Ann E. Nemirovsky

*** **** ***** *** *********, NY 14618 (c) 585-***-**** email address: ad1gpj@r.postjobfree.com

Summary of Licenses, Training and Skills

License: New York State Registered Professional Nurse, License #485906-1, issued November 1996.

Certification and Training: ACLS certified, CPR/AED Certification, MDS and PRI documentation instruments, OSHA Compliance, Leadership & Retention Tactics, Telemetry Monitoring, Certified Hospice Volunteer, Alzheimer’s Support Facilitator, AANAC Certification, Coaching Supervision Leadership Training, Eden Training Certification, Certificate of Completion - NYSHFA Long Term Care Leadership Institute RN Nurse Educator Program, Crucial Conversations Education from Excellus

Skills: Excellent Assessment Skills with appropriate and timely actions based on the situation, DRG, ICD-9 and CPT coding systems, Knowledge of Medicare and Medicaid qualification criteria, Experience in Microsoft Office Environments, excellent IV therapy skills, skin wound assessment and treatment skills, confident and competent in highly technical and complicated nursing cases, Excellent written and verbal communication/presentation approach with high priority placed on honest, open and accepting cross communication for input on self-correction and personal improvement . Highly effective approach to facilitation/mediation of root cause analysis, conflict resolution and overcoming differences related to culture, background, ethnicity and socioeconomic status, Very good knowledge of HEDIS Gap Criteria and plan management

Professional Experience

ROCHESTER AMBULATOR SURGICAL CENTER, Rochester, NY 8/2022-present

RN Staff Nurse - Pre and Post Anesthesia Care

Monitoring and responding appropriately to pre and post-operative patients' vital signs, heart rhythms on telemetry, responsiveness, and recovery from anesthesia

Administering medications to treat pain, nausea, and other symptoms of anesthesia

Communicating with doctors, surgical staff, and other nurses about patients' medical state

Updating patients' medical records

Monitoring and treating patient’s surgical sites

Helping patients stand, walk and return to pre-surgical or safe level status

Answering patients' and family members’ questions and concerns

Cleaning, feeding, and providing support to patients

GASTROENTEROLOGY GROUP OF ROCHESTER, Rochester, NY 4/2021-8/2022

RN Staff Nurse

Supportive of gastroenterology procedures including admission, procedure preparation, recovery, and discharge.

ACLS certified and prepared for orientation/training with GI procedures.

Evaluates, assesses, treats, and cares for patients during the process of GI procedures in a fast-paced outpatient environment.

Provides educational support pertaining to procedures taking place as well as treatment of GI illness and diagnosis

Identifies key areas of concern presented by the patient as well as conveying results and explanation during post-procedure..

Conveys areas of concern to physicians and reassuresthe patientthat necessary communication has taken place.

Reliance on fellow staff and self-education for guidance in new situations andnew areas being encountered.

Remains flexible with direction from management/supervision in order to maintain smooth/seamless flow within the unit.

Maintains friendly, professional demeanor toward Patients, Family Members, Physicians and Fellow Staff throughout.

Strives to maintain healthy, team-oriented, friendly focus in communicating and carrying out activities throughout the work day.

EXCELLUS SAFETY NET INTEGRATED CLINICAL PROGRAM, Rochester, NY 12/2018-4/2021

RN Medical/Behavioral Health Complex Case Manager

Collaborates with interdisciplinary care team to develop a comprehensive plan of care to identify key strategic interventions toaddress member’s needs and mitigate health care cost drivers.

Implements the Care Management Process per department policies, procedures and guidelines. Facilitates quality, cost effective medical and benefits management.

Applies care management criteria and professional clinical judgment to determine a member’s appropriateness for care management services. Investigates members that are appropriate.

Works in collaboration with members’ physicians and other health care providers to assess the needs of the member, facilitate development of an interdisciplinary plan of care, coordinates services, evaluates effectiveness of services and modifies the member plan of care as necessary.

Collaborates with member to determine specific objectives, goals and actions to address program needs identified during assessment.

Participates in interdepartmental coordination and communication to ensure delivery of consistent and quality health care services.

CENTENE CORPORATION – EXCELLUS BLUE CROSS BLUE SHIELD, Rochester, NY 5/2017-12/2018

RN Utilization and Care Management

Coordinates, integrates, and monitors the use of medical and health care services for members.

Ensures and maintains compliance with internal and external standards set by regulatory and accrediting entities.

Performs a variety of technical and administrative tasks essential to the efficient operation of the Medical Services Utilization Management Department.

Conducts care management activities in accordance with departmental, corporate, state, federal, accreditation standards and uses a systematic approach to identify members meeting program criteria.

Assesses opportunities to coordinate education, support, coaching, care coordination and treatment options, and collaborates with providers.

Implements the Care Management processes as appropriate to each individual member in order to facilitate quality, cost effective medical and benefits management by using multiple sources of policy, procedure and member clinical condition management programs.

ROCHESTER REGIONAL HEALTH SYSTEM, Rochester, NY 2/2015-5/2017

RN Park Ridge Inpatient Chemical Dependency

Provide stabilization, medication and nursing care to teens and adults in an intense, fast-paced, inpatient environment.

Ability to critically think about patient’s substance use and the potential and/or actual effects it may have on the body.

Understanding multi-system complications, including physical, mentaland psychological implications.

