Nurse, Rn Resume Samples

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JB
J Brown
Jaquelin
Brown
12624 Ryan Fields
Phoenix
AZ
+1 (555) 485 0690
12624 Ryan Fields
Phoenix
AZ
Phone
p +1 (555) 485 0690
Experience Experience
Philadelphia, PA
Nurse RN
Philadelphia, PA
Champlin-Brakus
Philadelphia, PA
Nurse RN
  • 10% Customer service to Health Services department clients (answer phone, questions, assist with completing paperwork)
  • Assist in completion of annual performance appraisals for all unit personnel, including competence checklist
  • Demonstrate a passion for caring as evidenced by interactions with co-workers, residents, families, and visitors
  • Perform other duties, as assigned
  • Participate in and/or provide in-service education sessions
  • 30% Triage and treatment of employees with work related and personal injuries/ illnesses
  • Adhere to facility policies and procedures and participates in facility quality improvement and safety programs
Detroit, MI
Nurse Rn Clinical Coordinator
Detroit, MI
Jacobson, Harvey and Moen
Detroit, MI
Nurse Rn Clinical Coordinator
  • Participates in the development, implementation and coordination of clinical services and programs for designated patient populations. Activities may include but are not limited to
  • Patient and family education, Discharge planning and follow-up, Case management, Research
  • Promotes an interdisciplinary approach in patient care delivery
  • Serves as a resource for patients and their families
  • Acts as a patient advocate utilizing the Patient Bill of Rights
  • Participates in promoting and maintaining a safe and therapeutic environment
  • Supports the mission, philosophy, goals and objectives of the Department of Nursing and The Mount Sinai Medical Center
present
Phoenix, AZ
Nurse, Rn, Asst Manager, Patient Safety / qi
Phoenix, AZ
Koss and Sons
present
Phoenix, AZ
Nurse, Rn, Asst Manager, Patient Safety / qi
present
  • Prepares annual evaluations that represent the performance and developmental goals of the employees under direction of Nurse Manager
  • Collaborates with Nurse Manager to implement and monitor employee development
  • Effectively works with medical staff to promote positive patient outcomes
  • Continually seeks to improve own professional nursing practice
  • Provides nursing care in accordance with professional practice standards
  • Continued professional development for self and others
  • Willingly offers assistance and expertise to other departments
Education Education
Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
New York University
Bachelor’s Degree in Nursing
Skills Skills
  • Maintains clinical professional competence, knowledge and skills through use of appropriate resources
  • Demonstrates proficiency in knowledge of instrumentation, supplies and equipment
  • Demonstrates knowledge of sterilization methods, including gravity and pre-vac steam, gas, Steris and Sterrad
  • Follows Hospital and Departmental policy with regard to the use of computers, personal or professional, in the workplace
  • Available to staff for consultation and assistance
  • Prepares sterile setup, checks that proper supplies and equipment are available for case
  • Demonstrates proficiency in the preparation of sterile field
  • Consistently demonstrates and promotes high standards of care
  • Applies research findings in the implementation of patient care
  • Facilitates orientee access to and use of e-mail, perioperative charting, and voicemail
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13 Nurse, Rn resume templates

1

Quality Operations Compliance & Accreditation Nurse Rn Resume Examples & Samples

  • Five years or more of clinical experience
  • Experience with HEDIS specifications and medical records review a plus!
  • NCQA and/or accreditation experience
  • Previous experience in utilization management, discharge planning and/ or home health care
2

Population Health Management Nurse RN Resume Examples & Samples

  • Coordinate: in versus out-of-network movement; care in out-of-network facilities; care with specialty networks; care with DME providers; transfers to SNF and back
  • 2-5 clinical experience preferably in an acute care, skilled or rehabilitation clinical setting
  • Special Certifications: Case Management Certification
  • Health Plan experience Previous Case Management experience
3

