Registered Nurse Manager

DOMINIQUE GILLYARD MSN CCM

*** ********** ***, ******, ** 75068 H: 972-***-**** *****************@*****.***

PROFESSIONAL SUMMARY

Experienced Registered Nurse for 10 years. High performer in disease and case management. Certified Case

Manager. Case and utilization management supervisor experience. Excellent communication skills. Presenter in

constituents' s ite v isits a nd consultant g roups f or e xternal s ales.

SKILLS

Strong clinical judgment Demonstrated ability to communicate, problem

Familiarity with NCQA standards, state/federal solve, and work effectively with people.

regulations and measurement techniques. Skilled at supervising high functioning

Patient/family focused teams. Able to use effective management principles.

WORK HISTORY

Case Manager Specialist, 0 3/2011 to C urrent

Cigna – P lano, TX

Coordinated services as needed (home health, DME, etc.) Utilizing Milliman criteria to determine if

patients are in the correct hospital setting.

Making referrals to outside sources ensuring continuum of patients' care utilizing advanced nursing

knowledge, experience and skills to ensure appropriate utilization of resources and patient quality

outcomes.

Ensured that discharged member receive the necessary services and resources for ensuring the continuity

of care in both the inpatient and outpatient setting utilizing the appropriate resources within the

parameters of established contracts and patients' health plan benefits by making welcome home calls.

Presenter for constituents' site visits and consultant groups.

Excellent communication skills.

Provide external.

Representation for clinical operations and products at selected client meetings, including external sales for

nursing services.

Interacting with Medical Directors on challenging cases coordinating care for members.

Educating.

Utilization Case Management Supervisor, 0 7/2010 to 0 3/2011

Aetna – D allas, TX

Aetna - Dallas, TX Oversaw, coordinated and monitored all Utilization Management team clinical and non

clinical team activities to facilitate integrated proactive utilization management.

Responsible for developing high performing teams.

Meeting and exceeding benchmarks for incoming medical request for inpatient and outpatient services.

95% and above Turn Around time.

Functioned as hands-on supervisor for daily integrated Utilization Management activities.

Managed and evaluated team members in the performance of various utilization management activities.

Performed and promoted interdepartmental integration and collaboration to enhance the continuity of care

for Aetna Medicaid members.

Worked with the Nursing Director to ensure adequate staffing and service levels, and maintains customer

satisfaction by implementing and monitoring staff productivity and performance indicators.

Interviewed and hired new staff members.

Conducts performance evaluations in a timely manner.

Provides coaching, counseling an.

Case Manager, 11/2006 to 0 7/2010

United HealthCare Optum Health – R ichardson, TX

Coordinating services as needed (home health, DME, etc.) Utilizing Milliman criteria to determine if

patients are in the correct hospital setting.

Presenter for constituents' site visits and consultant groups.

Excellent communication skills.

Provide external representation for clinical operations and products at selected client meetings, including

external sales for nursing services presenting at consultant road shows.

Ensured that discharged member receive the necessary services and resources for ensuring the continuity

of care in both the inpatient and outpatient setting utilizing the appropriate resources within the

parameters of established contracts and patients' health plan benefits by making welcome home calls.

Making referrals to outside sources ensuring continuum of patients' care utilizing advanced nursing

knowledge, experience and skills to ensure appropriate utilization of resources and patient quality

outcomes.

Interacting with Medical Directors on challenging cases coordinating care for me.

Labor and Delivery Nurse, 0 9/2005 to 11/2006

Las Colinas Medical Center – I rving, TX

Specializing in the care and assessment of maternity patients.

Knowledge and experience in experienced in speculum exams, fetal monitoring, drawing labs, IV and IV

infusion Responsible for the care of the maternity patients during antepartum, labor, and postpartum

Assisting the doctors during surgeries, scrub nurse, and administering epidurals.

Preparing patients for surgeries. Caring for patients before and after surgeries.

Experience in catching babies, drawing labs, testing, and assessment of the newborn.

Labor and Delivery Nurse, 0 6/2005 to 0 9/2005

American Mobile Travel Nursing Assignment – D allas, TX

Specializing in the care and assessment of maternity patients.

Knowledge and experience in experienced in speculum exams, fetal monitoring, drawing labs, IV and IV

infusion Responsible for the care of the maternity patients during antepartum, labor, and postpartum

Assisting the doctors during surgeries, scrub nurse, and administering epidurals.

Preparing patients for surgeries. Caring for patients before and after surgeries.

Experience in catching babies, drawing labs, testing, and assessment of the newborn.

Labor and Delivery Nurse, 0 3/2004 to 0 6/2005

Louisiana State University Hospital – S hreveport, L A

Specializing in the care of maternity patients.

Knowledge and experience in experienced in speculum exams, fetal monitoring, drawing labs, IV and IV

infusion Responsible for the care of the maternity patients during antepartum, labor, and postpartum

Assisting the doctors during surgeries, scrub nurse, and administering epidurals.

Preparing patients for surgeries.

Caring for patients before and after surgeries.

Experience in catching babies, drawing labs, testing, and assessment of the newborn.

EDUCATION

High School Diploma : G eneral Studies, 1 997

Mansfield High School - Mansfield, L A

Bachelor of Science : N ursing, 2 003

Grambling State University - Grambling, L A

Master of Science : N ursing, 2 010

Loyola University - New Orleans, L A

Ph.D.: N ursing,

Texas Woman's University - D enton, TX

I was accepted into the Ph.D. program at Texas Woman's University and decided to take a break. I did want to

share I was accepted and working towards my Ph.D.

ACCOMPLISHMENTS

Human Resources Assisted in new hire process by calling and scheduling appointments with candidates,

filling out required paperwork and preparing new hire manuals.

Trained team of staff nurses in utilization procedures to ensure consistent quality of care.

HealthCare Systems Management Residency where I worked with Brittany Pham, Operations Management

on developing Diabetic Health Programs including calculating FTE's and developing scripting for

engagement staff.

CERTIFICATIONS

Certifications

Registered Nurse in Texas, License number 715626

Registered Nurse in California, License number 806411

Certified Case Manager, License number 00132411

AWARDS

Presented to David Cordani, Ceo of Cigna and his board of directors demonstrating our clinical programs,

integration and clinical IT systems. Received two Cigna Awards totaling $150.00 dollars with certificates from

the Director of Health Management Clinical Operations and Direct management for a superb presentation.

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