Tatyana Shamalova RN, BSN, PRI

EXPERIENCE

St. Francis Hospital, The Heart Center, Roslyn NY 11/2017- Present

RN Care Manager (Medicine, Cardiology, Surgery, Neurology, Acute Rehab) Case Manager (Orthopedic and Surgery), ER/Observation

• Determines the necessity for admission and continued stay for patients via chart review and health care team consultation

• Reviews the plan of care, monitors patient's progress, and identifies barriers to meet timely outcomes

• Formulates and implements safe discharge plans with a multidiscipline approach

• Ensures quality performance of the health care team through proper documentation and follow through

• Communicates with third party insurance carriers, providing timely responses to insurance review requests while obtaining authorizations for continued stay and discharge needs

• Use of Interqual and Milliman Criteria

New York University Medical Center, New York, NY 5/2015-11/2017 RN Care Manager (Medicine, Cardiology, Surgery, Neurology, Acute Rehab)ER/Observation

• Determines the necessity for admission and continued stay for patients via chart review and health care team consultation

• Reviews the plan of care, monitors patient's progress, and identifies barriers to meet timely outcomes

• Formulates and implements safe discharge plans with a multidiscipline approach

• Ensures quality performance of the health care team through proper documentation and follow through

• Communicates with third party insurance carriers, providing timely responses to insurance review requests while obtaining authorizations for continued stay and discharge needs

• Use of Interqual and Milliman Criteria

New York University Medical Center, New York, NY 5/2014-2015 RN Care Manager(ER/Observation) – Per diem/Weekends Mount Sinai Medical Center of Queens 2011 – Present RN Case Manager (Orthopedic and Surgery),ER/Observation-Perdiem/Weekends

• Determines the necessity for admission and continued stay for patients via chart review and health care team consultation

• Reviews the plan of care, monitors patient's progress, and identifies barriers to meet timely outcomes

• Formulates and implements safe discharge plans with a multidiscipline approach

• Ensures quality performance of the health care team through proper documentation and follow through

• Communicates with third party insurance carriers, providing timely responses to insurance review requests while obtaining authorizations for continued stay and discharge needs

• Use of Interqual and Milliman Criteria

Jamaica Hospital Medical Center, Jamaica, NY 2005-2011 Case Manager)/Utilization Reviewer (ED, Med/Surg, ICU, Telemetry, TBI, Acute Rehab)

• Determines patients at risk and/or in need of skilled discharge planning services

• Retro and Concurrent Utilization Review of Commercial, Medicaid, Medicare and Private Payor

• Utilizes Milliman / Interqual Guidelines to identify in house patients and assign appropriate ORGs/GRGs as indicated

• Issues Medicare notices of non-coverage and corresponding paperwork upon MD approval

• Implements a post-hospital plan of care, in collaboration with all health care team members, for patients on timely fashion as to not increase length of stay unnecessarily

• Refers patients/families to appropriate in house services in order to facilitate an expeditious discharge

North Shore University Hospital, Forest Hills, NY 2002-2014 RN Per Diem - Weekends

Jamaica Hospital Medical Center, Jamaica, NY

2001-2005

RN - Acute Rehabilitation, Med Surg /Trauma

Flushing Hospital Medical Center, Flushing, NY

2001-2004

RN - Medical/Pediatric Clinic

Rego Park Adult Home Care Center, Rego Park, NY

2002-2003

RN (Per Diem)

Previous Experience

1998-2001, Staff LPN, Assistance of Living, Queens, NY 1998 – 2000, LPN (Per Diem), Midway Nursing Home, Queens, NY 1990 – 1992, RN, Medical/Surgical, Samarkand Medical Cancer Center, Samarkand, Uzbekistan 1985 – 1990, RN, OB/GYN, Maternity Hospital, Samarkand, Uzbekistan EDUCATION

Long Island University, BSN Degree -May 2014

2000 - Completed Nursing Boards in USA

AAS, Nursing - Samarkand

1985 - Samarkand Medical College, Samarkand, Uzbekistan Bachelor of Science in Nursing CERTIFICATION / COURSES

PRI/Screen certified

Infection Control

Domestic Violence

BCLS, ACLS, Child Abuse identification and Reporting Universal Precaution

Basic HIV/AIDS workshop

Stroke course

Diabetes course

LANGUAGES

Russian

CREDENTIALS

2000 - New York State Registered Professional Nurse 1998 - New York State Licensed Practical Nurse

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