Health Home
Resume:
Delores Wesley BSN, RN
** **** **. **********, ** 01803
accd1b@r.postjobfree.com
. BSN professional well organized with a solid work ethic and extensive
experience in Hospital, Home Health and Corporate Health Insurance
settings
. Successful Clinical Consultant, Corporate Trainer, Health Educator and
Fitness Instructor
. Experienced in Utilization Review and Electronic Health Records
implementation and support
. Understanding of HIPPA and JCAHO regulations, Medicare and Medicaid
Documentation
. Case Management and Telephonic Health Coaching
. Adept at interfacing and maintaining, productive working relationships
with C-level executives, Providers, employees, and management in the
health care setting
LICENSE, CERTIFICATION
* MA RN License No. 175340
* AFAA Certified Group Fitness Instructor
OFFICE/COMPUTER SKILLS
* Microsoft Office 2010, Word, Excel, Outlook, Power Point proficient
* Electronic Health Records, Case Tracker, Interqual, ORION, Toast Masters
Public Speaking
WORK EXPERIENCE
National Nurse Reviewer
AllOne Health Resource (Contract) - Woburn, MA
8/2013 to present
. Review of medical records, consultation with Physicians and telephonic
contact to determine medical illegibility under the guidelines for the
Department of Transportation
. Ensures that each employee is medically safe for DOT truck driving.
RN Health Coach (Contract)
Marathon Health at Tufts University - Medford, MA 05/3013 to 08/2013
. Educated employees at Tufts University on health promotion and disease
prevention.
. Taught healthy lifestyle behaviors, nutrition, and physical activity,
BMI, smoking cessation and stress management through Motivational
Interviewing.
Utilization Review RN (Contract) 01/ 2013 to 03/2013
Senior Whole Health - Cambridge, MA
. Reviewed Medicare/Medicaid eligibility of hospitalizations to
determine whether diagnosis and treatment are medically necessary for
appropriate time frames for inpatient Admission, Concurrent, and
Discharge dates. Ongoing communication with Hospital and Community
Nurse Case Managers regarding updates on the patient's condition and
length of stay
Delores Wesley pg. 2
RN Health Educator (Contract) 02/
2011 to 09/ 2011
General Electric - Lynn, MA
. Consulted GE employees regarding their individual health risks and
provided education on incorporating healthy lifestyle behaviors
. Conducted seminars regarding Metabolic Syndrome, Obesity and Smoking
cessation
. Documented strategies and statistic reports of successful weight loss
and lifestyle change
Clinical Review Nurse (Contract) 05/
2010 to 02/ 2011
Health Management Systems - Charlestown, MA
. Reviewed numerous Adult Medical/Surgical, Pediatric, Maternity and
Neonatal, pre and post hospitalization Electronic Health Records
implementation and support
. Determined the of appropriateness of hospitalizations for successful
approval of either Medicaid payment or MD referral for Medicaid
reimbursement
Quality Assurance Nurse (Contract) 01/
2008 to 05/ 2010
Nizhoni Health Systems Home Health - Somerville, MA
. Taught, trained and conducted home health documentation to the RN
staff regarding HIPPA regulations, Medicare and Medicaid policies,
appropriate nursing diagnosis, teaching, assessment, Implementation
and evaluation of each patient's plan of care
. Executed chart audits of all OASIS documentation for Nursing, PT, home
health aide supervision notes, medication sheets, MD orders and ICD.9
coding for appropriate nursing diagnosis Prepared and presented
quarterly OASIS Recert Audit.
. Acted as a resource for Medical Records personal, insuring chart
policies and accuracy
.
Program Coordinator & Health Coach, Prevention/ Wellness
01/ 2005 to 05/2008
Blue Cross Blue Shield - Quincy, MA
. Worked effectively with accounts to develop customized management
programs to engage employees in healthy behaviors.
. Coordinated and managed external vendor relationships for corporate
wellness fairs, biometric screenings, seminars and health promotion
endeavors
. Tracked all account activity in database, to create Health Risk Issue
Reports to present to accounts
. Built and maintained effective relationships with internal and
external sales staff, product management, marketing and vendors
Home Health Nurse 01/
1995 to 12/ 2005
Boston Visiting Nurse Association - Charlestown, MA
. Provided nursing care to patients in a home environment
. Maintained a caseload of 25 to 30 patients
. Acted as a liaison contact with each patient's MD; Instrumental in
training VNA staff in CPR/AED Recertification
Delores Wesley pg. 3
Other Relevant Experience
Agency Staff Nurse
Americare Healthcare Agency
Provided patient care to Adult Medical, Surgical, Orthopedic, Maternity and
neonatal patients in the following hospitals:: Massachusetts General
Hospital; Deaconess Hospital; St. Elizabeth's Hospital; Boston Medical
Center; Boston, MA; Whidden Memorial Hospital Memorial Hospital; Everett,
MA;
New England Memorial Hospital; Stoneham, MA; Malden Hospital; Malden, MA
Fitness Instructor 01/
1995 to Present
Boston Sports Club - Boston, MA
. Teach Aerobic classes, including kickboxing, Aquatics and Step to
various age groups
. Educates patrons on best practices to stay physically healthy
Education
M Ed Candidate
Lesley University - Cambridge, MA
BSN
Boston College - Chestnut Hill, MA
Volunteer Experience
. Alumni Board of Directors, Boston College
. Board of Trustees Brimmer and May School
. Appeared in Blue Cross Blue Shield Annual Report, 2005
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