Medical Nurse Practitioner
Resume:
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
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