utilization management nurse resume example with 19+ years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000
Cell:
resumesample@example.com
:
Summary
Competent and caring Nursing professional offering 20 years coordinating and carrying out patient care in a Geriatric Behavioral Health and Medical-Surgical environments. Demonstrated ability to perform with speed and accuracy to assess patients, deliver treatments and delegate tasks. Proven history of advocating for patient needs and fostering top-quality care.
Diligent Nurse with solid foundation in Geriatric Behavioral Health. Expert in all areas of patient care with success in leading teams in providing top-notch care. Trained in Meditech and Cerner computerized electronic medical records
Experienced nursing professional bringing demonstrated clinical expertise, leadership skills and technical knowledge. Proficient in updating charts, monitoring medications and working with multidisciplinary teams to optimize patient care. Quality-driven and efficient with strong interpersonal abilities.
Highly organized Case Manager, Utilization Review Nurse and Charge Nurse with 30 years of experience as Registered Nurse. Offering a proven history of successfully advocating for patients and working with practitioners. Passionate about delivering quality care and facilitating efficient healthcare coordination.
Skills
Patient record auditing
Patient assessments
Care plan management
Clinical Instruction
Staff training
Patient care management
Care planning
Staff Development and Precepting
Intake and discharge
Computerized charting specialist
Geriatric treatment knowledge
Broad medical terminology knowledge
Experience
Utilization Management Nurse, 06/2001 to Current Humana Inc. – Henderson, NV,
Coordinated with healthcare team to establish, enact and evaluate multidisciplinary treatment team care plans.
Managed and provided leadership to help staff with direct and indirect patient care.
Provided training and supervision to new hires in Behavioral Health unit.
Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
Participated in continuing education programs and department workshops to enhance training and nursing knowledge.
Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
Executed appropriate steps for patient treatment following careful review of physician medical regimen.
Counseled patients and caregivers, providing emotional, psychological and spiritual support.
Developed and maintained quality care systems and standards, including creating and improving medical protocols and guidelines.
Communicated with primary care physicians or emergency care providers to relay patient needs.
Addressed unit staff concerns, including staffing ratios, resource management, allocation of responsibilities and optimized workload management.
Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
Used facility EMR system to update patient records, transmit prescriptions and transfer files.
Trained and mentored new RNs on best practices, hospital policies and standards of care.
Developed and adapted individualized treatment plans according to patient recovery goals.
Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
Ensured quality patient care from admission to discharge through direct supervision of all nursing and ancillary staff.
Imparted medical, operational and patient care knowledge to junior nurses to maximize performance and quality of team operations.
Charge Registered Nurse, 06/2001 to Current Davita – Lincoln, ME,
Identified areas in need of clinical improvement and implemented process changes to accommodate.
Oversaw delivery of high-quality, cost-effective care with focus on patient safety, comfort and dignity.
Immunized patients against diseases such as influenza and pneumonia to protect vulnerable populations from serious illnesses.
Monitored delivery of patient care for entire unit, including implementation of care plans.
Maintained comprehensive patient care plans and monitored staffs' implementation of physician's orders.
Administered oral, intramuscular and IV medications to patients and monitored responses.
Imparted medical, operational and patient care knowledge to junior nurses to maximize performance and quality of team operations.
Answered patient questions and provided take-home materials for further information.
Maintained adequate unit supplies to meet expected patient demands.
Coordinated care with physicians and other clinical staff to prepare for treatment, carry out interventions and enhance continuum of care to deliver comprehensive services.
Used facility EMR system to update patient records, transmit prescriptions and transfer files.
Administered injections, medications and wound care according to needs.
Collaborated with physicians and nursing staff to deliver quality care.
Performed patient evaluations and developed care plans in alignment with needs.
Completed clinical tasks while adhering to defined policies and procedures.
Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
Conducted patient assessments and diagnostic tests to provide physician with important patient health information used to create focused treatment plans and manage ongoing care.
Treated patients by administering various types of medications and therapies.
Built and maintained excellent rapport with patients and loved ones.
Case Manager, 06/2008 to Current Community Healthlink, Inc. – Worcester, MA,
Determined and coordinated appropriate level of care to meet individual patient needs.
Coordinated resources from diverse providers for intervention plans.
Coordinated support services and optimized communication between healthcare workers and patients.
Communicated with legal services providers, social services agencies and local judicial systems regarding cases.
Managed all logistics for abuse and neglect cases from start to finish.
Collaborated with various healthcare providors to facilitate delivery of services.
Reviewed effectiveness of treatment for individual and family situations.
Developed appropriate care plans for at-risk individuals and high-risk families.
Diagnosed and treated high-volume caseload in busy emergency room setting.
Optimized program resource utilization to prevent unnecessary hospital admissions.
Coordinated between various entities to manage cases.
Documented plans, findings and results and submitted to employers and insurance carriers.
Collaborated with different disciplines to provide cohesive care to patients.
Informed patients and families of treatment options and at-home care strategies to reduce unnecessary burden on hospital resources.
Used facility EMR system to update patient records, transmit prescriptions and transfer files.
Assisted patients in receiving high-quality, appropriate care with best possible results.
Reviewed treatment plans against individual goals and healthcare standards.
Education and Training
Bachelor of Science: Nursing, Expected in 12/2015 to Mount Aloysius College - Cresson, PA GPA:
Diploma in Nursing: Registered Nursing, Expected in 06/1988 to Conemaugh Valley Memorial Hospital - Johnstown, PA, GPA:
Any information uploaded, such as a resume, or input by the user is owned solely by the user, not LiveCareer. For further information, please visit our Terms of Use.