Care Coordinator Nurse, RN Resume Examples & Samples

  • Examine clinical programs information to identify members for specific Case Management/Chronic Care / or Disease Management activities or interventions by utilizing established screening criteria
  • Provider education on referral management and processes
  • Monitor practice's patient participation in Humana's clinical programs
  • Promote Humana's clinical programs and resources
  • Facilitate member clinical program engagement
  • Identifies areas to engage member clinical program participation
  • Consult with Clinical Program Case Mangers and nurses to identify member specific opportunities to address with a Provider
  • Identify Chronic Complex members not participating in Humana Cares and refer PODS members to program
  • Expertise on Clinical Programs available to PODS members, and ability to analyze available data to identify members who can benefit from available programs
  • Consult with PODS owner on Clinical Program opportunities needing addressed in a Provider visit
  • Review member specific and provider specific data to identify concerns needing follow up by assigned Case Managers
  • Identify medication usage opportunities needing Pharmacy Consultant involvement
  • Coordination of Clinical Program specific representation or input in to PODS Owner or Strategy Meetings
  • Ability to work with a team
  • Strong analytical skills, able to manipulate and interpret data
  • Education: Bachelors or Associates degree in Nursing
  • Previous experience working in managed care
  • Utilization management and case management knowledge and experience
  • Provider and member rewards program knowledge and experience
  • Understanding of clinical programs
4

Nurse, Rn Resume Examples & Samples

  • Demonstrates competency to establish outcome oriented patient goals
  • Provides patient and family teaching in accordance with practice standards
  • Accesses and uses the minimum necessary patient identifiable information to perform job responsibilities and duties and only for authorized purposes
  • Meets identified self-learning needs and annual review requirements
  • Establishes clear plans and goals
  • Completes unit-specific and annual competencies on time
  • Attends, participates, and organizes weekly in-services and continuing education programs which directly affect own practice
  • Facilitates orientee access to and use of e-mail, perioperative charting, and voicemail
  • Facilitates student orientation
  • Plans, implements and evaluates educational offerings designed to enhance staff knowledge
  • Plans, implements and evaluates programs that support staff education and development (CPR instructor, Perioperative 101 residency program, Staff in-services)
  • Facilitates, provides and evaluates development of educational modules and training plans
  • Provides for patient’s privacy throughout perioperative period
  • Protects dignity of patients throughout perioperative period
  • Regards patient under general anesthesia with respect; models high standard for other team members to follow
  • Performs draping as necessary
  • Utilizes chain of command appropriately
  • Is courteous and helpful on the phone; identifying unit and self
  • An equivalent combination of education and experience will be considered
5

Nurse, Rn, Clinical Procedure Areas Resume Examples & Samples

  • Full time 100% Days position open (0830-1900, 10 hr shifts, 4 days/week; plus on-call req'd)
  • Per diem position open, variable hours
  • Additional per diem/on-call position open (for taking call M-Th, 8pm - 7am)
  • APA - 60% Days (12 hr shifts) position open
  • *******************************************
  • APA - per diem position open
6

Nurse, RN, Outpatient Clinics Resume Examples & Samples

  • Adult Medicine Clinic, (M-F position.)**
  • Sports Medicine/Ortho/Spine Center Clinic**
  • 100% Day shift position. The UW Medicine Spine Center represents state-of-the-art clinical care, teaching and research, bringing together an array of board certified specialists to provide a cost effective, multidisciplinary approach to spine care. Management options range from exercises to major surgery. The UW Medicine Spine Center offers patients and their referring physicians expertise in: Interventional Pain Management, Musculoskeletal Care Physical and Rehabilitation Medicine Radiology Neurosurgery and Orthopedic Spine Surgery. Has worked at least one year as a RN
  • Pioneer Square Clinic**
  • 90% Day shift position. Requires one years of nursing work experience
  • Pioneer Square Clinic: Health Care for the Homeless**
  • 90% Evening (Monday - Friday) position available. Requires one years of nursing work experience. Experience working with people who are homeless, mentally ill, substance abuse, marginalized with complex medical and social needs. Working knowledge of trauma informed care, harm reduction, motivational interviewing and standards of care for people without housing. Good communicator and collaborator with other professionals inside and outside of Harborview Medical Center. Knowledge of community resources for vulnerable people in the Seattle/King County area. Experience working with diverse populations including limited English speakers, LGTBQ, immigrant/refugees, and people of color
  • Burn/Plastics Clinic**
  • 100% Day position. 2 years working as a RN required
  • Outpatient Mental Health Services (OBOT Program)**
  • 100% Day shift position available. Outpatient RN Care Manager for the OBOT program. The OBOT Program offers medication assisted treatment to adults with opioid use disorders in a behavioral health clinic setting
  • Eye Institute**
  • 100% and 80% Day shift positions available. The clinic RN supports surgical practices within the practices as well as performing blood draws and Fluorescein Angiograms in clinic. The Clinic RN also supports telephone triage for opthomalogy practices
  • Eye Institute (Operating Room)**
  • 100% Day position available. Previous RN experience preferred
  • 90% rotating/variable position available; Per diem position available. Experience in an inpatient setting is preferred with two years of RN experience
  • SANE Nurse position (Sexual Assault Nurse Examiner)**
7

