Registered Nurse, Population Health, Utilization Management
Resume:
EDWARD J. ARNOLD
P.O. Box ****
Monument, CO ****2
**.******@******.****.***
SUMMARY:
Managed Population Health program at both medical center and small outpatient clinic. Supervised a staff of 12 disease/case managers demonstrating medical management experience and staff training ability. Consistently recognized for initiative & analytic abilities to achieve improved outcome metrics and enhanced efficiency during 20 years as a registered nurse.
KEY QUALIFICATIONS:
• Utilization Management
• Supervision
• TRICARE/MHS Experience
• Population Health
• Staff Development/Training
• Clinical Adherence
• Clinical Expertise
• MS Office skills
• Secret Clearance (Exp 2021)
EXPERIENCE:
Utilization Management / Utilization Review
• Spearheaded targeted prospective/retrospective reviews of 40,000 referrals/yr driving cost containment beyond $142,000 for small clinic.
• Performed inpatient concurrent reviews for medical necessity based directed criteria.
• Evaluated proposals on source selection panel for Air Force Referral Management contract award.
• Completed Milliman Care Guidelines Training (Inpatient/Surgical/General Recovery/Ambulatory).
Population Health
• Collaborated with physicians, nurses & support staff to identify at-risk populations; maintained proactive disease management program for 2,000 patients/case management for 500 patients.
• Partnered with IT/Biometrics personnel to develop workflows/protocols within Electronic Medical Record (EMR) to ensure appropriate preventive & disease-specific screening.
• Coordinated implementation of Patient-Centered Medical Home initiative & NCQA certification.
• Analyzed outcome metrics for trends; validated findings; developed action plans; metrics rose 12% in 6 months.
Clinical expertise
• Nominated for New Mexico Nurse of the Year – 2006.
• 20 years as a Registered Nurse; 5 years direct patient care experience / 3 years office practice.
• Completed both Clinical Nurse Specialist & Nurse Practitioner practicum while earning Masters.
MS Office Skills
• Exceptional Excel data management/analysis; Access query construction; Word fluent
Process Improvement
• Implemented cancer screening action plan reaching 1,000 women in first year/cut costs by 90%.
• Overhauled medical inprocessing program for over 800 personnel establishing benchmark program.
Supervision
• Seized Chief Nurse responsibility of 50-bed contingency aeromedical staging unit; maintained quality care/safe patient transports for 500 patients with staff of 12 nurses & 40 non-licensed personnel.
• Managed nursing personnel/operations for Family Health Clinic providing over 700 appts/month. Transitioned through severe provider shortage while maintaining access/quality of care focus.
• Navigated personnel transitions for five contract-to-civil service positions without interruption in clinical service.
• Planned medical staging, first aid, & emergency response for installation open house; accommodated over 90,000 visitors safely with full emergency response capability on-hand.
Staff Development / Training
• Instructed medical rescue skills reaching 92% currency for entire installation at Robins AFB, GA.
• Orchestrated scenario-based drills and preparations for Robins AFB air show as Medical Exercise Evaluation Team Chief; response teams mission-ready/performed without incident.
• Identified shortfall in facility cardiac arrest care; developed training plan for upgrade of essential equipment; most up-to-date care now available throughout facility.
Clinical Adherence
• Maintained 7 clinical practice guidelines using up-to-date evidence-based interventions. Performed over 600 chart audits per year for variance analysis to optimize care for acute/chronic disease conditions.
• Integrated clinical adherence monitoring into provider peer-review program; cut monthly audit workload by 12 hours/month.
EMPLOYMENT HISTORY:
May 11 – Aug 13: Chief, Healthcare Integration; 88 MDG, Wright-Patterson AFB, OH.
*Mar 12 – Sep 12: Chief Nurse; 559 AMDS; Lackland AFB, TX. **Temporary Assignment**
Aug 10 – May 11: Air Force Institute of Technology- PhD Candidate, Georgia State University, GA.
May 09 – Aug 10: Chief, Healthcare Integrator; 78 MDG, Robins AFB, GA.
Aug 07– May 09: Chief, Group Education & Training, 78 MDG, Robins AFB, GA.
Apr 05 – Aug 07: Flight Commander, Group Education & Training, 377 MDG, Kirtland AFB, NM.
Apr 04 – Apr 05: Nurse Manager, Family Medicine Element. 377 MDG, Kirtland AFB, NM.
Apr 03 – Apr 04: Nurse Manager, Pediatric Element. 377 MDG, Kirtland AFB, NM.
May 00 – Apr 03: Chief, Outcomes / Referral Management, 375 MDG, Scott AFB, IL.
Aug 98 – May 00: Graduate Student, Virginia Commonwealth University- School of Nursing.
Jun 95– Aug 98: Assistant Nurse Manager, 35 MDG, Misawa AB, Japan.
Feb 94 – May 95: Clinical Nurse, 89 MDG, Andrews AFB, MD.
Aug 93– Feb 94: Nurse Intern, 89 MDG, Andrews AFB, MD.
May 93– Aug 93: Staff Nurse: Incarnate Word Hospital, St. Louis, MO.
EDUCATION:
2000 MS: Adult Health Nursing– Virginia Commonwealth University, Richmond, VA.
Graduated Summa Cum Laude.
1993 BSN– St. Louis University, St. Louis, MO. Graduated Summa Cum Laude.
1991 BSE– Duke University, Durham, NC. Major: Biomedical Engineering
LICENSURE / CERTIFICATION:
Current, unrestricted nursing licenses in Colorado, Georgia & Ohio
Nursing Professional Development Certification Exp. 07/18
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