MARIBEL DELA CRUZ, BSN, RN

*** ******* ** • Roseville, California, USA 95747

916-***-**** • 530-***-**** • acg6td@r.postjobfree.com

NURSE CONSULTANT • NURSE CASE MANAGER

Dedicated healthcare professional with exemplary work ethics, management experience,

and more than 19 years of success in diverse medical environments.

• Demonstrated aptitude for fostering collaborative relationships with colleagues.

• Proven ability to identify and develop opportunities to improve patient care.

• Consistent record of providing medical staff, patients, and communities with

information and training needed to achieve best possible health outcomes.

Management • Team Leadership • Training • Employee Development • Patient Education •

Communication

PROFESSIONAL EXPERIENCE

JEAN MARTIN GROUP HOMES, North Highlands, California • 2008 – Present

12-bed facility providing residential care to developmentally disabled clients.

Nurse Consultant/RN Care Manager

Supports ongoing health and wellness of residents by providing nursing expertise and

around-the-clock availability to staff with questions regarding nursing care. Oversees

nursing admission process for new residents. Assesses long-term health needs of each

patient and designs plan of care in partnership with attending physician and psychiatrist.

Educates staff and ensures proper implementation of nursing care plan. Adjusts nursing

care plan as needed to address changes in residents’ behavior and wellbeing, and

communicates status of residents and revised plan of care to physician, psychiatrist,

administrator, assistant administrator, and staff. Verifies doctor’s orders to ensure timely

and correct implementation. Reviews printed Medication Administration Records against

doctor’s orders. Administers scheduled injectable medications and completes monthly

drug regimen review of each resident. Generates monthly, semi-annual, and annual

nursing summary reports for all residents. Verifies laboratory and diagnostic exams,

checks lab results, and informs attending physician as needed. Advises assistant

administrator regarding scheduled immunizations

Prepares educational materials and conducts regular in-service training events for staff

and personnel.

• Reduced resident hospital visits by educating staff on health maintenance

and disease prevention.

Health Net Federal Services, Rancho Cordova October 2012 – September 2014

For over 20 years, Health Net has partnered with the Department of Defense to provide

health care services to the men and women who serve and their family members. Health

Net assists nearly 3 million beneficiaries including active duty, retired, National Guard

and reserve, and family members. Health Net was one of the first companies in the U.S.

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to develop comprehensive managed care programs for military families. Health Net

Federal Services is the managed care support contractor for the TRICARE North Region.

Disease Management Specialist RN

Provides one-on-one and group based disease management education to veterans,

active military personnel and their dependents by telephone. Performs initial, on- going

and post intervention patient assessment. Participates in program planning and update

meetings. Delivers one-on- one and group health resource information. Conducts brief

needs assessment to assist the beneficiary and identify resources needed to assist with

the appropriate management of the condition presented by the beneficiary and/or group.

Maintains current information on available resources including community and local

programs available, cost, and resource contact information. Invites beneficiaries to

complete and return program satisfaction surveys. Develops and maintains policies and

procedures. Assists beneficiaries by referring to appropriate organization resources or

contacts as indicated.

• Provides health education to beneficiaries with diabetes, COPD, heart failure and

asthma thereby helping them to successfully manage their chronic conditions.

Xerox, West Sacramento, California August 2011 – Sept 2012

A global leader in business process outsourcing contracted with the Department of Health

Care Services

( DHCS) to manage California Medicaid Management Information Systems ( CA-MMIS) for

payment processing of healthcare providers of the Medi-Cal fee-for-service program.

Nurse Consultant, Professional Claims/Medical Review/Utilization Review

Served as a clinical consultant for CA-MMIS. Identified significant opportunities for clinical or

financial improvement in medical management. Developed and designed interventions that

improved or maintained the quality of care while reducing the overall cost of care when

possible. Kept abreast with continuously evolving health care practices, equipment and

technology. Adjudicated claims and appeals.

• Provided clinical information to staff and other Medical Professionals to facilitate

proper and accurate adjudication of claims.

• Responded to appeals and reviewed medical necessity and identified levels of care.

RIDEOUT MEMORIAL HOSPITAL, Marysville, California • February 2007 –

September 2010

137-bed acute care hospital specializing in medical surgical cases.

Staff Nurse II

Provided comprehensive nursing care to medical- surgical patients on telemetry in

collaboration with nursing colleagues, physicians, and other healthcare clinicians.