Nurse, Rn Resume Examples & Samples

  • Safety is the flight nurse’s first priority. As such, you must comply with all published safety policies and procedures. If you observe an unsafe practice or condition in any aspect of organization, you must initiate reporting and resolution of the issue. This may include submission of safety concern forms to ALNW safety committee
  • Will actively and positively participate in shift briefings, cabin checklists, debriefings and other procedures
  • Acquires extensive working knowledge of policies, procedures and protocols related to the Airlift Northwest program
  • Acquire and maintain strong knowledge base in critical care practice
  • The Flight Nurse is accountable to the Chief Flight Nurse for adherence to written standards care and ALNW policies and procedures
  • The Flight Nurse must be able to stabilize and manage patients involved in air transport. This includes field emergency stabilization, ICU interhospital interventions, as well as management of specific air medical problems in flight
  • The Flight Nurse is expected to have knowledge of applicable sections
  • On arrival at referring site, introduces transport personnel, assists with
  • Participates in any debriefing meeting with Medical Director, Chief Flight Nurse,
  • Participates in teaching and training of orientees
  • Participates in public education programs and public relations functions
  • Patient transport experience preferred
  • Current license in Washington
  • Excellent physical health with full use of all extremities and no lifting limitations
  • Professional certification (CCRN/CEN/CFRN etc.,) required pre-employment
8

Nurse, Rn Resume Examples & Samples

  • Safety is the flight nurse’s first priority. As such you must comply with all known safety policies and procedures. During flight if you observe an unsafe practice or condition you must speak up and resolve the issue
  • Will actively and positively participate in shift briefings, cabin checklists, debriefings procedures
  • If you observe a general condition or practice which you feel may be unsafe you should report that to the Airlift Northwest safety committee
  • Acquire and maintain strong knowledge base in critical care practice. The Flight Nurse must be able to stabilize and manage patients involved in air transport. This includes field emergency stabilization, ICU interhospital intervention, as well as management of specific aeromedical
  • Participates in debriefing meeting with Medical Director,
  • Will uphold all Airlift Northwest policies and procedures related to Compliance, HIPPA and all applicable federal, state and/or local laws and regulations
  • Current license in Alaska & Washington. (Washington nursing license takes approximately 6 weeks to obtain)
  • Excellent physical health with full use of all extremities
  • ATLS audit. May be obtained within six months of employment
9

Appeals Nurse RN Resume Examples & Samples

  • Requires unrestricted RN license in the state of New Jersey
  • Requires a minimum of 2 years experience in a managed care/healthcare setting; or any combination of education and experience, which would provide an equivalent background
  • BS/MS in Nursing preferred
  • Experience working with Appeals, Complaints and/or Grievances for a health insurance company preferred
  • Managed Care experience strongly preferred
  • Quality/Attention to detail
  • Experience in the insurance industry preferred
10

Call Center Nurse, Rn-buffalo Resume Examples & Samples

  • Uses coaching techniques, activation and motivational skills to empower the member to take action and participate in the shared decision making process
  • Empowers consumers with skills to enhance their interaction with their provider
  • Coordinates services and referrals to health programs and community services
  • Current, unrestricted RN licensure in New York state
  • Ability to navigate a Windows based environment and create, edit, save and send documents utilizing Microsoft Word. Ability to navigate Outlook and conduct Internet searches
  • Able to work varied shifts including every other weekend
  • Bachelor's degree in Nursing (BSN)
  • Call Center experience a plus
11

