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Nurse Advocate Nurse Investigator Resume Example

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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary
Experienced Registered Nurse with unique experience in Caregiving and Advocacy for individuals of all ages with disabilities and/or mental health issues

Experience as a Education Consultant and Healthcare Advocate for individuals with various developmental disabilities , specifically Autism

Hestia HealthCare Strategies, LLC.- owner
Skills
Autism Consultant

Healthcare Advocacy

Letter and Report Writing

Caregiver Education and Plans

Discharge plans

Medical Insurance Appeals
Healthcare System Navigation
Physician Collaboration

Resource Advocacy

Government Services Applications, i.e. Katie Beckett Waiver

  Individualized Education Plans504 Plans  

Medical Record Review

 
Work History
Nurse Advocate, Nurse Investigator, 11/2001 to 10/2009
Bbyo Plainview, NY,
  • Presented education and conflict resolution strategies for students with disabilities to advocacy classes and development meetings of public school teachers 
  • Provided presentations for the community on issues regarding students with disabilities education rights and accommodations thru the IDEA and 504 plans, criteria for Medicaid benefits and strategies of advocacy
  • Presenter at the Protection and Advocacy Agencies National Convention 2003- "How to Review Medical Records"
  • Counseled individuals on their educational rights and appropriate accommodations of students with various medical conditions, learning disabilities, mental illnesses and autism
  • Collaborated with physicians to clarify their patients' medical needs and documentation for their education plan and accommodations 
  • Developed and shared with physicians guidelines for medical reports so as to pinpoint critical information needed for education plans and accommodations.
  • Provided consultations to Staff attorneys on the aspects of specific disabilities and medical conditions 
  • Reviewed medical records and psychological reports to determine eligibility for government programs and other programs of support
  • Counseled individuals with disabilities through the application process for these services including, Independent Care Program, Community Care Support Program, Katie Beckett waivers, Medicaid appeals, SSI, NOW and COMP Waivers
  • Testified as an Expert Witness in legal hearings involving individuals with traumatic brain injuries, cerebral palsy and autism.
  • Collaborated with contracted physicians, private attorneys and educators in complex cases 
  • Initiated guidelines for Investigative Case Summaries, Telephone triage procedures, staff training and procedures for proper disclosure of protected information 
  • Developed and presented the Investigation Department Training Manual.
  • Knowledgable of various medical conditions including developmental disabilities, Autism, Cerebral Palsy, Attention Deficient Disorder, Mental Health, Traumatic Head Injury, Dementia, Cystic Fibrosis, End Stage diseases, Diabetes, Crohns Disease and AIDS.
  • Processed monthly reports for department performance and management
  • Counseled and educated parents with children with disabilities about issues regarding obtaining medical care, education, private and government services
  • Oversaw and directed Department Managers with their cases involving medical care
  • Extensive review of medical records for omissions, errors and substandard medical care followed by intervention
  • Extensive experience assisting individuals with disabilities to move to or remain living in the Community or most integrated environment
  • Developed Investigative reports of cases of abuse and neglect and reported to specific regulatory agencies, including but not limited to Georgia Department of Education, State Composite Board of Medical Practitioners, State Profession Licensing Board, Department of Justice, Georgia Medical Care Foundation, State Office of Regulatory Services, Centers for Medicare Services
  • On site monitoring and investigations of state mental institutions, Intermediate Care Facilities, Nursing Homes and Acute Care and Speciality Hospitals
Camp Nurse, 05/2000 to 07/2003
Anthem, Inc. Grand Prairie, TX,
  • Triage medical care for injuries for 500 children.
  • Coordinated medical care and management for 40 Children with special needs.
  • Counseled and educated young adults serving as camp unit counselors on including campers with disabilities into their activities.
Disability Case Manager, 02/1994 to 11/1997
Aspirus Woodruff, WI,
  • Certification for appropriateness of medical and psychiatric care of employees on short term disability.
  • Managed over 100 active cases of employees out on short term disability.
  • The cases were a mixture of employees with short term injuries or conditions and life long disabilities and mental illnesses.
  • Medical record review and analysis for short and long disability cases for employees.