Comprehension of medical and medication requirements of the individual patient combined with substance use and addiction

WESLEY GARDENS SKILLED NURSING FACILITY, Rochester, NY 8/2012-2/2015

RN Employee Health Nurse, Staff Educator and Infection Control Leader

Conduct all new employee physicals, obtain health history, vaccination requirements and annual health requirements

Present orientation to all new employees and Nursing Department orientation to all new CNAs and Nurses.

Develop many continuing education opportunities for nursing staff including clinical topics and other topics related to staff, residents and families in a long-term care setting.

Maintain and ensure completion of mandatory in-service requirements for all staff and new in-service materials based on deficiencies, citations and current issues or trends within the facility.

KIRKHAVEN SENIOR SKILLED NURSING FACILITY, Rochester, NY 3/2011-8/2012

RN Nursing Supervisor

Maintain oversight and direction of care delivery at a 140 bed skilled nursing facility

Possess the ability and confidence to think critically and quickly in order to prioritize, multitask and provide high quality care.

Develop and continually strive to enhance communication pathways, leadership skills, mentoring abilities and coachingmethods in order to maintain and improve upon care delivery, a positive work atmosphere and staff /staff and staff/resident relationships.

THE JEWISH HOME OF ROCHESTER, Rochester, NY 9/2008 – 3/2011

MDS Nurse Specialist/Coordinator

MDS completion for the long term care and rehabilitationresident population - including resident assessment, medical record review, interface with direct care staff, and all care team members.

Daily monitoring and assurance of timely completion of each MDS assessment tool for all disciplines. Frequent communicationwith multi-disciplines regarding timeliness, discrepancies and other issues of concern.

Very knowledgeable of Medicaid and Medicare Reimbursement tools, criteria for documentation and methods of scheduling.

MAXIMUS FEDERAL SERVICES, Victor, NY 3/2008 – 7/2008

Clinical Appeals Adjudicator

Clinical review and decision assignments to high volume of Medicare part A and part B appeal types.

Excellent knowledge base of Medicare coverage criteria, including medically reasonable and necessary decision criteria, individual benefit periods, liability assignment and navigation of Medicare and other associated websites and relevant resources

Highly accurate and efficient use of Medicare Appeals System (MAS) including data entry, medical code assignments, and analysis and comprehension of financial statements associated with healthcare billing.

WOODSIDE MANOR NURSING HOME, Rochester, NY 9/2007 – 3/2008

Director of Nursing – Skilled Nursing Facility

Successfully guides and directs the nursing and medical operations of a 44 bed skilled nursing facility

Oversight and management of resident care, quality assurance and improvement, financial allocations and budgetary adherence

Management of 50-plus staff members, including RNs, LPNs and CNAs

CORRECTIONAL MEDICAL SERVICES, MONROE COUNTY JAIL, Rochester, NY 12/2006 – 8/2007

Health Services Administrator – Monroe County Jail

Successfully oversees, manages and directs each member of the healthcare team, including Medical Director, mid –level medical providers, Director of Nursing, Director of Mental Health Department, Medical Records and Secretarial Staff

Oversees and directs administrative and clinical operations and outcomes for two correctional centers with an approximate total of 1,500 inmates and staff total of 50 FTEs.

ST. ANN’S COMMUNITY, THE HERITAGE, Rochester, New York 03/2005 – 12/2006

Assistant Director of Nursing – Skilled Nursing/Assisted Living Facility

Consistently provide leadership and coaching to Nurse Managers and Nursing staff of 200-bed facility in collaboration with Director of Nursing.

Responsible for infection control and skin integrity management programs; Review and revise facility policy and procedures.

Accountable for maintaining facility readiness for NYS DOH annual survey, PRI periods and other audit situations.

Involved extensively in resident, family and employee relations and conflict resolution.

WESLEY GARDENS NURSING HOME, Rochester, New York 01/2004 – 03/2005

Nurse Manager/Team Leader – Skilled Nursing Facility

Accountable for 66 residents and 45 staff on two long-term skilled nursing units.

Responsible for management of residents’ clinical and care plan requirements, family support and guidance, budgetary details and a variety of administrative components.

GENEVA LIVING CENTER, Geneva, New York 09/2002 – 03/2005

Nurse Manager/Team Leader - Skilled Nursing Unit

Accountable for 36 residents and 25 staff members on a long-term skilled nursing unit.

Responsible for direction and management of residents’ individual care plan, family and staffing needs, budgetary details and

various administrative responsibilities

UNIVERSITY OF ROCHESTER MEDICAL CENTER, Rochester, New York 07/1999 – 09/2002

Quality Assurance Administrator - Department of Medicine

Reviewed all departmental cases pertaining to mortality, patient relations, blood utilization, utilization management, insurance coverage issues, state reportable incidents, sentinel events and physician compliance discrepancies.

Coordinated quality assurance/quality improvement activities for In and Out Patient Departments of Medicine.

Analyzed length of stay statistics and trend analysis pertinent to various diagnoses

UNIVERSITY OF ROCHESTER MEDICAL CENTER, Rochester, New York

Registered Nurse - Neonatal Intensive Care Unit 04/1998 – 09/2002

UNIVERSITY OF ROCHESTER MEDICAL CENTER, Rochester, New York

Registered Nurse, Acute Care – Adult Inpatient Medical Unit 03/1997 – 04/1998

Education

William E. Simon Graduate School of Business Administration, University of Rochester Rochester, NY

Master of Business Administration March, 2002

Concentrations: Health Care Management and Business Environment & Public Policy

University of Rochester School of Nursing Rochester, NY

Bachelor of Science, Nursing May, 1996

Wadia College Pune, India

Senior High School year spent in India with Rotary International Youth Exchange Program June, 1992

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