Preservice Review Nurse RN Resume Examples & Samples

  • *This is an office based role located at 2716 N Tenaya
  • Evaluate and assess each request verifying eligibility and specific product
  • Determine benefit level based on site of service
  • Utilize written criteria to approve, pend or send the case to the medical director for review
  • Pend cases by documenting in the claim's payment system, contacting the provider for the necessary information via fax and / or phone and sending a letter to the member to alert them of the pending decision
  • Maintain 100% accuracy of clinical review case notes in Facets
  • Maintain productivity standards and maintain compliance with all regulatory agencies including NCQA, DOL, DOI for each state, Medicaid, CMS, and OPM
  • Maintain 100% accuracy in summarizing cases for the Medical Director to review using appropriate protocols based members clinical and benefit information
  • Maintain compliance with turnaround times based on the member's product, the type of request and the specific regulatory agency
  • Be knowledgeable of and comply with the Nurse Practice Act for each state that licensure is required to perform SHL business
  • Precepts / act as resource for new staff
  • Nursing degree (Associates level or higher)
  • A current, unrestricted RN license in state of hire
  • 2+ years of nursing experience (varied in at least 2 of the following: M/S, Critical Care, ER, surgical)
  • Detail oriented, excellent organizational skills
  • Ability to work well under pressure with sound decision making ability
  • Should be self-sufficient and assertive
  • 2+ years Utilization Management experience in managed care, acute, or rehab setting desired
  • Knowledge of ICD9 / CPT coding, and Milliman Care Guidelines
12

Call Center Nurse, Rn-blue Ash, OH Resume Examples & Samples

  • Adheres to ethical, legal/regulatory and accreditation standards
  • Current, unrestricted RN licensure (include state specific license)
  • Minimum 3 years of applicable clinical experience
  • Call Center experience
  • Previous experience in a telephonic role is highly preferred
13

Call Center Nurse, RN Resume Examples & Samples

  • Assesses and triages immediate health concerns
  • Current, unrestricted RN licensure in IL
  • 3+ years of applicable clinical experience
  • Ability to understand readiness for change and ability to move members along the continuum of change
  • Able to work varied shifts including weekends (Saturday or Sunday, sometimes both)
  • Coaching, motivational interviewing and/or decision support experience
14

Call Center Nurse, Rn-blue Ash, OH Resume Examples & Samples

  • Current, unrestricted RN licensure in Ohio or compact state
  • Associate’s Degree or greater
  • Must live within a commutable distance (60 miles or 60 minutes) of Blue Ash, OH
15

Transition Nurse RN Resume Examples & Samples

  • Manages plan change transition activities including Identifying members with special health care needs requiring transition and coordinate all activities required to successfully transition the member to or from Health Net
  • Ensures that transition activities are accomplished in accordance with applicable health plan/program contractor policies and procedures
  • Acts as an advocate for members leaving and joining the health plan/program
  • Interacts with personnel at all levels with external health plan and program contractors to facilitate communication between impacted parties, including health plan/program contractors and federal programs
  • Assists PCPs, internal health plan/program departments, and other contracted providers with the coordination of care for transitioning members
  • Ensures that continuity and quality of care for transitioning members is maintained during health plan/program contractor transitions
  • Participates in transition planning meetings
  • Makes recommendation to management in regards to developing transition policy
  • Assists with translation of contract requirements into recommendations for internal policies and procedures
  • Current, valid and unrestricted RN Licensure Required
  • Certified Case Manager preferred
  • Minimum five years managed care experience, including Case Management, Utilization Management, and/or Discharge planning
  • Experience working in a Managed Care Health Plan environment including Medicare / Medicaid
  • Experience with development of policies and procedures
  • Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position
  • Strong knowledge of NCQA, federal and state regulations/requirements
  • Demonstrated ability for assessment, evaluation and interpretation of medical/clinical information
  • Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs
  • Excellent verbal and written communications skills
  • Excellent case preparation and abstracting skills
  • Team player who builds effective working relationships
  • Experience using standardized clinical guidelines/criteria required
  • Must be able to work well with all levels in the organization
  • Facilitation skills required
  • Able to operate PC-based software programs including proficiency in Word, Excel, PowerPoint, Access and Project
  • Ability to effectively analyze, interpret, apply and communicate policies, procedures and regulations
  • Ability to effectively analyze and interpret contract requirements and translate into policies and procedures
  • Local travel required
16

