Registered Nurse Manager
Resume:
Francine Mondone
Davie, FL ****4
Phone: 954-***-****
Email: **********@***.***
SUMMARY
Thirty three years of experience as a Registered Nurse of which the last 17 years I have been working in management for Aetna
and Humana.
Humana Inc., Miramar, Fl.
2010-Present
Clinical Director-Long Term Care- 2012 to Present
• Implemented Humana’s first Long Term Care Plan in Florida.
• Responsible for writing all policies and procedures and creating workflows necessary for the implementation of this
product.
• Interviewing and hiring a complete compliment of professional staff, in all 3 regions, managers, supervisors, case
managers, and administrative staff, approximately 130 staff in all.
• Working with the training department to help create the training material, which is now being used company wide as
Humana expands its footprint of LTC in other states.
• Working closely with AHCA on a day to day basis to ensure the program and plan meets the needs of our members.
• Daily day to day responsibilities include utilization management of services and cost monitoring of network contracts
to prevent unnecessary or duplication of services.
• Analyzing the health of the teams though reports, identifying gaps and finding efficiencies in the program’s
development.
Operations Manager-2010-2012
• Implementing Institutional Special Needs Plan- in Broward and Miami-Dade.
• Responsible for creating all workflows and policies necessary to successfully adhere to the CMS approved Model of
Care. Humana is partnering with an outside vendor for the case management potion of this product.
• Responsible for managing this partnership and ensuring all metrics are met
2012-Implemention- PODs- Point of Delivery – a pilot program in Florida where I am responsible for coordinating a cross
departmental team to manage PPO members three primary areas of focus (also known as “the triple play”): documentation,
quality and care management.
Membership will be segmented across markets either by physician practice site or geography. The objective of the PODs is to
focus on high cost, complex members, facilitating collaboration with the providers and Humana programs to ensure members
get the needed care while maintaining focus on documentation, quality and care management.
Manager-On-Site Nurse Liaison Program-2010-2012
• Oversee the daily management of 6 team leads and the on-site nurse liaisons
• The primary responsibility of this team is to visit and assess the needs of our Medicare/Medicaid members while they
are in an acute and/or sub-acute facility in the tri-county area of South Florida.
• Collaborates with the member's provider team to monitor provider-based care and discharge planning at all levels of
care in accordance with established criteria and makes recommendations to improve such efforts where appropriate as
it compares to the member's personal health care goals.
AETNA LIFE INSURANCE CO., Plantation, FL (Kemper National Services and Broadspire)
1996 to 2010
Operations Manager- November 2005 to 2010
Disability and Absence Management
• Responsibility for administering disability plans for numerous national accounts which generate $48M revenue
annually. Manage people and processes to achieve department goals.
• Continuous evaluation of processes and workflows to achieve improved outcomes. Led a team of five Operations
Supervisors, and 53 indirect reports.
Claim lead, STD Operations – June 1998-November 2005
Responsible for the daily operation of the administration of short term disability and FMLA benefits for national
clients.
• Served as Project Manager for Claims related processes identified for improvement. Direct responsibility for 12-16
employees comprising of RN and Disability Claim Analyst that adjudicate claim and medically manage to an
appropriate and timely return to work or smooth transition into long term disability.
Senior Nurse Review- July 1996-June 1998
Assess and triage all new claims within the first 24 hours of initiation. Give clinical claim direction to analyst based on
diagnosis, co-morbid factors, and claim history. Review all claims, at a minimum of every 30 days, to ensure proper
clinical management, assess possible return to work opportunities based on job junction and functionality. When
necessary recommend and monitor usage of various product lines such as disease management and peer reviews
NorthRidge Hospital- Fort Lauderdale, Florida- 1995-1996
Westside Regional Hospital-Plantation, Florida-1990-1995
Florida Medical Center- Fort Lauderdale, Florida- 1988-1990
RN-Operating Room Manager
Responsible for the daily scheduling, staffing and budgeting of various size operating rooms. Completing performance
evaluations and ensuring that productivity and quality standards were achieved. Prepared & monitored annual budget.
Education
Registered Nurse
Flushing School of Nursing
NY License:315507-1
Florida License:1960962
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