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Nurse Reviewer Medical Management Resume Example

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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary
Driven and compassionate health professional with 14 years hands-on experience. Worked well in fast-paced residential ,transitional, long-term care as a RN supervisior. Hospital experience in Med. surge,  telemetry, and post anesthesia care. Home health with case management ,private duty pediatric and community health. Active in preventive ,wellness, and flu clinics. Experienced a temporary assignment that introduced me to medical management as a nurse reviewer. The experience has me excited and interested me into transitioning my past experience into a successful medical management career, as a Nurse reviewer. I will bring entry level experience along with integrity, loyality and accountability. I will offer great clinical experience. Strong oral and written communication skills. I have  knowledge of computer, functions and Microsoft word. Highly conscious decision maker. Dedicated RN looking to move forward into a bright future in medical management as nurse reviewer. Motivated in learning, well organized team player, excited for the opportunity to offer and transition into Medical management as a nurse reviewer dedicated to excel in Medical management as a nurse reviewer.  Studied at WBAVT-School of practical nursing and Wilkes-University, Bachelor of Science RNBSN
Education and Training
Expected in 2001
LPN: License practical nurse
WBAVT-Practical Nursing - plains, pa
GPA:
Expected in 2009
Bachelor of Science: LPN-BSN
wilkes-university - wilkes-barre, pa
GPA:
Skill Highlights
  • Proven patience and self discipline Excellence in communication management with
  • motivational techniques,conflict resolution ,Team training and strong supervisional
  • skills
  • .Geriatrics experience
  • ,Wound care and training ..
  • certifications  central line intravenous .Port a  cath chemo disconnects. certifications 
  • administration.
  • Home health Oasis 
  • LPN-RN
  • Home care: case management. excellent communication with peers, and other required management of charting and chart reviewing
  • case management
  • Nurse reviewer medical management and peer reviews one on one with medical director prepared documentation for review of claims ,approvals review Medicare reimbursement .Oasis assessment.
  • community flu /wellness clinics and substitute school nurse
  • atena insurance referals for short stay emergency room and follow up assessments after hospital stays.
Professional Experience
05/2014 to 06/2014
nurse reviewer medical management Camp Recovery Philadelphia, PA,
medical management nurse reviewer
02/2013 to Current
RN Iconma, L.L.C. Coral Gables, FL,
private duty
school nurse
wellness clinics
flu clinics​
01/2007 to 01/2011
LPN/RN The Rehab Center At Bristol Bristol, VA,
  • Staffing private duty,hospital and long term
  • Supervised and evaluated the activities of medical, nursing, technical, clerical, service, maintenance and other personnel.
  • Evaluated patient care procedural changes for effectiveness.
  • Implemented standards and methods to measure the effectiveness of agency activities.
  • Corresponded with operations staff to ensure key client deliverables and revenue goals were met.
  • Completed daily rounds of the nursing department to verify that all nursing service personnel were performing their work assignments in accordance with acceptable nursing standards.
  • Supervised and evaluated the activities of medical, nursing, technical, clerical, service, maintenance and other personnel.
05/2004 to 08/2008
LPN/charge Ascension (System Office) Dalton, GA,
LPN charge
01/2001 to 01/2003
RN Supervisor Genesis Healthcare City, STATE,
  • Carefully developed and retained qualified staff, as well as trained a number of Evaluated patient care procedural changes for effectiveness.
  • Directed the installation of improved work methods and procedures to achieve agency objectives.
  • Monitored the nursing and operation of support departments to ensure that resident needs were met and facility was properly maintained.
  • Diligently monitored the QA (Quality Assurance) program to improve performance and maintain high standards of care.
  • Regularly evaluated employee performance, provided feedback and assisted, coached and disciplined staff as needed.
  • Readily available in to fill gaps for on call rotation when necessary.
  • IV therapy ,medication pass charting chart reviewing.Careplanning admission discharge instructions requirements.
to
RN Charge Golden Living Center City, STATE,
  • Evaluated patient care procedural changes for effectiveness.
  • Analyzed facility activities and data to properly assess risk management and improve services.
  • Corresponded with operations staff to ensure key client deliverables and revenue goals were met.
  • Readily available to fill gaps for on call rotation when necessary.
  • Actively maintained up-to-date knowledge of applicable state and Federal laws and regulations.
  • Implemented standards and policies to measure the effectiveness of agency activities.
Skills
 Oasis
chart review
MDS
Intravenous care management
port a cath
picc line
cadd pumps
wound care
negative pressure therapy
medical termology
kangroo pumps
computer skills,windows 
word, power point, excell

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Resume Strength

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  • Target Job

Resume Overview

School Attended
  • WBAVT-Practical Nursing
  • wilkes-university
Job Titles Held:
  • nurse reviewer medical management
  • RN
  • LPN/RN
  • LPN/charge
  • RN Supervisor
  • RN Charge
Degrees
  • LPN
  • Bachelor of Science