URB. CAPARRA TERRACE

c/** SO #***, SAN JUAN, PR *0921

NILDA LUZ PINEIRO, RN. BSN. addch5@r.postjobfree.com 787-***-****

Licenses:

• Puerto

Rico RN,

PROFILE

Professional candidate is seeking for a position that offers me a constructive and challenging work environment in a Medical office, Medical Insurance Company, Laboratory or Health Institution. Where I can utilize my clinical education and healthcare skills toward my professional development.

Well-developed skills in handling patients. Able to lead others in demanding circumstances and remain calm in stressful situations. Self-motivated, hardworking individual. Enjoy working with public and diverse populations. Excellent communication skills. Available for interview at any moment.

EDUCATION

BSN Degree un Sciences of Nursing

2004 -06

Colegio Universitario of San Juan

180 Jose Oliver Ave. San Juan, PR 00918

MAGNA CUME LAUDE GPA 3.99

ASN Degree in Sciences of Nursing

180 Jose Oliver Ave. San Juan, PR 00918

1989-1991

Colegio Universitario of San Juan

GPA 3.89

Clinical Experience:

Nurse Coordinator, Clinical Health Services

Federal Occupational Health/FEMA /Program Support Center U.S. Department of Health and Human Services

150 Carlos Chardon Ave. -Rm G49, Hato Rey, PR00918- Site Z45 Duties: Assists with all aspects of health services staffing, competency, processes, customer service, and quality improvement. Essential Duties and Responsibilities Include, but are not limited to the following. Other duties may be assigned. Oversee and manage the administrative and operational activities of occupational health services • Assure compliance with regulatory requirements related to clinical operations • Responsible for securing and developing all records, equipment, and programs related to occupational health services • Collaborate with outside resources BSN

Nursing

License.

• Member

of the

College of

Nursing

Profession

als of

Puerto

Rico

Certifications:

• BLS-

Certificati

on

Updated.

Puerto Rico

Certifications:

• Phleboto

my

• ECG

• OSHA

• HIPPA

• Diabetes,

CHF, HBP

Value Added

training:

• Advanced

Supervise

d and

Policies.

8/2015

for program development, such as healthcare providers, third-party administrators, legal advisors, medical director, regulatory agencies, Coordinate Counselor services for employees ( physiology ) services. Community Outreach, Vaccine . FEMA -inspector (contract) - BCFS Case Manager Disaster May 05/2018 San Antonio Tx, 78232

Supervise HS -Valerie Madrid 210-***-****)

Duties: Coordinate services from Housing, section 8, appeals letters and food bank services,Coordinate doctor appoiments with Mental health services to give a counselor services and Social Services.

Hurricane Maria survives Disaster Case Management Program:

• Conduct client intake and assessment to develop individual client recovery plans and establish eligibility for assistance and services.

• Review a summary of the recovery plan with the client at each interaction to determine progress and set up next steps to achieve recovery

• Monitor and document client progress according to DCM policies and procedures

• Maintain detailed and up-to-date client files through Apricot and CAN records

• Advocate on behalf of client to access resources and construction assistance through volunteer community partners with the long term care groups.

• Provide regular reports of casework activities, progress, and problems to supervisor

• Close cases as appropriate as case plan is completed; completing case closure documents

• Perform other duties assigned to fulfill the mission of Catholic Charities and the Disaster Case Management Program.

Work with other social service agencies and informal support systems to coordinate outreach and assistance efforts.

Utilization Nurse Management Supervisor Feb-2016-

20017

Utilization Management Department, Clinical Medical Service, Carolina, PR 00985

Sra. Jessica Robles (Nurse Manager) 787-***-****

• Under the direction of the Utilization Management Medical Director and Manager, supervises the Concurrent Utilization Management Staff and other Staff as assigned.

• Ensures that inpatient concurrent review and retrospective review requests are performed using nationally recognized Medicare Guidelines or other evidence based criteria, and performances guarantee.

• Provides leadership in Health Services programs, operations, projects, policies and procedures to ensure high quality results, under the provisions of the applicable health benefits plan.

• Monitors outcomes of monthly quality and performance audits with training or performance management implementation as appropriate. Assists the Manager / Director of Care Management with the development, design, and implementation of new programs and initiatives (MedHok). Tracks accomplishments vs. planned goals and objectives on a quarterly basis. Special Cover Needs Supervisor March, 2015- June

,2016

Clinical Affairs Dept.

Government Health Plan- First Medical, Ext. Villa Caparra 530 Calle Marginal Buchanan

Guaynabo, P.R. 00966. 787-***-****)

(Supervise up to 18+ employees) support personnel who perform and support case management activities.

• Assists Case Managers with complex cases in coordination of management care options, complaints, adjustments in referrals and authorizations. Maintains a knowledge base of current standards of case management, clinical guidelines, as other regulatory guidelines. Analyzes and identifies trends for quality improvement activities to maintain utilization and care management standards.

• Acts as a liaison with internal and external customers to facilitate quality, cost effective care and compliance of the managed care philosophy. NURSE-RN 2012-2016

Platinum Care

Group – 400 Lake St Ste 305, Roselle, IL 60172

630-***-****- Marquitas Carlos (Nurse Administrator) Conducted screening, diagnostic treatment and rehabilitative and supportive services as the senior nurse. Medical assistance duty. Home care services, Hospices. Perform physical assessments, vital signs and record patients' medical information Operate and monitor medical equipment.

• Administer medications in general.

• Considers aspects such as age and life stages, state of health, race and culture, values, and previous experiences to provide quality of care Area of Expertise:

• Management Computers

Programs (MS Office,

Internet Explorer, Excel,

Outlook and others).

• Languages: English and

Spanish.

• Excellent management and

communication skills with other

people.

• Electronic Medical Record:

MedHok/MedOne/Inmediata

• Medical Terminology and

Audits.

• MCG Guidance. (Care Plan)

Medicare Guidance.

• Distribution operations.

• Quality Control/ & Planning.

• Medicaid and Government

Compliance.

• Project Management.

• Training Staff. Project

implementation &

Restructuring.

• Productivity Improvements.

• Team building, motivation &

Leadership.

• Payroll and Schedule. (ADP)

References: Available upon

request.

Contact this candidate