OBJECTIVES

Competent and results-oriented Family Nurse Practitioner with extensive healthcare background seeks job to contribute skills and experience to promote institution’s growth while continuing career development.

CORE COMPETENCIES & SKILLS

Over 14 years of experience in the healthcare field, including 7 years nursing services.

Teaching, Training & Mentoring

Optimal patient care, planning and treatment protocols abilities

Clinical and time management skills

Knowledge of hospital operations and Emergency Medicine

General clinical, anti-aging and surgical skills

Diagnostic testing and Interpretation

Medical documentation management

Multi-tasking abilities

Great trustworthiness, reliability and professional work ethics

Exceptional analytical capabilities

Leadership and interpersonal relationships

Case Manager

Solid organizational abilities

Outstanding listening skills

Team player

Compassionate and dedicated

Positive attitude and proactive

Excellent communication skills.

Fully bilingual (English-Spanish)

Computer proficiency: MS Word, Excel, & Power Point

EDUCATION

2018 South University, Master of Science in Nursing, Savannah GA

2015 Bachelor Science of Nursing, Miami FL

2011 Practical Nursing, Miami FL

LICENSES AND CERTIFICATIONS

Family Nurse Practitioner

CPR and Basic Life Support

IV Certification

Affiliations

American Association of Nurse Practitioners (AANP)

PROFESSIONAL EXPERIENCE

Utilization Review /Nurse Liaison

August 2016- Present

Humana

Ensure patient care is provided according to the medical necessity of patients. Check if the provided medical care meets the insurance company standards by MCG Guidelines. Pre-Authorizations. Reviewed admissions cases and ensure appropriate patient placement. Concurrent review and Retro reviews. Work closely with the interdisciplinary team and stayed current of patient status. Knowledge of rules and regulations of Medicaid and Private insurance company. Case management and discharge planning. Currently onsite reviewer at Jackson Memorial Hospital, ad covering telephonic Larkin Community Palm Spring Campus.

Utilization Review Nurse/RN

April 2015 to August 2016

Magellan Complete Care

Ensure patient care is provided according to the medical necessity of patients. Check if the provided medical care meets the insurance company standards by InterQual program. Pre-Authorizations. Reviewed admissions cases and ensure appropriate patient placement. Concurrent review and Retro reviews. Work closely with the interdisciplinary team and stayed current of patient status. Knowledge of rules and regulations of Medicaid and Private insurance company. Case management and discharge planning. Currently onsite reviewer at University of Miami Hospital, Jackson Memorial Hospital, Jackson North Medical Center, Jackson South Community Hospital, Hialeah Hospital, Palm Spring General Hospital and Palmetto General Hospital.

Utilization Review Nurse/RN

October 2014 to April 2015

Leon Medical Centers Health Plans/Cigna Health-Springs

Ensure patient care is provided according to the medical necessity of patients. Check if the provided medical care meets the insurance company standards. Reviewed admissions cases and ensure appropriate patient placement. Monitored patients for 24 hours and determined and performed stay review. Assessed provided care and suggest physician to modify patient’s status at the hospital if necessary. Work closely with the interdisciplinary team and stayed current of patient status. Case management and discharge planning. Knowledge of rules and regulations of Medicare and Private insurance company. Process patient’s reimbursement by providing accurate clinical audit and reviewing medical records received from members.

LPN/Registered Nurse

December 2012 to October 2014

Behavioral Health Service at St Luke's Center - Catholic Charities of the Archdiocese of Miami

Supervise nursing assistants and care of assigned residents.

Administer medications and treatments according to physician orders and scope of practice.

Communicate with physician, residents, and family regarding resident status and care. Case management and discharge planning.

Complete appropriate documentation and charting including incident reports, orders, and care plans.

Monitor physical and mental status of residents including vital signs, physical assessments, and skin

assessment.

RN/LPN

February 2012 to Present

Living Care Home Health - Miami, FL

Delivered skilled nursing care in routine/stressful period.

Monitored patient's physical condition. Administered prescribed medications.

Participating in multidisciplinary nursing team to improve policies and procedures.

Intake Coordinator

April 2010 to February 2012

Casper Home Health - Miami, FL

Verify medical order for home health.

Coordinates patient's services with nurses, physical, occupational, speech therapist and Social worker.

Patient coding and billing.

Assistant Manager

August 2008 to February 2010

Therapeutic Associates of South Florida

Coordinates patient's appointments with physical and occupational therapist.

Review medical records.

Patients coding and billing.

Review charts for all aspect of procedure, documentation and signature for review of medical doctors,

chiropractic, physical and occupational therapist.

Ordered all patients medical device and supplies needed for medical use.

Made sure all chart were complete.

Dynamic Medical Service

November 2004-August 2008

Coordinates patient's appointments with MD, physical and occupational therapist.

Review medical records.

Patients coding and billing.

Review charts for all aspect of procedure, documentation and signature for review of medical doctors,

chiropractic, physical and occupational therapist.

Ordered all patients medical device and supplies needed for medical use.

Made sure all chart were complete.

LANGUAGES

Spanish and English

REFERENCES

To be furnished upon request

Contact this candidate