Edeline Lesperance, RN

*** ********* ***., ********, **

Cell: 203-***-****

ado21u@r.postjobfree.com

Professional Objective:

Seeking a challenging position as a professional registered nurse in case management, medical/surgical, mental health, geriatric or pediatric care where extensive experience, training and commitment to health care skills may be professionally utilized while allowing for advancement.

Summary of Qualifications:

● Specialized in ventilators, tracheotomy care, wound care, colostomy/ileostomy care, and burn patients with extensive dressings, IV therapy management, cardiac disease management, mental health behavior, pain management and palliative care.

● Expertise in coordinating discharge planning and home care with patients, family members, doctors, nutritionist, physical therapist, occupational therapist and social workers with strong documentations and follow through.

● Proven written in teaching/demonstration skills for extensive education regarding diabetes and home care.

● Skilled at prioritizing and handling multiple assignments with emphasis on meeting quality outcomes.

● Hard working and patient centered health care professional offering progressive responsibilities in diverse clinical environments.

● Team player who performs effectively in high pressured and fast pace setting.

● Fluent in English, French and Creole

Licensure:

● New York State Registered Nurse

Certifications:

● Certified Legal Nurse Consultant

● CPR, BCLS/AED, infection control barrier precautions, MDS, IV Management, Gerontology, EKG

Professional Experience:

Affinity Health Plan, Bronx, NY 2015-2021

Case Manager/Utilization Nurse Manager

● Perform utilization management, utilization review, or concurrent review (on-site at a hospital, or telephonic inpatient care management) of hospitalized members ensuring medical necessity, appropriateness of admission, and continued stay following evaluation of medical and benefit determination guidelines. Maintains compliance with all state mandated regulations.

● Collaboration with hospital staff, physicians, care/service coordinators, plan Medical Director, members and their families to provide the level of care necessary to meet member’s health needs.

● Maintain an active role in assuring the continuity of care for all inpatients through early discharge planning and working with hospital discharge planners and health plan social workers or other staff in the early identification of potential home care candidates or less restrictive level of care placement.

● Identification and management of members at high risk for readmission or with complex medical and psychosocial needs. Collaboration with Case Manager to coordinate post discharge care and services aimed at:

● increasing rates of timely outpatient follow-up,

● ensuring provider treatment plan, medications & outpatient services are in place,

● safe transition to outpatient setting,

● improving self management skills,

● addressing members psychosocial and non-medical needs

● Communicate directly with physician providers/designees when appropriate to gather all clinical information to determine the medical necessity of requested healthcare services.

● Maintains courteous, professional attitude when working with Affinity staff, hospital and physician providers, and members.

● Collect pertinent clinical information and documents all UM review information using the appropriate software system.

● Manage medical / benefits resources effectively and efficiently while ensuring quality care is provided as determined by guidelines of meeting Medical necessity.

● Communicate directly with appropriate internal staff regarding all inpatient cases and outpatient/ambulatory requests for health care services that do not meet medical necessity or appropriate level of care and out of network transfer issues.

● Manage assigned workload within established performance standards.

● Follow relevant client time frame standards for conducting and communicating UM review determination.

● Maintain and submit reports and logs on review activities as outlined by the UM program operational procedures.

● Contribute to MM program goals and objectives in containing health care costs and maintaining a high quality medical delivery system through the program procedures for conducting UM activities.

● Participate in a multi-disciplinary team approach to address member needs from the acute care phase through the post-acute care phase.

● Identify and coordinate quality of care issues or trends with the Quality Management department.

● Demonstrate proficiency with the principles and methodologies of process improvement. Apply these in the execution of responsibilities in support of a process focused approach.

Remedy Partners, Darien, CT

RN Care Coordination Nurse 2014-2014

● Review patient data in Remedy Partners’ proprietary software solution and develop appropriate 90-day care plan; Preform medication reconciliation during each patient transfer and oversee medication management during their episode of care

● Enter necessary information software solution for patient care management. Chart all patient interactions and communication accurately; Screen and respond to patient phone calls, directing the patient to their Primary Care Provider as needed.

● Connect patients and their families to community resources that can provide support as the patient transition from hospital to home; Schedule urgent visits as appropriate

● Accurately document each encounter with the patient on the appropriate form to be placed on patient chart for continuity of care; Initiate appropriate follow up; Monitor assigned patients for the duration of their episode of care;

● Maintain confidentiality of all patients information; Adhere to policies/safety practices established by Remedy Partners and perform other duties as assigned.

