Monica C. Cardona License #******

San Bernardino, CA 92404

909-***-**** (Cell) / 909-***-**** (Home) ads4l1@r.postjobfree.com

Qualification Summary

Highly skilled, passionate and licensed vocational nurse. A proven track record of working well under pressure. Excellent communicator and medical professional with patient care as my primary focus.

NURSING SPECIFIC SKILLS

•Knowledge of HMO and IPA operations with an emphasis on Concurrent Review, Discharge Planning and Utilization management.

•Managed/monitored all Acute Rehab inpatient stays for all of IEHP members while maintaining QA scores above 95% while under Post Acute/ Long Term Care and Inpatient Departments

•Developed and evaluated members treatment plans and acute stay to ensure they receive the appropriate services needed for safe transition to lower level of care during course of admission.

•Participate in weekly meetings with Medical Directors to discuss all acute rehabilitation, long term care inpatient stays and to create an appropriate plan of care, discharge needs.

•Collaborate with other departments to prevent re-admission to Acute and Skilled Nursing Facilities.

•Utilization of computerized clinical data entry system (MHK, CRM, Citrix, MCG, EPIC, Cerner)

•To assure effective and efficient utilization of facilities and services through ongoing monitoring for members who are at risk for extended length of stay, readmission and overutilization.

•Multifaceted intervention during admission to improve care transition by addressing challenges that may affect members outcome and provide recommendations to assist with treatment plan and discharge goals.

•Perform preadmission, concurrent and retrospective review for inpatient admissions and outpatient services, identify cases for that may benefit from interdepartmental referrals/TOC and to ensure the delivery of high quality, cost-effective medical care to all IEHP members.

•Review ongoing, inpatient care to evaluate the quality and appropriateness of care and to assess the medical necessity of the continued stay utilizing pre-established criteria.

•BLS Certified/ LVN/CNA experience with emphasis on Geriatric care, Alzheimer’s /Dementia, Acute Rehabilitation, Acute Inpatient admissions.

•Knowledge and experience with Co-Occurring Mental Health conditions, Chemical dependency detoxification and medication administration/ reconciliation

•Prepared and administered Subcutaneous, Intramuscular and Intradermal injections to military personnel. Update clinical information in MedPros system.

•Provided patient and family teaching of member new and/or chronic diagnoses.

•Assist with Weekend coverage for Inpatient department and intermittently for After hours nurses for admission notifications, Higher Level of Care, Discharge needs, transportation and alternative admission options if member did not meet criteria for Inpatient admission.

•Communicate effectively with diverse people including clients or their representatives, visitors and vendors.

•Problem solving by thoroughly investigating to obtain essential objective information to provide resolution in a timely manner

•Effectively De-Escalate situations with member/patient whom is irate by using whole person approach, empathy and actively listening.

ADMINISTRATIVE/CUSTOMER SERVICE

•Contact members to engage in Health Risk Assessment Process

•Confirm members are eligible for services through verification of plan eligibility and plan coverage

•Document information from assessment that identifies areas of need and summary of call

•Utilized my skills pertaining to oral and written communication, problem resolution and Internet research.

•Assisted staff with case files, case notes & workshop scheduling.

•Responsible for updating files, assisting participants with resume applications and job developing. Compiled and maintained accurate records, answered multi-line switchboard, assisted the public, answered questions and dispensed information over the phone and in person, helped organize special events.

•Handled complex or escalated calls from clients and/or advocates while providing excellent customer service.

•Scheduled appointments & meetings for the Associate Dean, drafted letters, memorandums & reports.

•Conducted employment verification for support services department.

•Performed general office duties such as maintaining records managements systems, basic bookkeeping & data entry.

EXPERIENCE

10/2019- Present Gale Healthcare Staffing Solutions

Tampa, FL

02/2015 – Present IEHP

Rancho Cucamonga, CA

05/2014 – 03/2015 Pacific Grove Hospital

Riverside, CA

06/2014 – Present LHI/Universal Wellness

Rosemead, CA

06/2014 – 01/2015 Randstad Staffing (UAM) Temp

Glendale, CA

02/2011 – 06/2014 Universal Protection Services

EDUCATION

Monterey Park, CA

Glendale Career College

Vocational Nursing (Graduate)

Glendale, CA

El Monte-Rosemead Adult School

El Monte, CA

Certified Nursing Assistant

Contact this candidate