  • Collaborated with employees' physicians, AT&T physicians, and contracted independent medical evaluators on employees' fitness for duty, and accommodations in the workplace.
  • Liaised between employees and their supervisors to prepare for a safe and timely return to work
  • Ensured proper care and documentation for continued benefits for employees on short or long term disability leaves
  • Extensive experience with supervisors, health care providers and employees
Quality Improvement Analyst, 04/1992 to 10/1993
Allina Health Systems Minneapolis, MN,
  • Coordinated in-house concurrent review of patient care.
  • Determined appropriateness of discharge, care and healthcare setting using Medicare criteria.
  • Developed criteria quidelines to manage Acute Care Rehabilitition Hospital stay reviews
Utilization Management Coordinator, 07/1989 to 02/1992
Pacific Medical Centers San Fernando, CA,
  • Coordinated Utilization Management and Quality Assurance for health care of large specific company accounts.
  • Developed and implemented in-house concurrent guide to provide consistency in the review of Acute Rehabilitation Hospital Stays.
  • Applied Interqual Criteria to medical reviews.
Registered Nurse Specialist, 10/1988 to 07/1989
University Of Chicago Medical Center Flossmoor, IL,
  • Performed triage in large clinic for pulmonary emergencies.
  • Coordinated treatment for AIDS patients in an outpatient setting.
  • Supported discharge care plans for patients with chronic pulmonary diseases in their home or assisted living settings.
Staff nurse, 04/1987 to 10/1988
University Of Chicago Medical Center Tinley Park, IL,
  • vascular/ renal transplant acute care unit.
Staff nurse, 11/1986 to 04/1987
Maricopa County, Arizona Chandler, AZ,
  • Acute Care Neurology medical unit.
Registered Nurse, 04/1986 to 10/1986
Maricopa County, Arizona Morristown, AZ,
  • Substance abuse unit in an acute psychiatric hospital.
Registered Nurse, 02/1985 to 02/1986
Maricopa County, Arizona Sun City, AZ,
  • Acute Care orthopedic surgery unit.
Registered Nurse, 11/1984 to 02/1985
Maricopa County, Arizona Surprise, AZ,
  • acute care rehabilitation unit.
Registered Nurse, 06/1983 to 09/1984
Albany Medical Center City, STATE,
  • Acute Care orthopedic surgery unit.
Caregiving Coordinator and Nurse Advocate, 10/2013 to Current
Hestia Health Care Strategies, LLC City, STATE,
  • Provide medical oversight of Medical care and medical information to promote personal safety and well being of the care recipient and their caregivers  
  • Assist care recipients to define and voice their wishes to family and healthcare providers  
  • Promote Caregivers education and Caregiving planning- formal and informal       
  • Schedule medical, dental and therapy appointments as needed for care recipients          
  • Assist care recipients and the family with navigation through the healthcare system including health insurance ·         
  • Review, organize, summarize medical records for personal convenience and to share with medical doctors, clinics, emergency rooms and other healthcare facilities ·         
  • Collaborate with the physicians and other healthcare professionals to promote health education, treatment implementation and caregiver skills  
  • Assist family caregivers and care recipients in identifying and accessing community and regional services in healthcare settings.
Education
Associate of Science: Professional Nursing, Expected in 1983
to
Hudson Valley College - Troy, New York
GPA:
 Nursing
Bachelor of Arts: Sociology, Expected in 1 1980
to
Siena College - Loudonville, New York
GPA:
Sociology
Certificate : Caregiving Management, Expected in Current
to
Rosalyn Carter Institute for Caregiving, Georgia Southwestern State University - Americus, GA
GPA:
Recipient of the Dolores Capitan Writing Award 2014
Affiliations
  • American Nurses Association, Georgia Nurses Association 
  • Developmental Disabilities Nurses Association 
  • Developmental Disabilities Nurse Association - Georgia Chapter, President (2005-2008) 
  • Panel Participant- Project DOCC - Delivery of Chronic Care,  Emory Medical School, Atlanta, GA (2003 - present) 
  • National Nurses Business Association
  • Dream Power Therapeutic Equestrian Center- Board of Directors
Skills
ADA, benefits, clarify, conflict resolution, government, legal, meetings, Excel, Microsoft Office, Outlook, PowerPoint, Word, Page, Presenter, presentations, staff training, Telephone

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Resume Overview

School Attended
  • Hudson Valley College
  • Siena College
  • Rosalyn Carter Institute for Caregiving, Georgia Southwestern State University
Job Titles Held:
  • Nurse Advocate, Nurse Investigator
  • Camp Nurse
  • Disability Case Manager
  • Quality Improvement Analyst
  • Utilization Management Coordinator
  • Registered Nurse Specialist
  • Staff nurse
  • Staff nurse
  • Registered Nurse
  • Registered Nurse
  • Registered Nurse
  • Registered Nurse
  • Caregiving Coordinator and Nurse Advocate
Degrees
  • Associate of Science
  • Bachelor of Arts
  • Certificate

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