Quality Control Grand Prairie
Resume:
Gloria Norman
Grand Prairie, Texas *****
Phone: 214-***-**** Email: ************@*****.***
Education
West Coast University, Dallas Texas, May 2 2021
Master's in health administration
University of Oklahoma Health Science Center, Oklahoma City, 10, 2003
Bachelor of Science, RN, BSN
Skills
Monitoring
Management of Material Resources
Management of Personnel
Management of Financial Resources
Quality Control Analysis
Effective Communication
Negotiation
Instructing, Group Facilitation
Critical Thinking
Developing Strategies
Problem Solving
Understanding of Policies & Procedures
Knowledge of State and Federal Regulations
Accomplishments & Awards
American Nurses
Association
Trauma Nurse Core Course 2023
Work Experience
Texas Health Arlington Memorial Hospital: Resource Nurse
March 2023-Current
Provides nursing care for patients. Assesses patient needs, then plans and implements appropriate care.
Assesses, diagnoses, and monitors the physical, psychological, and social needs of patients.
Collaborates with other medical staff to plan, implement, and evaluate care given to the patient population, such as medical procedures, treatments, and medications.
Documents patient history, symptoms, medication, and care given according to organizational standards and in compliance with applicable regulations.
Comforts patients and their caregivers and educates them on the patient's condition, care given, medications, self-care skills, and next steps.
BCBSIL: RN MT Quality & Appeals
Coding Investigator Auditor
October 2021- May 2022 responsible for performing clinical, billing, coding and lowest cost setting reviews for services pre and post payment while leveraging medical, contractual, legislative guidance, internal policy, and other resources to validate claims submitted
conducting research; preparing documentation of findings and consulting with Medical Directors and business areas as needed
BCBSIL: RN-Wellbeing Health Advisor-C1 Non-Custom
October 2019- 2021
Encourage and educate members to utilize appropriate resources and web-based tools available to them to access information regarding their condition as well as track progress towards wellbeing goals.
Guide members through transition of care, handling a member’s complex needs as well as acute and chronic conditions.
Bedford Wellness & Rehab
April 2019-July 2020
Weekend Supervisor, Unit Manager
Aligning delivery of care with policy and procedures as well as state and federal regulations and licensing requirements.
Responsible for the overall operations, integration, coordination.
Medix: contract with Blue Cross Blue Shield
October 2018-February 2019
Evaluation of medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of the applicable health benefits plan.
Clinical Instructor, Concorde College, Grand Prairie Tx,
June 2015 - January 2019
Prepare and deliver lectures to undergraduate or graduate students
Developed students skillsets related to direct patient care, disease management, medication administration, wound care, dosage calculations, IV therapy, trach care, foley administration assessments, creation of care plans, finger sticks and medical record documentation.
Keep abreast of developments in the field by reading current literature, talking with colleagues, and participating in professional conferences.
Case Management Coordinator, Superior Health plan, Dallas Tx, August 2015 - April 2017
Direct or provide home health services.
Develop practice protocols for mental health problems based on review and evaluation of published research.
Develop, implement, or evaluate programs such as outreach activities, community mental health programs, and crisis response activities.
Participate in treatment team conferences regarding diagnosis or treatment of difficult cases.
Develop and implement treatment plans.
Nurse Manager, Deharo- Salvidor Parkland Hospital, 1400 Westmoreland Dallas Tx, September 2012 - February 2015
Direct, supervise and evaluate work activities of medical, nursing, technical, clerical, service, maintenance, and other personnel.
Establish objectives and evaluative or operational criteria for units they manage.
Maintain awareness of advances in medicine, computerized diagnostic and treatment equipment, data processing technology, government regulations, health insurance changes, and financing options.
Consult with medical, business, and community groups to discuss service problems, respond to community needs, enhance public relations, coordinate activities and plans, and promote health programs.
Inspect facilities and recommend building or equipment modifications to ensure emergency readiness and compliance to access, safety, and sanitation regulations.
Cath Laboratory RN, Parkland Hospital, Dallas, Tx, June 2004 - June 2012
Analyze the indications, contraindications, risk complications, and cost-benefit tradeoffs of therapeutic interventions.
Perform emergency medical procedures, such as basic cardiac life support (BLS), advanced cardiac life support (ACLS), and other condition stabilizing interventions.
Document data related to patients' care including assessment results, interventions, medications, patient responses, or treatment changes.
Set up, operate, or monitor invasive equipment and devices such as colostomy or tracheotomy equipment, mechanical ventilators, catheters, gastrointestinal tubes, and central lines.
Tools & Technology
WINDOWS, MICROSOFT, EXCEL
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