Medical Nurse
Resume:
Gail Luca
North Plainfield, NJ 07060
********@*******.***
Experience:
MCMCLLC
Medical Review
**** **** **** *****ce, Suite 100
Overland Park, KS 66212
. Review medical records to determine causal relationships, legitimacy of
alleged injuries, preexisting and unrelated conditions, and potential
medical outcomes.
. Determine which medical records are missing and if any additional records
needed to complete a thorough review of claims
. Evaluate whether treatment provided was appropriate or excessive
. Provide factual evidence for use in limiting damages
. Recommend appropriate medical experts, peer reviewers, etc.
. Research unusual injuries, medical conditions, and complications that may
impact recovery
3/11/13 to 11/12/13
United Health Services
Physician Practice RN
35-57 Harrison St., Johnson City, NY 13790
. Telephone triage
. Assist with all physical exams and procedures as needed
. Administer medications and treatments
. Arrange for medication refills and diagnostic testing
. Obtain prior approval from insurance carriers
. Assist with case management of clients
. Patient teaching and data abstraction into electronic medical records
5/29/12 to 2/28/13
New York County Health Services Review Organization Quality
Management
199 Water Street, NY, NY 10038
. Perform site audits and chart reviews for the NYC WeCARE program
. Prepare detailed written reports on findings of site audits and chart
reviews
. Assist with development of audit tools
11/10/08 to 2/17/12
ArchCare/Mary Manning Walsh Home Quality
Management
1339 York Avenue, NY, NY 10021
. Direct and coordinate quality studies amongst interdisciplinary
departments
. Investigate and report on all falls and Incidents (behavioral,
psychiatric, dementia) within the home
. Chair bi-weeklylncident and accident committee meetings
. Chair quality management committee meetings monthly and on a quarterly
basis
. Report on all quality measures with plan of action to the board of
directors on a quarterly basis
. Oversee medical safety and corporate compliance issues in relationship to
quality issues
. Proficiency in Excel, PowerPoint, Outlook
Accomplishments: Successful surveys with NY Department of Health
Initiated use of new QIS (Quality Indicator Survey) preparation program
12/18/06 to 10/31/08
Executive Health Exams Int. Clinical Review/Clinical
Intervention Nurse
10 Rockefeller Plaza, NY, NY 10020
. Verification of medical reports for clinical content in correlation with
all testing and clinical findings
. Design effective and efficient health care based on approved criteria
. Recommendations made based on preventative health care criteria
. Provide telephonic outreach, assessment, education and health coaching
. Referrals made for abnormal exam findings
Accomplishments: Oriented and trained new employees
3/16/06 to 12/15/06
01/13/04 to 06/03/05
United Health Services
Float RN
35-57 Harrison St., Johnson City, NY 13790
. Travel to all primary clinics as needed to perform RN duties as needed
. Telephone triage
. Assist with all physical exams and diagnostic testing procedures
. Administer medications and treatments
. Arrange for medication refills and diagnostic testing with insurance
contact for prior approvals
. Patient teaching and data abstraction into electronic medical record
11/21/05 to 03/06
Beth Abraham Health Services Day Healthcare
Center Nurse
612 Allerton Ave Bronx, NY 10467
. Responsible for clients health (behavioral, psychiatric, dementia) and
well-being while attending the day care center
. Perform physical assessments on an emergent basis or as scheduled as per
case management
. Administration of medications and treatments
. Communication of client's needs and care to all disciplines involved
(home care nurse, nurse manager, physicians, dietary and activity
personnel)
1/02 to 01/16/04
Vestal Nursing Center QI/QA Coordinator/Day Supervisor/ Staff
Educator
860 Old Vestal Road Vestal, NY 13850
. Audit all processes, monitor outcome of audits and institute changes
based on need.
. Prepare and present quarterly QI reports
. Assist with monitoring and updating policy and procedures
. Investigate and document all incident reports and medication errors
. Issue and monitor verbal and written employee warnings
. Daily supervision of nursing activities and resident care
. Contact resident family members at time of resident passing and perform
memorial service
. Monitor all mandatory credentialing and licensure of staff
. Perform mandatory education and in servicing of all staff
. Assist employees in obtaining state mandated licensure when needed
Accomplishments:
. New restraint program which allowed for the use of least restraint
possible
. Instituted the "Falling Leaf" program which reduced resident falls by 15%
in 3 months
. Improved the monitoring of controls used for urinalysis
. Redesigned the "Medical Administration Record" to help decrease
medication errors
. Reformed policy and procedure for incident reporting to provide better
investigation of incidents
08/12/96 to 10/02
Lourdes Hospital
Clinical Site Coordinator
169 Riverside Drive Binghamton, NY 13905
. Supervision of clinical staff and activities at Vestal Medical Associates
Primary Care site
. Responsible for staffing, credentialing, nursing evaluations, ordering of
clinical supplies, monitoring of sample medications
. Assisted with assessments and healthcare needs of all patients, i.e.;
school physicals, work physicals, pre-operative physicals, gynecological
exams
. Performed EKGs, application of holter monitors, phlebotomy, urinalysis,
administration of medications, allergy injections, patient teaching,
telephone triage, scheduling of diagnostic testing, calling pharmacies for
prescriptions, and ensuring completion of paperwork for workers
compensation claims
. Attendance of monthly meetings to communicate changes and needs
. Assisted nursing personnel in obtaining continuing education credits
. Monitored physician consults and office visits
. Assisted with orientation of medical residents to the facility
. Assisted with the coordination and application of community influenza
clinics
. Worked in conjunction with local schools to precept student nurses and
medical office assistants
Float RN
. Administration of patient medications and treatments, minor surgical
procedures, telephone triage, and patient referrals
. Supervision of LPNs and Medical Office Assistants when needed
RN/Occupational Health Nurse
. Triage, assessment and coordination of care for all clients at walk-in
clinic
. Administration of prescribed medications and treatments
. Assist with occupational medical exams, i.e.; vision screening,
audiometry, urine drug testing, spirometry, scheduling of lift tests,
testing for color blindness,
. Assist with patient transfers to higher level of care when necessary
11/26/94 to 08/02/96
Endless Mountains Healthcare
Emergency Room Nurse
3 Grow Ave Montrose, PA 18801
. Assessment, triage, medication administration, IV administration,
phlebotomy, EKGs, medical treatments, pt. education, preparation for
discharge or transfer to hospital floor and or another facility.
01/27/93 to 11/08/94
Muhlenberg Regional Medical Center Emergency
Room Nurse
Park Ave & Randolph Road, Plainfield, NJ 07061
. Assessment, triage, medication administration, IV administration, EKGs,
medical treatments, patient education, patient transfers and patient
discharge
Staff
Nurse on Neuro/Orthopedic Unit
. Assessment and post-operative care of patients
. Medication administration, dressing changes, IV administration, blood
transfusions, coordination of patient testing, monitoring of lab values,
patient education, preparation for patient discharge
EDUCATION
*Bachelor Degree in Nursing Western Governors University 2011-2012
*Bachelor's Degree State University of NY at 2001-2002
Human Development Binghamton
*Associate Degree in Science Coop Program with Muhlenberg Reg. Med. Ctr. &
Union County College 1989-1992
Registered Professional Nurse
RN LICENSURE
State Registered: License Number: Expiration Date:
NY 468183-1 02/29/2015
NJ 26NO10339300 05/31/2014
PA RN340871L 04/30/2014
BLS, ACLS, PRI Certification
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