Responsibilities View nurse notes, manage nurses and caregivers, accept clinical assignments, communicate with payout plans and insurance companies, hiring staff for multi state agency, advocating services, signing up private pay home care clients and answering general questions Accomplishments still accomplishing many task Skills Used Nursing judgement Various Computer systems
- Clinical nurse supervisor at Nurse Contracf
- LPN Supervisor at REscare
- LPN Charge Nurse at Emeritus
- MA/office admin at Neurosurgey Inc
4 years, 9 months at this Job
- Lpn IV/ Med - Lpn
Successfully supervise two (2) function areas within the Medical Services Department 11/2011-05/2013:
• Prior Authorization/Precertification Nurses
• Six (6) RNs charged with pre-certifying all outpatient/inpatient scheduled requests for appropriate services and medical necessity
• Concurrent Review Registered Nurses
• Six (6) RNs charged with reviewing all inpatient admission to ensure appropriate level of care and medical necessity
• Aided in reduction of admission in three (3) key chronic conditions
• Developed consistent workflows and work processes
• Assisted with reducing day out in determination status * Medical Services Supervisor 6/2008-11/2011
• Successfully supervise three (3) function areas within the Medical Services Department:
• Intake Specialist (Triage)
• 17(seventeen) non-clinical individuals charged with providing extraordinary customer service to the medical community requesting authorization for covered services.
• Efficiently and accurately constructed service request cases for self-approval or to be forwarded to clinical nurse review
• Consistently ensured state-mandated metrics were obtained
• Appeal Team * Profitably supervised a team of two (2) non-clinical staff members and one (1) clinical nurse in the process of reviewing denied/challenged claims * Guided the Appeal Team to successfully obtaining the NCQA Accreditation in beginning in 2010 * Developed review process in retrospective claims for ambulance/air transportation
• Fax Management Team * Developed team to analyze, separate, and process faxes appropriately * Developed and implemented work flows and processes for faxed materials * Clinical liaison for the non-clinical staff MJR, RN, CCM
• 2 * Clinical Appeal Nurse:01/2008-6/2008 * Research cases for medical necessity using InterQual criteria * Present denied claims for reconsideration and resolution * Teamed physician advisors and network management for resolution * Clinical Care Concurrent Review Nurse: 09/2006-01/2008 * Review inpatient admissions for medical necessity and appropriate level of care using InterQual * Consult with Medical Director on adverse determinations * Referred potential candidates for Case Management * Verified member eligibility and benefits
- Clinical Nurse Supervisor at Medical Services Department
- RN Case Manager at Heartland Hospice
- RN Case Manager at East Cooper Regional Medical Center
- RN Case Manager at Hillside Rehabilitation Hospital
6 years, 8 months at this Job
- Associate - Nursing
Working full time as the lead Clinical Nursing Supervisor and board coordinator in the main OR at Riverbend; supervising all staff, coordinating rooms and all variables involved, serving as liaison between surgeons and staff, and supervising staff and surgery schedules. Position includes collaborating and coordinating closely with all units in the hospital, maintaining efficiency while being cost effective, and striving to maintain a customer-based environment where patients, staff, and physicians alike receive quality, individualized care.
- RN/Clinical Nurse Supervisor at Peacehealth Riverbend
- RN at Riverbend Day Surgery
- RN/Director of Nursing at Monte Nido & Affiliates/Rainrock Treatment Center
- RN at Ambulatory Surgery Center(s)
2 years, 4 months at this Job
- Masters - Family Nurse Practitioner
- Masters of Nursing Science - Nursing Leadership and Management
Duties include charge nurse for 46 bed Mother/Baby unit and newborn nursery, ensuring smooth operation and safety. Provide direct and indirect care of postpartum mothers (many high risk, acute patients) with various social needs and disease processes as well as their newborns. Collaborate with L&D and Antepartum units to provide rooms for incoming patients, make nurse assignments, staff unit appropriately daily, compile various reports, supervise floor RNs and clinical assistants. Compile monthly schedule for 45+ personnel. Train and supervise new graduate RNs as well as all floor RNs.
- Clinical Nurse Supervisor at Seton Medical Center
- RN to Christopher Seeker, M.D at Austin Area OB/GYN
- Postpartum Nurse at St. David's North Austin Medical Center
- Secretary, bookkeeper, administrative assistant at Glass & Company, CPAs
7 years, 8 months at this Job
- BSN - Nursing
• I oversee 20 nurses and therapists in a Home care agency setting with a census of 200 patients.
• Interviewing, hiring staff, and educating staff in clinical skills, policy and procedure.
• Involved in case conferencing with clinicians and managing all aspects of the agencies day to day operations. Educating clinicians regarding insurance requirements and cost effective quality healthcare
- Clinical Nurse Supervisor at Great Lakes Caring Home Health Agency
- A staff nurse caring for acute rehabilitation patients at Northeast Rehabilitation Hospital
- case manager at Home Health VNA Newburyport and Lawrence MA
- Labor and Delivery RN at Anna Jaques Hospital
3 years, 2 months at this Job
- BSN - Western Governors
Job duties: Consist of case managing Oklahoma state resident of various programs that on are Oklahoma Sooner Care such as: Review clinical documentation for medical necessity, adjudicate claims, create policy and procedures surrounding national coding guidelines and CMS. Also, I advocate for patients and research claims and coordinates with various health facilities to ensure adequate care for the member's. ◦ September 2011-Present Norman Regional Hospital (405) 307- 3035 Toby ◦ Flex Pool RN ◦ Job duties: Supervises nursing care, and in collaboration with the physician, coordinates total patient care for patients by leading and directing an interdisciplinary care teams. Cares for infants to geriatric patients. Floats from one unit to another as requested. Assessments of patients, administration of medications and utilizing patient identifiers making sure safe and effective care is being provided.