Discussed treatment plans and discharge instructions with patients’ families, and

educated patients and their caregivers on health maintenance and disease prevention

strategies. Reviewed nursing reports from outgoing RN, personally assessed each client,

developed, implemented, and evaluated plan of care. Checked Medication

Administration Record against doctor’s orders and informed pharmacy of any

discrepancies. Administered medications, treatments, and therapies. Initiated and

maintained intravenous (IV) lines for fluid, medications, blood, and blood products.

Monitored and recorded vital signs, including pain level, as well as intake and output.

Created electronic record of patient observations. Performed nursing assessments and

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gave intravenous medications and fluids to patients under the care of LVNs. Supervised

Certified Nursing Attendants (CNAs).

• Earned numerous recognition based on colleague recommendations.

• Provided comprehensive care to medical-surgical and nephrology clients

on telemetry.

KAISER PERMANENTE MEDICAL CENTER, Sacramento, California • May 2008 –

August 2008

Facility affiliated with the largest managed care consortium in the United States.

Staff Nurse II

Received nursing reports on assigned clients from outgoing RN, performed nursing

assessment for each client, and developed individualized plan of care to meet their

unique needs. Collaborated with physician and other healthcare clinicians to ensure

quality of care. Referred urgent and emergent health conditions to attending physician.

Provided nursing care to medical-surgical clients. Verified Medication Administration

Record against doctor’s orders and communicated any discrepancies to pharmacy.

Administered medications and treatments. Monitored and recorded vital signs and client

intake and output. Initiated and maintained patent IV lines for fluid, medications, blood,

and blood products. Administered transfusions and infusions. Observed patients and

recorded findings

electronically. Assisted patients with activities of daily living. Treated wounds and

provided nursing care to clients with various types of medical equipment. Supervised

CNAs involved in patient care. Provided healthcare education and detailed discharge

instructions to clients and their families.

• Honed medical-surgical nursing skills. Honed motivation and teaching skills.

GLOBAL CITY INNOVATIVE COLLEGE, Taguig City, Philippines • January 2005 –

September 2005

Private institution offering undergraduate degrees in nursing, education, English,

business administration, and hospitality management.

Clinical Instructor/Faculty

Presented expert instruction to nursing students working toward Bachelor of Science in

Nursing (BSN). Planned and implemented effective teaching strategy for classroom and

clinical instruction. Assessed learning needs of individual students and provided

appropriate support. Contributed as member of nursing program. Mentored new faculty

and performed peer evaluations.

• Motivated BSN students to apply knowledge of nursing principles in

clinical practice.

• Honed teaching and leadership skills.

NURSE CORPS, ARMED FORCES OF THE PHILIPPINES, Quezon City, Philippines •

Jul 1995 – February 2005

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Service branch committed to providing comprehensive nursing care to military personnel

and their dependents, as well as authorized civilians.

Military Nurse

Analyzed health of individuals and populations and used available data to determine

nursing needs. Defined desirable health outcomes, created appropriate care strategy

with realistic goals, and partnered with patients, families, and communities to achieve

best outcomes. Managed nursing activities, supervising both enlisted personnel and

civilian employees. Identified opportunities for delivering patient care. Participated in

civil-military medical missions.

• Served as a military nurse and officer.

• Gained experience in diverse clinical areas, including Emergency Room,

Medical-Surgical, Pediatrics, OB-Gyn, Hemodialysis Unit, Outpatient Medical

Setting and Nursing Administration.

• Successfully completed physically and mentally challenging Technical

Service Officer Basic Course and Military Occupational Specialty Training in

Hemodialysis Nursing.

• Achieved assignment to military’s premier medical institution, a 1200-bed

acute care facility.

• Contributed to evacuation of hundreds of civilians from path of erupting

volcano.

• Earned numerous merit medals, awards, and decorations for exemplary

service.

EDUCATION, PROFESSIONAL DEVELOPMENT & CERTIFICATIONS

Bachelor of Science in Nursing (Cum Laude)

University of Cebu, Cebu City, Philippines

Case Management Certificate Program

Kaplan University USA

Case Management/ Utilization Review Practical Workshop/Training

Temple Community Hospital

Los Angeles, CA, USA

Registered Nurse

California Board of Registered Nursing

Basic Life Support for Health Care Providers (BLS-HCP)

Military Occupational Specialty Training in Hemodialysis Nursing

LANGUAGE SKILLS: Tagalog, Cebuano, English.

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MARIBEL DELA CRUZ Page 4• acg6td@r.postjobfree.com

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