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Registered Nurse Manager

Location:
Garland, Texas, United States
Posted:
September 13, 2018

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Resume:

DOMINIQUE GILLYARD RN MSN CCM

* ******* ***** *******, ** 75040 Mobile: 972-***-**** ac6074@r.postjobfree.com

PROFESSIONAL SUMMARY

Experienced Registered Nurse for 12 years. Leadership experience. Director of Case Management. ER and Acute Inpatient Hospital Case Management. Certified Case Manager CCM. Interqual Utilization Review. Discharge Planning in Acute Hospital Setting. Excellent communication skills. LTACH experience. Presenter in constituents' site visits and consultant groups for external sales. Passion for patients.

SKILLS

Acute Inpatient and ER Case Management

Acute to Acute Hospital Transfers

Interqual Utilization Review

Strong clinical judgment

RN Supervisor and management skills

MSN Health Systems Management CCM

Familiarity with NCQA standards both state and federal.

WORK HISTORY

Director of Case Management

Promise Hospital of Dallas

Dallas, TX June 5, 2017 – March 7, 2018

Report to the Chief Financial Officer of the Hospital

Lead a collegial and dedicated team of case managers and social workers

Developed and maintain policies, procedures and standards for Case Management

Implement admission and discharge planning

Support patient transitions to ensure that quality, appropriate services are delivered

Create and nurture relationships with internal and external customers

Work closely with the Leadership Team, Social Services

Children’s Medical Center Travel Case Manager RN

Dallas, TX March 6, 2017- June 7, 2018

Interqual Clinical Reviews

Milliman Clinical Reviews

Utilization Review

John Muir Hospital WC Travel Case Manager RN

Walnut Creek, CA Sept 22, 2016 – March 1, 2017

Renewed Travel Contract with John Muir

Provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.

Discharge Planning

LTAC, SNF, HHC Placement

Interqual Clinical Reviews

Acute-to-Acute Hospital Transfers

Kaiser Permanente Travel Case Manager RN

Anaheim, CA Hired to Full time Staff

Feb 16, 2015 - Sept 22, 2016

Renewed Travel Contract with Kaiser 3 times then hired on to full staff

Provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.

Discharge Planning

LTAC, SNF, HHC Placement

Interqual Clinical Reviews

Acute-to-Acute Hospital Transfers

Baylor Medical Center Carrollton RN Case Manager

Carrollton, TX Dec 16, 2013 – Feb 16, 2015

Provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs.

Discharge Planning

LTAC, SNF, HHC Placement

ER Case Management

Interqual Clinical Reviews

Acute-to-Acute Hospital Transfers

Social Work cross training experience with family counseling

CPS and APS reporting

Case Manager Specialist

03/2011 to December 16, 2013

Cigna – Plano, 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

Presenter for constituents' site visits and consultant groups.

Prior Authorization Utilization Case Management Supervisor, 07/2010 to 03/2011

Aetna – Dallas, TX

Supervised Utilization Management team clinical and nonclinical team activities to facilitate integrated proactive utilization management.

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.

Satisfaction by implementing and monitoring staff productivity and performance indicators.

Interviewed and hired new staff members.

Case Manager, 11/2006 to 07/2010

United HealthCare Optum Health – Richardson, 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.

EDUCATION

High School Diploma: General Studies, 1997

Mansfield High School - Mansfield, LA

Bachelor of Science: Nursing, 2003

Grambling State University - Grambling, LA

Master of Science: Nursing, 2010

Loyola University - New Orleans, LA

Family Nurse Practitioner Program

University of Massachusetts Boston

Current Graduation May 2018

ACCOMPLISHMENTS

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

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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