Nurse RN / LVN Resume Examples & Samples

  • 40% - Evaluate/assess employee injuries and illnesses and determine medical direction to ensure quality medical care
  • 25% - Maintain employee records to facilitate OSHA and Work comp record keeping according to established policies and procedures to ensure location compliance
  • 15% - Be a liaison between health professionals, employee and other management personnel to facilitate communication while ensuring professional standards of Occupational Health are maintained and confidentiality of medical data is protected
  • 10% - Assist and own occupational health related compliance programs
  • 5% - Administer all other responsibilities/duties as delegated/assigned to the nursing staff are completed on time and accurately
  • 5% - Responsible for being on call for nurse line
  • Must have RN or LVN certification
  • Current Active license to practice professional nursing in California
  • CPR/First Aid certification
  • Knowledge of the Industry
  • Very Team Oriented
  • Candidate must be sensitive to the needs of a multicultural/multilingual environment
  • Able to utilize established practice guidelines and procedures as directives to perform position accountabilities
  • Able to use independent thinking with nursing knowledge and legal limitations to make appropriate decisions and recommendations
  • Able to utilize established protocols and policies to make autonomous medical decisions
  • Able to prioritize and establish treatment plans and goals for employee care
17

Preservice Review Nurse RN Resume Examples & Samples

  • Utilize written criteria to approve, pend or send the case to the Medical Director for review
  • Pend cases by documenting in the claim’s payment system, contacting the provider for the necessary information via fax and/or phone and sending a letter to the member to alert them of the pending decision
  • Maintain productivity standards and maintain compliance with all regulatory agencies including NCQA, and CMS
  • Appropriately summarize cases for the Medical Director to review with benefit information based on the member’s specific product
  • Maintain compliance with turnaround times based on the member’s product, the type of request and the specific regulatory agency
  • Precepts/ acts as resource for new staff
  • Maintaining the established productivity standards, along with being within the timeframes required for completion by policy, procedures and all regulatory bodies
  • Knowing the policies, procedures, and processes that relate to the position
  • Active unrestricted RN license in the state of Georgia
  • Minimum of 2 years of varied RN experience (preferably Critical Care, Medical, Surgical)
  • Computer proficiency in Microsoft Office and ability to learn new systems
  • Knowledge of ICD9 and CPT coding
18

Tricare Utilization Mgmt Nurse RN Resume Examples & Samples

  • Works with Medical Management team as Clinical Resource Tool (CRT) Nurse
  • Maintain thorough knowledge of coding policies and procedures, and medical terminology / technology
  • Ensures UHC M&V work instructions and policies are compliant with TRICARE manuals and contract
  • Attend and participate in Prior Authorization List (PAL) Committee and Episode of Care (EOC) Committee and collaborate with PGBA on ensuring coding in CRT is consistent with PGBA processing of referrals / authorizations
  • Work closely with Utilization Management team to ensure timely updates of CRT for change orders and contract modifications
  • Collaborates with claims to ensure end-to-end processing of authorizations
  • Stays up to date on TRICARE coverage changes
  • Consistently meet established productivity, schedule adherence, and quality standards while maintaining good attendance
  • Act as a resource for TRICARE coverage for others with less experience
  • 3+ years TRICARE experience
  • 3+ years of Managed Care experience
  • 5 years of clinical nursing practice in a patient care setting
  • Demonstrated ability to work independently and as a team
  • Advanced skills in the use of Microsoft Excel, Outlook and Word
  • Experience in developing Policies and work instructions
  • Ability to obtain favorable adjudication following submission of Department of Defense form SF86 NAC form SF86
  • Pre-authorization / Utilization Management experience
  • Knowledge of Milliman Care Guidelines
  • Coding experience
  • Clinical claims review experience
  • BSN or Healthcare related degree
  • Previous Military experience (working with the military or being in the military)
19

Rgistered Nurse Rn-cv OR Resume Examples & Samples

  • Graduate of an accredited School of Professional Nursing, BSN Preferred
  • Current licensure Board of Nursing
  • Current BLS , ACLS certification
  • CVOR experience
20

Preservice Review Nurse Rn-weekends Resume Examples & Samples

  • Ability to communicate in writing and verbally, all types of benefit determinations including decisions regarding coverage guidelines, contractual limitations and reimbursement determinations
  • Telephonic discussion with health care providers and/or members to explain benefit coverage determinations and to obtain additional clinical information
  • Adapt to a highly changing environment and a heavy case load
  • A current unrestricted RN license in the state of residency -will be required to obtain FL and WA RN license
  • Demonstrate a proficiency in computer skills – Windows, Instant Messaging, Clinical Platforms, Microsoft Suite including Word, Excel and Outlook
  • Must have a designated work space and access to install secure high speed Internet via cable/DSL in home
21

