard Fillmore Suburban Hospital | City, STATE,
  • Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 16 patients per shift.
  • Assessed need for, ordered, obtained and interpreted appropriate lab tests.
  • Self-directed with astute judgment skills. High level of personal accountability.
  • Managed care for post-operative patients through discharge.
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans.
  • Closely monitored acute conditions.
  • Diagnosed and treated patients with chronic and acute health problems such as MI, arrhythmias, asthma, COPD and pneumonia.
  • Participated in unit-based Quality Assurance Program.
  • Ensured efficacy of treatments through monitoring of treatment regimens.
  • Followed infection control procedures.
  • Monitored fluid intake and output levels.
  • Measured urine and delivered specimens to lab.
  • Assisted residents with bathing, dressing, feeding, lifting and transferring.
07/1986 to 06/1987 Staff Nurse/Supervisor St. Francis Nursing Home | City, STATE,
  • Chronic patient care in chronic care unit,  adeptly handling all aspects of treatment from medication to wound care to monitoring for patients 
  • Oversaw and managed clinical and support staff in patient care activities while maintaining a high level of staff morale and professionalism.
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans.
  • Closely monitored acute conditions.
  • Monitored patient reactions to drugs and carefully documented progress of individuals participating in clinical trials.
  • Ensured HIPAA compliance.
  • Diagnosed and treated patients with chronic and acute health problems such as MI, arrhythmias, asthma, COPD and pneumonia.
  • Participated in unit-based Quality Assurance Program.
  • Developed and implemented nursing care plans.
  • Followed infection control procedures.
  • Assisted patients with daily functions.
  • Monitored fluid intake and output levels.
  • Assisted residents with bathing, dressing, feeding, lifting and transferring.
08/1985 to 07/1986 RN Floor nurse, part time Charge Nurse Sisters Of Charity Hospital | City, STATE,
  • Assessed need for, ordered, obtained and interpreted appropriate lab tests.
  • Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication to wound care to monitoring for 10 patients per shift.
  • Self-directed with astute judgment skills. High level of personal accountability.
  • Effective counseling in health maintenance and disease management.
  • Managed care for post-operative patients through discharge.
  • Liaised between patients and physicians to ensure patient comprehension of treatment plans.
  • Instructed patients and family members on proper discharge care.
  • Developed and implemented nursing care plans.
  • Delegated staff nurse duties.
  • Ensured efficacy of treatments through monitoring of treatment regimens.
  • Assisted patients with daily functions.
  • Followed infection control procedures.
07/1984 to 09/1985 RN Medication nurse Beechwood Nursing Home | City, STATE,
  • Assisted patients with daily functions.
  • Monitored fluid intake and output levels.
  • Closely monitored acute conditions.
  • Monitored patient reactions to drugs and carefully documented effectiveness.
  • Ensured HIPAA compliance.
  • Documented patient information obtained from interviews.
  • Delegated staff nurse duties.
  • Ensured efficacy of treatments through monitoring of treatment regimens.
  • Followed infection control procedures.
  • Provided all daily living tasks to enhance quality of life for elderly patients.
  • Assisted residents with bathing, dressing, feeding, lifting and transferring.
Education
Expected in 1984 Associate of Science | Nursing Erie Community College, Williamsville, New York GPA:

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Resume Overview

School Attended

  • Erie Community College

Job Titles Held:

  • HEDIS Abstractor-Nurse
  • HEDIS Abstractor -Nurse
  • Certified Case Manager
  • Long Term Care Manager
  • Assistant Director of Nursing
  • Evening Shift Supervisor
  • Staff Nurse
  • Staff Nurse/Supervisor
  • RN Floor nurse, part time Charge Nurse
  • RN Medication nurse

Degrees

  • Associate of Science

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