I am creative and enthusiastic with progressive management skills and diverse capability range in many areas of nursing services. I have proven ability to work with physicians and other healthcare professionals to achieve quality, safety and financial and patient satisfaction.
Skills
Mastery of Microsoft, Word, Office Outlook, Excel, and Power point.
Proficient with McKesson, Epic, Cernel
Professional written communication abilities
CPR Phlebotomy Certified
Train the Trainer Certified (Instructor for CNA)
Reviewed and revised policies and procedures.
Lead fiscal management of telemetry and critical care operating budget for nursing and hem-dialysis.
Milliman (MCG) and InterQual Trained
Professional relationships
Knowledge of auditing systems
Professional communication
Director of Telemetry/Clinical Manager for ICU and Telemetry
Familiar with HFAP, Joint Commission, and NCQA Certification
Certification Fellow Community Health Center Executive Management
Education and Training
Spertus Institute For Jewish Learning And LeadershipChicago, ILExpected in 05/2005 – –Master of Science:Human Services - GPA:
Chicago State UniversityChicago, ILExpected in 12/2001 – –Bachelor of Science:Nursing Science - GPA:
Malcolm X CollegeChicago, IL, Expected in 05/1992 – –Associate of Science:Nursing Science - GPA:
Experience
Erickson Living - Utilization Management Nurse Lead Pompton Plains, NJ, 09/2018 - 10/2019
Adheres to accreditation, contractual and regulatory time frames in performing all utilization management review processes.
Performed initial, concurrent and retrospective review activities, discharge care coordination for determining efficiency, effectiveness and quality of medical /surgical services and servicing as liaison between providers and Medical and Network Management Divisions with the three IPA groups assigned too.
Consulted with the Medical Director on all cases that do not meet clinical criteria
Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
Utilized computerized Resource and Patient Management System Maintains accurate and timely documentation in the Electronic Health Records (EHR) and review cases using MCG (Milliman) and/or Interqual criteria.
Health Alliance Of Hudson Valley - Case Management & Transition Care Nurse Wallkill, NY, 01/2015 - 03/2018
Observed strict confidentiality and safeguarded all patient-related information.
Oversaw assigned utilization review activities and transitional care duties on a daily basis, ensuring level of care and length of stay was medically appropriate.
Reviewed, oversaw, and intervened with discharge planning needs, ensuring coordination and continuity of health care for enrollment's as they transferred between locations or different levels of care.
Followed up with patient family member post-discharge as part of their transition of care, aiding in member not being remitted.
Provided leadership support to clinical staff, professional and nonprofessional teams. Accountable for day-to-day operation for clinical staff of 19-bed telemetry unit and 15-bed intensive care unit on 24-hour coverage by phone or pager
Saint Anthony Hospital - Registered Nurse Clinical Manager City, STATE, 03/2011 - 10/2014
Provided leadership support to clinical staff, professional and nonprofessional teams. Accountable for day-to-day operation for clinical staff of 19-bed telemetry unit and 15-bed intensive care unit on 24-hour coverage by phone or pager.
Successfully implemented quality improvement for core measures, decreasing agency cost due to vacancy in telemetry unit by hiring qualifying staff.
Resolved staffing issues by recruiting and hiring top-level talent.
Consulted with healthcare clients on nursing procedures and policies, implementing changes for improvement.
PCC Community Wellness Center - Clinical Administrator City, STATE, 05/2008 - 05/2011
Coordinated delivery of exceptional patient care by evaluating workflow and facilitating positive patient and physician changes for customer satisfaction.
Provided leadership support for clinical staff.
Provided administrative accountability to include assessment, planning, implementation, and evaluation of delivering quality patient care.
Participated in QA & PI process, clinic’s strategic plan. Developed and implemented P&P. Coordinated daily operation to ensure quality patient care. Monitored budget in a cost-effective manner.
Resolved conflicts promptly among physicians, nurses and other healthcare employees to keep workflow on task.
Recruited well-qualified candidates to fill vacancies and offer residents unparalleled care.
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.
Resume Overview
School Attended
Spertus Institute For Jewish Learning And Leadership