Preservice Review Nurse Rn-telecommute Resume Examples & Samples

  • Function as a member of a self-directed team to meet specific individual and team performance metrics
  • Work independently and collaborating with Medical Directors and non-clinical partners
  • Have an active RN license in GA
  • Minimum of 3 years total RN experience including recent clinical experience in an inpatient/acute setting
  • Familiarity with Milliman Care Guidelines
22

Call Center Nurse Rn-future Telecommute Potential Resume Examples & Samples

  • *This is a work from home position after training has been completed, contingent on meeting all standard quality and performance criteria.***
  • We are an inbound call center open 24/7 including holidays
  • Provides health education and coaches consumers on treatment alternatives to assist them in best decision making
  • Prepares individuals for physician visits
  • Active, unrestricted RN license in the state of North Carolina
  • 2+ years of experience in any clinical setting
  • Must live within a commutable distance of our Greensboro office location (50 minutes or 50 miles)
  • Ability to work evening shifts including weekends
  • Ability to work Monday - Friday during daytime hours for first 3-6 weeks for training
  • Previous experience in a call center environment
23

Nurse, Rn Resume Examples & Samples

  • Entry level RNs are welcome to submit your employment application prior to obtaining RN licensure; Washington RN license issuance would be required to begin employment in RN position)
  • If an entry-level RN, then a BSN degree is required. (There is some limited availability for entry-level, ADN-prepared nurses, if currently a Harborview employee in a role such as Hospital Assistant or Nursing Technician, and with approval from Chief Nursing Officer)
  • If an experienced RN, then either ADN degree or BSN degree meets the requirement
24

Telephonic Case Manager Nurse Rn-saratoga Resume Examples & Samples

  • Utilizing Milliman criteria to determine if patients are in the correct hospital setting
  • Making “welcome home” calls to ensure that discharged member receive the necessary services and resources
  • Active, unrestricted RN license in the state of New York
  • 2+ years clinical experience (any setting)
  • Intermediate / proficient level of experience with MS Office applications
  • Passion and commitment to excellence
  • Positive attitude and solution-oriented
  • Ability to handle multiple tasks and function in a high volume environment
  • Ability to work well as part of an interdisciplinary team
  • Must be willing / able to obtain CCM within 2 years of employment
  • Must live within a commutable distance (50 minutes or 50 miles) of our Saratoga, NY or Buffalo, NY office locations
  • Experience in managed care (MCO)
  • Disease management experience
  • Certified Case Manager (CCM)
  • Knowledge of disease processes for chronic illnesses in the senior population
  • Knowledge of Medicare guidelines and regulations
25

Senior Clinical Admin Nurse RN Resume Examples & Samples

  • �Will cover for the DON when out of the office
  • Will manage the Intake Coordinator in the Pensacola office
  • Will take orders from the MD's
  • Will manage the intake process & oversee the Tallahassee Nurses
  • Will see patients in the Infusion Suite in Pensacola
  • Will work with the Intake department & oversee the Referral sources & go through the patients Medical history & Medications
  • Schedule will be Monday - Friday from 8am - 5pm
  • Will go into the on-call rotation & will work approximately 7 days per month
  • Must be a licensed RN
  • Must also be available to rotate on call schedule
26

Prior Authorization Review Nurse RN Resume Examples & Samples

  • Perform utilization and concurrent review using MCG and CMS criteria
  • Arrange alternative care services; Contact and maintain communication with acute long term care, acute rehabilitation, or skilled nursing facilities to move patients through the care continuum
  • Consult with the Medical Director as needed to troubleshoot difficult or complex cases
  • Unrestricted, active RN license
  • 3 years RN experience in an acute setting
  • Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches
  • Knowledge of utilization review process and prior authorization process in a managed health care industry
  • Knowledge of ICD10 and CPT coding
  • Knowledge of MCG Guidelines
  • Detail oriented, self - sufficient and decisive
  • Excellent organizational skills, written and oral communication skills
  • Sound decision making ability
  • Utilization management, prior authorization, and case management experience
  • Working knowledge of MCG
  • Undergraduate degree (BSN) or equivalent experience
27

