To whom it may concern; **/*/****

Look no further, I am a seasoned well-organized nurse who has been in the healthcare industry for > 20 yrs with FL compact licensing along with 9 RN licenses throughout the USA. My experience is vast from clinically hands on with patient care in critical care, ER with ability to float to all units of hospital to fill the needs when staffing dictated need. Well aware of all levels and needs of care from long term care, critical care, emergency care to insurance with knowledge in HEDIS,ICD codes, CPT codes, STARS, authorizations, utilization, prior authorization, review of claims, discharge planning and case management for Medicare/Medicaid and or SNP. Pharmaceutical nurse educator for a pharmaceutical company representing widely used medication. I am looking to learn and grow with an organization with core values of strength and commitment to not only our patients but our coworkers and company.

I love making a difference in patients’ lives even though I am no longer at the bedside with hands on care. My career can still help patients stay independent while teaching them of resources and assistance programs to help them remain independent in their homes if possible. My patients are my most important thoughts in my daily routine and advocating for them is a calling. I am organized, meticulous, diligent and very team oriented. I have been given numerous awards in my career as well as lead positions to train others as well as being the super user of systems to help in troubleshooting and guiding coworkers in their daily system issues. The telecommuting remote/virtual work concept is not new to me and I am very well adjusted in this process. I greatly appreciate your time and consideration in reviewing my extensive medical background and assets I can bring to this opportunity and look forward to collaborating and helping in the health and wellbeing of your members and teams. Have a blessed day and I look forward to hearing from you. Lynn Palles RN

adij8h@r.postjobfree.com

813-***-****

My resident license is for FL and is compact.

Other active licenses: CT, CA, HI, IL, MA, MN, NV, OH, VT no restrictions to obtain others or maintain these if mandated by employer Lynn Palles

15711 Indian Queen Dr

Odessa, FL33556

813-***-****

adij8h@r.postjobfree.com

Experience: Remote: Home office Frisco, TX

AmerisourceBergen LASH Frisco, TX

Telehealth Educator RN- Pharmaceutical Nurse Navigator for medication Dupixent June 2019- Present

Under general direction of the Senior Nurse Manager or Nurse Manager, responsible for providing clinical product and diagnosis related information and services to physicians, nurses, health professionals and patients based on program requirements

Staff telephone consumer support position in a call center (WAH) environment for patients, providers or field team members – depending upon program requirements. Accepted inbound calls and made outbound calls to patients or other parties based on program requirements. Provided disease process and drug support education per approved call guides/scripts. Provided emotional support to patients and caregivers. Collaborated with work across functional teams (ex. reimbursement support) with ability to understand key principles of reimbursement, patient assistance and co-pay assistance. Assessed patient risk for compliance and adherence to treatment regimen; identifying barriers to care and referring to additional support services. Received notification through but not limited to web portal, patient assistant program, fax enrollment form, electronic enrollment form or phone. Calling patients to provide information about the product, program, send out information kits if needed and management advise for any side effects. Entered consumer activities accurately in Clinical Data Bases outlined in business rules. Having ability to work within and document all reportable activities timely and accurately in Clinical Data Base following business rules and defined scripting. Intaking and reporting adverse events as directed. Accountable for being flexible during program developments, enhancements and with changing program needs. 30% of positions are dedicated to quality initiatives. Continuing to obtain and maintain additional required nursing licenses. Supported on-call nursing activities, volunteered for special projects, assisted in training of onboarding staff. Received awards and recognition in several areas. Experience: Seasonal for Yearly Auditing

Altegra Health DBA Change Healthcare Alpharetta, Georgia HEDIS and State Measures Auditor then advance Quality Assurance reviewer March 2015-present every season

Working for a company doing HEDIS/State measures auditing of charts provided from accounts throughout continental US for review. With high % of accuracy of auditing I was requested to then do Quality assurance reviews on other HEDIS measure auditors. Reviewed charts for assigned HEDIS/State measures for compliance and accuracy of documentation by hospitals, physician offices and clinics. High accuracy with assignments therefore trained to review other auditors’ proficiency and report compliance or noncompliance of recording. This was an as needed audit position that was part time and seasonal. Was told would be requested to do further auditing when needs arise again. Experience:

