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Medical Review Nurse Resume Example

Resume Score: 90%

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MEDICAL REVIEW NURSE
Professional Background

Detailed oriented Registered Nurse with strong clinical and communication skills demonstrated by 39 years of varied experience in health care.

Skill Highlights

  • Licensed RN in Florida
  • 39 years of nursing experience
  • Strong written and oral communication skills
  • Adept in researching medical and health care delivery issues
  • Strong aptitude for data analysis

  • eDOC imaging system experience
  • HIMR experience
  • Medicare Part B experience
Accomplishments

Clinical Services:

  • Represented the state of Florida by receiving the March of Dimes Nurse of the Year award 1987

 

Implementation:

  • Developed the Resolve Through Sharing bereavement program at University Hospital in Jacksonville, Florida 1986-1987

 

Professional Experience
September 2015
to
December 2015
ICATT staffing/First Coast Service OptionsJacksonville, FloridaMedical Review Nurse

Current position doing Medical Review for Medicare Part B payment claims, making medical review claim adjudication decisions, development of recommendations for further corrective action based on medical review findings, utilization of data analysis to review provider practices and identification of concerns, overpayment and need for corrective action, provision of education for providers subject to the medical review process utilizing CMS guidelines and local/national coverage determinations.

February 2015
to
December 2015
Kindred Hospital of North FloridaGreen Cove Springs, FloridaRegistered Nurse

Performance of nursing duties in a Long Term Acute Care Hospital caring for critically and chronically ill patients on mechanical ventilation with multiple co-morbidities and severe non-healing wounds.

September 2011
to
February 2015
NORTH FLORIDA REGIONAL MEDICAL CENTERGainesville, FLRegistered Nurse

Nursing care in the Clinical Decision Unit with stabilization of patients prior to admission to the hospital or discharge, nursing care of Chest Pain Unit patients. Received the Nurse of the Year award for the department in 2012.

January 2005
to
September 2011
State of Florida Department of Corrections/Office of Health ServicesTallahassee, FLRegional Infection Control Nurse

Supervision of regional infection control programs within the Department of Corrections, surveillance and containment of infectious outbreaks within the Department, establishment and review of performance standards, preparation of monthly reports related to institutional and statewide infection rates and the conduction of contact investigations with the Department of Health.

January 2005
to
September 2011
Putnam Community Medical CenterPalatka, FLRegistered Nurse

Medical and surgical nursing in a small community hospital in accordance with ANA, hospital and community standards as an adjunct to employment with the Department of Corrections.

January 2004
to
January 2005
STATE OF FLORIDA DEPARTMENT OF CORRECTIONSLake Butler, FLExecutive Director of Nursing

Development and review of organizational policies and procedures, supervision and evaluation of 110 staff members, management of work schedules and staff assignments, preparation of facility program reports, staff recruitment, inspection of facility for emergency preparedness and provision of technical assistance to other agencies pertaining to medical, nursing and technical personnel within the health care facility.

January 2001
to
January 2004
RECEPTION AND MEDICAL CENTERLake Butler, FLINFECTION CONTROL COORDINATOR

Surveillance and containment of infectious disease, preparation of reports related to institutional infection rates and the conduction of institutional contact investigations at the facility under the direction of the Office of Health Services.

January 1999
to
January 2001
STATE OF FLORIDA DEPARTMENT OF CORRECTIONSLake Butler, FLRegistered Nurse Specialist

Patient care within a Crisis Stabilization Unit within the Department of Corrections.

January 1996
to
January 1999
ORANGE PARK MEDICAL CENTEROrange Park, FLRegistered Nurse-Emergency Room

Stabilization of trauma patients in an emergency room setting utilizing ACLS and PALS protocols.

January 1995
to
January 1996
FIRST AMERICAN HOME CAREMiddleburg, FLRN CASE MANAGER

Case management services to Medicare eligible homebound patients.

January 1989
to
January 1991
BAPTIST MEDICAL CENTERJacksonville, FLRegistered Nurse

Pre-op and PACU nursing care for Ambulatory Surgical patients.

January 1991
to
November 1994
Phelan and Ameen OB/GYNJacksonville, FLRegistered Nurse

Office nurse duties in OB/GYN office.

January 1986
to
January 1989
UNIVERSITY MEDICAL CENTERJacksonville, FLRegistered Nurse-Charge

Charge nurse duties on an LDRP unit. Developed a bereavement program for parents experiencing neonatal death, resulting in the presentation of the March of Dimes Nurse of the Year award for the state of Florida.

January 1984
to
January 1986
MIDWAY HOSPITALSt. Paul, MinnesotaRegistered Nurse

Labor/Delivery, GYN and Level II nursery patient care.

Education and Training
ST. MARY'S COLLEGE OF O'FALLON; O'FALLONO'Fallon, Missouri, USAAssociate Degree in Nursing: NURSING

Major in Nursing

Member of Phi Theta Kappa

Certifications

REGISTERED NURSE-STATE OF FLORIDA

RN1835672

EXPIRATION DATE 4/2016


BLS-BASIC LIFE SUPPORT

EXPIRATION DATE 12/2015

Skills

Health education, Infection control, eDOC imaging, HIMR, advanced computer skills


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Resume Overview

Companies Worked For:

  • ICATT staffing/First Coast Service Options
  • Kindred Hospital of North Florida
  • NORTH FLORIDA REGIONAL MEDICAL CENTER
  • State of Florida Department of Corrections/Office of Health Services
  • Putnam Community Medical Center
  • STATE OF FLORIDA DEPARTMENT OF CORRECTIONS
  • RECEPTION AND MEDICAL CENTER
  • ORANGE PARK MEDICAL CENTER
  • FIRST AMERICAN HOME CARE
  • BAPTIST MEDICAL CENTER
  • Phelan and Ameen OB/GYN
  • UNIVERSITY MEDICAL CENTER
  • MIDWAY HOSPITAL

School Attended

  • ST. MARY'S COLLEGE OF O'FALLON; O'FALLON

Job Titles Held:

  • Medical Review Nurse
  • Registered Nurse
  • Regional Infection Control Nurse
  • Executive Director of Nursing
  • INFECTION CONTROL COORDINATOR
  • Registered Nurse Specialist
  • Registered Nurse-Emergency Room
  • RN CASE MANAGER
  • Registered Nurse-Charge

Degrees

  • Associate Degree in Nursing : NURSING

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