Greenwich Woods, Greenwich, CT

RN PT Supervisor 2014-2014

● Oversight Supervision in management of the day to day nursing activities performed by nurses, nursing assistants and others in assigned care.

● Responsibilities include as necessary, providing direct nursing care, management supervision and care will be a professional manner in accordance with federal, state and local regulations and current acceptable policies, procedures and principles relating to the operation of the facility Premier Home Healthcare, Stamford, CT 2010- 2013

Office Administrator/ Field Nurse Supervisor

● Interpretation and execution of the polices of the governing authority.

● Program planning, budgeting, management and evaluation based upon community needs and agency resources.

● Maintenance of ongoing liaison among the governing authority, committees, the professional advisory committee and staff.

● Employment of qualified personnel, evaluation of staff performance per agency policy, provision of planned orientation and in-service education programs for agency personnel.

● Development of record system and statistical reporting system for program documentation, Planning and Evaluation which includes at least the data specific in these regulations.

● Preparation of a budget for the approval of the governing authority and implementation of financial policies, accounting system and cost controls.

● Assurance of an accurate public information system.

● Maintenance of the agency’s compliance with licensure regulations and standards.

The William & Sally Tandent Center, Stamford, CT 2009-2012 RN Supervisor/Manager

● Responsible for directing resident care for 108 beds units and 35 staff (RN, LPN, and CNA’s). Utilizing of MDS/PRI as a care planning tool, weekly coordination of disciplines for formal care planning, maintaining optimal level of functioning for assigned units, delegation of responsibilities to unit staff and problem solving.

Family Care Visiting Nurse Association Inc., Stratford, CT 2006-2008 RN Case Manager

● Visited and cared for about 45 patients (infants, toddlers, adolescent, young, middle age and older adults) in home care setting with DMR, mental and behavior health issues and language barrier.

● Collaborate with physicians, therapists, social workers, pastoral care and management team resolve nursing problems. Interpreting facility policies and insure that resident’s needs are fully met.

● Assessed treatments, wound care, medication and vital signs reporting any abnormalities to MD.

● Supervise LPN’s and CNA’s delegating patient care. Greenwich Woods Health Care Center, Greenwich, CT 2003-2009 RN Night Supervisor

● Oversight Supervision in management of the day to day nursing activities performed by nurses, nursing assistants and others in assigned care.

● Responsibilities include as necessary, providing direct nursing care, management supervision and care will be a professional manner in accordance with federal, state and local regulations and current acceptable policies, procedures and principles relating to the operation of the facility. Caring Inc, Stamford, CT 2003-2006

RN Supervisor

● Extensive medical/surgical in mental health care to home patients. Supervising, directing in manage operational activities of 230 patients, MDS completions and produced educational videos in service for new staff with specialized operation.

ARI Department of Mental Health, Stamford, CT 2002-2003 Licensed Practical Nurse

● Supervised and assisted residents in a group home care facility with meds and etc.

Daws Critical Care Agency, West Virginia 1994-2006 LPN/RN Staff Relief Nurse

● Assisted various skilled nursing facility in hospitals throughout Fairfield County by providing floor nursing and/or relief supervision

● As a LPN, employed direct patient care with administration of medication St. Joseph Medical Center, Stamford, CT 1994-2004

Agency Nurse

● Responsible for patient care on the ICU, Telemetry, Psych and maternity.

● Collaborate with physicians, therapist, social workers, Pastoral care to resolve nursing problems and interrupting hospital policy and ensure that patient needs are fully met.

Staff Builders, Stamford, CT 1991-1994

● Extensive home care for pediatric and maternal care patients providing private duty, hospital and ICU staffing.

Education:

Duke University

Population Care Coordination Program

Phoenix University

Online courses for Bachelors/Masters in Nursing with a minor in Business Fairfield University, Fairfield, CT

Gerontology Cetification 2006

Vicki Milazzo Institute, Seattle, WA

Certified Legal Nurse Consultant 2003

Regents College, Albany, NY

Associate Degree in Nursing 1997

American Career Travel School, Pompano Beach, FL

Certified Travel Agent 1989

Elizabeth Seaton College, Yonkers, NY

Licensed Practical Nurse 1989

Excellent References Available Upon Request

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