Health Integrated an EXL company Remote: Home office Tampa, FL DSNP CM -Medicare and Medicaid Case manager April 2018- June 2019 (contract ending) Telephonic care of patients with multiple diagnoses, needs and concerns. Having strong communication skills and ability to make patients comfortable talking about their many needs. Having the ability to manage 200 + cases for management needs and coordination of care. I am trained in multiple computer and systems programs for coordinating and managing caseload. Follow guidelines and policy for protecting health information of members while working from home environment. Complete full assessments of patients including physical, psychological and environmental needs. Collaborate with coworkers, Social services, Community health educators, field care managers, medical directors and other department personnel to achieve coverage of the patient’s total needs. I assisted patients with questions and concerns to help them understand the different requirements and needs for their healthcare. Help patients to find specialty physicians and treatments to maximize their return to health. Educate patients on the disease process of multiple diagnoses and promote self-care with those patients. Assist in monitoring patient progression of care to help maximize spending of healthcare dollars. I educated patients with monitoring of self-care while maintaining documentation to review with physicians. Educational materials were sent to help in the education of disease processes and care to empower patients in maintaining their maximum health potential. Collaborating in weekly interdisciplinary team reviews with input from patient MD, medical director, Social workers, Pharmacy to maximize patient health and wellbeing

Experience:

Humana St. Petersburg, Florida

Humana Cares Manager (CORE) July 2009- Feb 2018 (company wide layoff) Telephonic care of patients with multiple diagnoses, needs and concerns. Having strong communication skills and ability to make patients comfortable talking about their many needs. Having the ability to manage 200 + cases for management needs and coordination of care. I am trained in multiple computer and systems programs for coordinating and managing caseload. Follow guidelines and policy for protecting health information of members while working from home environment. Complete full assessments of patients including physical, psychological and environmental needs. Collaborate with coworkers, Social services, Community health educators, field care managers, medical directors and other department personnel to achieve coverage of the patient’s total needs. I assisted patients with questions and concerns to help them understand the different requirements and needs for their healthcare. Help patients to find specialty physicians and treatments to maximize their return to health. Educate patients on the disease process of multiple diagnoses and promote self-care with those patients. Assist in monitoring patient progression of care to help maximize spending of healthcare dollars. I educated patients with monitoring of self-care while maintaining documentation to review with physicians. Educational materials were sent to help in the education of disease processes and care to empower patients in maintaining their maximum health potential. Assist with the training and motivation of the HCM's team that were incoming to the program. I shared documents and resources with team members to help them benefit their members to maximum potential. Represent my team in the EAC, employee activities committee to help build team morale and friendship. Numerous awards given and currently super user and educator to team on all systems and policies WellCare Health plans Tampa, Florida

DSNP RNCM (Dual Special Needs Population) June 2008 to July 2009 (left for career growth) Telephonic care of patients with multiple diagnoses, needs and concerns. Having strong communication skills and ability to make patients comfortable talking about their many needs. Having the ability to manage 200 + cases for management needs and coordination of care. I am trained in multiple computer and systems programs for coordinating and managing caseload. Complete full assessments of patients including physical, psychological and environmental needs. Coordinate care for patients who have both Medicare and Medicaid healthcare plans. Facilitate the planned care with physicians, home health agencies, durable medical equipment and other facilities to maximize the healthcare for our patients. Collaborate with coworkers, medical directors and other department personnel to achieve coverage of the patients’ needs. Assisted patients with questions and concerns to help them understand the different requirements and needs for their healthcare. Help patients to find specialty physicians and treatments to maximize their return to health. Educate patients on the disease process of multiple diagnoses and promote self-care with those patients. Assist in monitoring patient progression of care to help maximize spending of healthcare dollars. Patients were sent monitoring equipment and assisted with maintaining documentation to review with physicians. Educational materials were sent to help in the education of disease processes and care to empower patients in maintaining their maximum health potential.

St Joseph's Hospital Tampa, Florida

Registered Nurse Float Team, March 2003 to June 2008 Primary care of patients in an acute care setting with critical care being a specialty area. Work with other team members and disciplines to allow maximum return to health potential of patients. Follow MD orders; call MD's and other consultants on the patient case. Assist all therapists, caseworkers, social workers and other facilities to help with patient care. Delegated duties to other team members and staff when assigned in lead position. Trained other staff members and new nurses in accordance to facility guidelines. Fill in as relief charge when needed. Be flexible with staffing needs and hours. Worked for Telemetry floor then as float nurse working all areas of the hospital to care for patients. Critical care, Emergency, and all specialty floors.

Further jobs info upon request. Have worked in other hospitals and LTAC hospitals as well as agency nursing to Pinellas and Hillsborough county.

Education: St Petersburg Junior College St. Petersburg, Florida Associate Degree Nursing Graduate 1994

Additional Training:

ACLS= Advanced Cardiac Life Support

Telemetry certified

Community: Have done volunteer teaching at elementary, middle and high schools for Great American Teach in for the last 20 years. Also, volunteer first aid provider for Brownie troop, competitive travel Soccer team and Flag Football teams.

Licenses:Registered Nurse for State of Florida Compact (state of Residence) Other active licenses: CT, CA, HI, IL, MA, MN, NV, OH, VT Testimonials:upon request

References: Available upon request both professional and personal.

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