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Jessica Claire
  • Montgomery Street, San Francisco, CA 94105
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Summary

Enthusiastic individual with superior skills in working in both team-based and independent capacities. Bringing strong work ethic and excellent organizational skills to any setting. Excited to begin new challenge with successful team.

Caring, hardworking and service-oriented Registered Nurse with more than 10 years of experience. Well-versed in offering evidence-based, therapeutic care for patients dealing with a wide range of illnesses from cardiac to renal.

Accomplished Registered Nurse in Utilization Review with 4+ years of experience dedicated to quality care of diverse patients. Smoothly blend hands-on skills with advanced clinical background. Successful at working with all levels of healthcare providers, physicians and administrators to address patient needs.

Skills

BLS and ACLS CERTIFIED

GREAT COMMUNICATION SKILLS

RELIABLE

WORK WELL WITH OTHERS

CRITICAL THINKING SKILLS

EAGER TO ALWAYS LEARN

Experience
Utilization Review Registered Nurse, 09/2015 to 12/2017
Capital HealthBrowns Mills, NJ,
  • Determined and coordinated appropriate level of care to meet individual patient needs.
  • Optimized program resource utilization to prevent unnecessary hospital admissions.
  • Collaborated with physicians on patient medications, medical needs and performance.
  • Collaborated with physicians during medical rounds, updated treatment plans, and provided plan of care to patients and families.
  • Actively participated in family and patient planning processes.
  • Updated and maintained discharge plan of care with physician, members of healthcare team, patients, and families.
  • Obtained recommendations for inpatient or outpatient level of care by discussing cases with physician advisor.
  • Helped patients navigate healthcare system and care options by educating on relevant subject areas and answering questions throughout treatment process.
  • Reviewed patient admissions to determine medical necessity as directed by the ASAM criteria.
  • Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
  • Contacted insurance carriers to obtain authorizations for services delivered to patients.
Utilization Review Nurse, 08/2014 to 11/2015
Department Of Population MedicineCanton, MA,
  • Determined and coordinated appropriate level of care to meet individual patient needs.
  • Informed patients and families of treatment options and at-home care strategies to reduce unnecessary burden on hospital resources.
  • Optimized program resource utilization to prevent unnecessary hospital admissions.
  • Advocated for patients by identifying insurance coverage, communicating care preferences to practitioners and verifying interventions met patients' treatment goals.
  • Collaborated with physicians on patient medications, medical needs and performance.
  • Collaborated with physicians during medical rounds, updated treatment plans, and provided plan of care to patients and families.
  • Updated and maintained discharge plan of care with physician, members of healthcare team, patients, and families.
  • Obtained recommendations for inpatient or outpatient level of care by discussing cases with physician advisor.
  • Helped patients navigate healthcare system and care options by educating on relevant subject areas and answering questions throughout treatment process.
  • Secured insurance authorizations to rehabilitation facilities or long-term care placement.
  • Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
  • Applied medical criteria and clinical judgement to researched cases to evaluate and establish determinations.
Registered Nurse, Emergency Department, 03/2008 to 10/2013
Mid-Columbia Medical CenterHood River, OR,
  • Initiated review, revision and creation of operational policies within emergency department.
  • Monitored and recorded patient condition, vital signs, recovery progress and medication side effects.
  • Administered medications, tracked dosages and documented patient conditions.
  • Conducted patient assessments and diagnostic tests to provide physician with important patient health information.
  • Created and maintained all absentee calendars, agency nurse schedules and staff meeting minutes.
  • Delivered direct patient care, including stabilizing patients and identifying treatment options.
  • Facilitated patient flow during emergency situations, directing evacuations, admissions and transfers.
  • Supervised ancillary staff of 2 on-call nurses, including scheduling shifts, delegating assignments and monitoring quality of care.
  • Treated patients suffering from chronic and acute medical concerns, including asthma, seizure disorders and pneumonia.
  • Set up trays, supplies and sterile fields for office procedures.
  • Maintained composure and efficiency during rapid response situation and emergency codes.
  • Worked alongside doctors and nurses to provide supplies, instruments and equipment for procedures.
  • Administered scheduled medications and therapies intravenously, rectally, orally, subcutaneously and via intramuscular injections while overseeing pain management plans.
  • Consistently maintained core measures, patient satisfaction and HCAPs above 95%.
  • Offered clinical leadership and oversight to 32 bed Emergency Room, including daily scheduling, tasking and administration.
  • Trained and mentored new RNs on best practices, hospital policies and standards of care.
  • Maintained optimal ventilator settings and operations to meet patient care needs.
  • Oversaw patient admission and discharge processes to coordinate efficient movements and related paperwork.
  • Coordinated and managed care for patients undergoing myocardial infarction screening and anticoagulation therapies.
  • Prepared for HIPAA and Joint Commission reviews, making required brochures and pamphlets available to patients in all clinics.
  • Communicated with primary care physicians or emergency care providers to relay patient needs.
  • Used facility EMR system to update patient records, transmit prescriptions and transfer files.
  • Supervised dialysis treatments for patients aging from child to adult in community hospital setting.
  • Addressed unit staff concerns, including staffing ratios, resource management, allocation of responsibilities and optimized workload management.
  • Trained new RN hires and ancillary staff members to meet patient service goals, champion standards of care and improve patient overall satisfaction.
  • Helped nursing staff provide quality, competent patient care for diverse emergencies.
  • Coordinated care for up to 4 patients per shift in busy Critical Care setting.
  • Performed blood and blood product transfusions and intravenous infusions to address patient symptoms or underlying causes.
  • Assessed patient health needs by reviewing and tracking EKG readings to address telemetry readings and quickly inform teammates on stability or acuity changes.
Education and Training
Associate of Applied Science: Nursing, Expected in 12/2007
College of Southern Nevada - Las Vegas, NV
GPA:

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Resume Overview

School Attended

  • College of Southern Nevada

Job Titles Held:

  • Utilization Review Registered Nurse
  • Utilization Review Nurse
  • Registered Nurse, Emergency Department

Degrees

  • Associate of Applied Science

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