- Clinical Nurse Supervisor at OHCA
- Contract Nurse at MSN Staffing Agency
- Star RN, Staff RN, and Charge Nurse at OU Medical Center
- AmeriCorps Representative at MSN Staffing Agency
7 years, 6 months at this Job
- Post-Masters - Family Nurse Practitioner
- MSN - Administration/Management
- B.S of Science - Nursing
- B.S. of Arts - African and African American Studies
- High School Diploma
• Provides direct and indirect patient care to the acutely ill and critical patient population.
• Supervise licensed RN’s, LVN’s, and non-licensed personnel as assigned in the acute care setting.
• Performing as Charge Nurse and responsible for making patient care assignments based on skill, experience, and temperament of other nursing personnel and based on patient acuity, ensuring patient and staff safety.
• Assist in performance evaluations and skills of agency/ temporary staff as well as permanent acute care staff.
• Responsible for directing and orienting new and current staff members as needed/ assigned in all aspects of acute care management.
• Participates in quality and process improvements in the department during all phases from planning to implementing, and sustaining efforts, including taking corrective action when employees fail to carry out delegated duties.
• Accountable for creating schedule for staff based on department needs.
- ER Clinical Nurse Supervisor at Mission Community Hospital
- Aesthetic Nurse at MD Aesthetics
- EP Pre/Post Nurse at Hartford Hospital
- Cardiac Intensive Care Unit Nurse at Saint Francis Hospital
7 months at this Job
- Bachelor of Science - Nursing
- Associate of Science - Nursing
• Monitor and manage the provision of patient care by direct observation, documentation review and the development and implementation of remedial or continuous improvement action plans.
• Assess and align staff expertise and scope of practice to patient census and acuity with consideration to the enforcement of departmental quality and compliance standards.
• Evaluate patient population trends, anticipate service requirements, and develop responsive plans. Assess, plan and maintain a state of unit readiness and responsiveness to developing circumstances.
• Assure compliance with quality initiatives and collection of data as assigned.
• Acts as a role model and clinical resource for staff.
• Supports the Nursing Strategic Plan by participation in and leading nursing strategic initiatives.
• Communicates necessary information regarding unit issues, circumstances and/or events to UMCRH PGHC leadership, staff and/or other appropriate individuals in an effective and timely manner..
• Collaborate with providers to assure exceptional patient care, resolution of issues, and support to the medical team.
• Collaborate with the Department Manager and Director in the assessment and documentation of staff performance pursuant to employee performance evaluations.
• Serve as liaison with other departments as needed to facilitate service excellence.
• Participate in the staff interview process to aid in hiring competent new employees.
• Collaborates with other disciplines and departments to assure timely procedures, admissions, transfers and discharges.
• Initiate unit rounds to assess/adapt physical environment and the monitoring of compliance with internal and external safety standards. Notify appropriate individuals of potential/current safety concerns.
• Other duties as assigned by Department Manager/ Director of Critical Care.
- ICU Clinical Nurse Supervisor at UM Capital Region Health Prince George's Hospital Center
- ICU Staff Nurse at UM Capitol Region Health Prince George's Hospital Center
- Staff Nurse at Revival Homecare Agency
- Unit Manager at UM Capitol Region Health Prince George's Hospital Center
8 months at this Job
- Bachelor of Science in Nursing - Nursing
- ADN - Mobility Program
Promoted from Transfer Center RN to supervisor in the inpatient psychiatric setting ◦ Advocate for patient and staff safety by collaborating with the team at the Transfer Center, psychiatrists and medical physicians, and upper leadership. ◦ Audit patient charts monthly and provide education to staff with corrective action when needed including verifying completion of InterQual upon patient admission ◦ Coach staff through formal disciplinary action when needed
- Clinical Nurse Supervisor/AOD at BAYCARE HEALTH SYSTEM
- at BAYCARE HEALTH SYSTEM
- Patient Placement RN for Behavioral Health at BAYCARE HEALTH SYSTEM
- Clinical Nurse Supervisor/Administrator on Duty at BAYCARE HEALTH SYSTEM
7 months at this Job
- Master's - PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER
- Bachelor's - NURSING
January 2015-Present * Supervise a staff of ~18 comprised of Nurses, Physical Therapists, and Home Health Aids. * Manage patient needs via triage, multi-disciplinary coordination, and field-based care. * Ensure staff compliance with company & state policies via chart audits. * Evaluate staff competency through direct observation in the field and the classroom. * Organize and facilitate monthly and annual in-services and team meetings, promoting continued education through evidence-based training. * Assist Clinical Director with monthly projects. * Developed and implemented new hire orientation training for the organization.
- Registered Nurse-Weekend Clinical Nurse Supervisor at Visiting Nurse Association of Southeastern Connecticut
- Registered Nurse-Homecare Case Manager at
- Registered Nurse at Yale New Haven Hospital
- Graduate Nurse-Trauma at Surgery Unit
4 years, 2 months at this Job
- Master of Science - Nursing
- Bachelor of Science - Nursing