Registered Nurse Quality Assurance

LORETTA ANDRIESSE

***** ******** ***** ***, ************, FL 32218 Cell Phone: 904-***-****

E-Mail:****************@*****.***

Professional Summary

Driven and compassionate healthcare professional with 40 years hands-on experience in fast-paced residential and hospital environments. Accountable and responsible with a strong focus on patient wellness.

Dedicated Registered Nurse adept at public and community relations, staff development and

project management.

Director of Nursing experienced at directing administrative and personnel matters in a 24/7 care facility for elderly clients. Strong problem-solver with excellent time management skills.

Director of Nursing driven to achieve the highest levels of client satisfaction through

comprehensive client care and emotional support.

Professional Case Manager with experience with providing recommendations for future action

based on medical review findings

Defines policy information used in making medical review decisions

Research medical and healthcare delivery issues

Experienced in chart/record audits for coding, and billing correctness

On-site audits of facilities and records for compliance with state and federal guidelines

Registered Nurse versed in research and analysis. Seeking a position to develop and

implement new and innovative health care improvement processes and admission

procedures.

Education and Training

Associate of Science, Nursing/Law

1983

Florida Jr. College Jacksonville, FL, USA

GPA 3.75

Major in Nursing

Skill Highlights

Staffing management ability

utilization review

Conflict resolution

compliance with AHCA

Proven patience and self-discipline

compliance with Federal guidelines

Critical thinking proficiency

ICD coding

Claims analysis and review specialist

assistance with admission and discharge

Cultural awareness and sensitivity

planning

In-depth claims knowledge

home and field case management

Staff training and development

communication with providers and

Sound decision making

members

Relationship and team building

Financial aptitude

Personal and professional integrity

Patient-oriented

Government relations knowledge

Confident public speaker

ACLS instructor

Skilled cardiac care nurse

Geriatric treatment knowledge

Psych and mental health care

proficiency

Committed to pediatric nursing

Broad medical terminology knowledge

Committed to compliance reporting

Staff training

Supervision and training

Sound judgment

Computer-savvy

Calm under pressure

Complex problem solving

PROFESSIONAL EXPERIENCE

Registered Nurse Case Manager2

Mar2014 to August 2017

Centene Corporation St. Louis, MI

Reduced and controlled expenses by assisting members with ED visits decrease and use of in network providers

Managed caseload of 20 clients, providing education, treatments, IV therapy, venipuncture

and wound care.

Assisted patients with multiple chronic diagnoses including COPD and asthma.

Responsible for primary care, case management and medication management.

Accurately documented all elements of nursing assessment, treatments, medications, discharge instructions and follow-up care.

Utilized strong assessment skills to determine necessary patient care.

Provided quality nursing care in accordance with resident care policies and procedures.

Coordinated with doctors and registered nurses to develop care plans for patients.

Prepared for HIPAA and JCAHO reviews, ensuring required brochures and pamphlets were

available to patients in all clinics.

Supervised 200 other practitioners and employees, led recruiting and hiring, managed

employee review process and ensured compliance with state and federal regulations

Actively participated in unit-based Quality Assurance Program.

Sound, ethical and independent decision-making ability consistent with medical protocols.

Headed onboarding process for new nursing staff..

Registered Nurse Specialist Aug 2013 to Dec 2013

Agency for Health Care Administration (State of Florida) Jacksonville, FL

August 2013 to December 2013

Cooperated with other health related agencies and organizations in community activities.

Ensured the accuracy of public information and materials.

Actively maintained up-to-date knowledge of applicable state and Federal laws and regulations.

Monitored the nursing and operation of support departments to ensure that resident needs

were met and facility was properly maintained.

Diligently monitored the QA (Quality Assurance) program to improve performance and

maintain high standards of care.

Registered Nurse Specialist Jul 2012 to Aug 2013

Florida Department of Elder Affairs Jacksonville, FL

Provided necessary health education training for patients.

Sound, ethical and independent decision-making ability consistent with medical protocols.

Actively participated in unit-based Quality Assurance Program.

Delivered high-quality and compassionate treatment to indigent and low-income patient community.

Prepared for HIPAA and JCAHO reviews, ensuring required brochures and pamphlets were

available to patients in all clinics.

Registered Nurse Specialist Oct 2010 to Jun 2012

Duval County School Board Jacksonville, FL

Utilized strong assessment skills to determine necessary patient care.

Organized, updated and maintained over 200 patient charts.

Sound, ethical and independent decision-making ability consistent with medical protocols.

Completed thorough record audits for compliance with state guidelines for school attendance

Registered Nurse Aug 2010 to Oct 2010

Peaches N A Basket Jacksonville, FL This position was only temporary as I was going under SS and only worked for supplemental income.

Actively participated in unit-based Quality Assurance Program.

Supervised [number] other practitioners and employees, led recruiting and hiring, managed

employee review process and ensured compliance with state and federal regulations.

Registered Nurse/Staff Development/Unit Manager Feb 2008 to June 2010

Life Care Center of Hilliard Hilliard, FL

Delivered high-quality and compassionate treatment to indigent and low-income patient community.

Directed facility's LPN program including recruitment, enrollment, budgeting and instruction.

Trained 75 new LPNs annually

Prepared for HIPAA and JCAHO reviews, ensuring required brochures and pamphlets were

available to patients in all clinics.

Partnered with team of Registered Nurses to ensure over all well-being of all patients.

Provided quality nursing care in accordance with resident care policies and procedures..

Park Meadows Nursing & Rehab Mar 2006 – Aug 2006

RN DON

Ensured HIPAA compliance

Participated in unit-based Quality Assurance Program

Evaluated patient care needs, prioritized treatment and maintained patient flow.

Developed and implemented nursing care plans

Demonstrated ability to lead and motivate outstanding healthcare teams.

Responsible for Nursing in 154 Bed Facility

This position was left due to the 3 hour commute each way on a daily basis

Director of Nursing June 2004 to August 2006

Southwood Nursing Home Jacksonville, FL

Ensured HIPAA compliance

Participated in unit-based Quality Assurance Program

Processed monthly reports for department performance

Self-directed with astute judgment skills.

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