Nurse, Rn, Nurse Residency Program Resume Examples & Samples

  • ***************************************
  • Attends and participates actively in all residency program activities
  • Promotes a culture of evidence-based practice by completely an evidence-based practice clinical project
  • Completes all required assessment tools at the beginning, middle, and end of the one year residency program
  • Commits to working at Harborview Medical Center (and to the initial unit hired to) for minimum two years from time of NRP cohort start date
  • If an ADN graduate at time of hire, has plans to enroll in BSN or MSN program within a reasonable timeframe
28

Telephonic Case Manager Nurse RN Resume Examples & Samples

  • Identifying gaps or barriers in treatment plans
  • Providing patient education to assist with self-management
  • Making Welcome Home calls to ensure that discharged member receive the necessary services and resources
  • Current, unrestricted RN license in the state of North Carolina
  • 3+ years of experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • Proficient level of experience with Microsoft Word, with the ability to navigate a Windows environment
  • Must live within a commutable distance (50 miles or 50 minutes) of Greensboro, NC
  • Bachelor's Degree or greater
  • Cardiac nursing experience
  • Critical care experience
29

Telephonic Case Manager Nurse RN Resume Examples & Samples

  • Current, unrestricted RN license in the state of Missouri
  • Must live within a commutable distance (50 miles or 50 minutes) of Maryland Heights, MO
  • Ability to work the hours of 10:00am to 7:00pm CST, Monday - Friday
30

Nurse RN Resume Examples & Samples

  • Current active Registered Nurse’s license to practice in State of Missouri
  • Must have effective interpersonal communication skills, both verbal and written
  • Proficiency with Microsoft Word, Excel and electronic Medical Charting software
  • Knowledge of OSHA, Worker’s Compensation, and Occupational Health preferred
  • Experience in one or more of the following nursing fields preferred: Occupational Health, Emergency, Orthopedics, and Urgent Care setting
  • One to three year’s practical experience as a registered nurse strongly preferred
31

Regsitered Nurse RN Neuro Nights Resume Examples & Samples

  • Licensure/Certification/Registration: Current licensure in the State of Colorado as a Registered Nurse; BLS – Healthcare provider
  • Education: Graduate of an accredited school of nursing. BSN Preferred
  • Experience: One-year experience in acute care preferred
  • Special Qualifications: Ability to communicate effectively with patients, families, physicians, and other health care team members. Ability to manage a team and work with others within a team to ensure quality patient care. Strong critical thinking skills
32

Registred Nurse RN Psych Adolescent PRN Resume Examples & Samples

  • The role of the Registered Nurse is to perform patient care under the direction of the Nurse Manager / Chief Nursing Officer
  • The Registered Nurse provides therapeutic and administrative services necessary for the care of the patient, and in support of the mission of Research Psychiatric Center
  • Graduate from an accredited school of nursing with either an ADN or BSN degree
  • CPR and NVCI required upon hire or within three months of hire
  • One to two years of experience in an inpatient psychiatric setting is preferred
33

Rapid Response Nurse / RN Resume Examples & Samples

  • Responds to Swat/Code Blue calls and quickly assesses patient condition for warning signs of clinical deterioration or crisis. Participates and fosters collaboration between members of the health care team in the care of patient’s through assessment, communication, immediate interventions, support, and education
  • Collaborates with staff RN in the management of the care of acutely ill critical patients to include but not limited to ventilator/pulmonary management, hemodynamic monitoring, vasoactive IV therapy, invasive lines, and/or cardiac pacing according to hospital policy
  • Evaluates and regularly reevaluates the nursing needs of the patient; initiates, develops, implements, and makes necessary revisions to the patient’s plan of care according to problems identified
  • Coordinates post-event debriefing. Monitors documentation for accuracy and completeness
  • Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures, analysis data, supporting and implementing changes by using evidence base practice and education necessary for improvement. Stays abreast of current evidence in the management of emergency conditions and regularly communicates new standards to the appropriate individuals/teams
  • Plans, provides, and documents patient and/or significant other education based on physical, behavioral, psychological, developmental, and age-related factors, after identifying barriers to learning. Assigns and delegates nursing care to team members in accordance with the patient’s needs and the capabilities of the team members
  • Provides follow up visits on the patients who are not moved to a higher level of care after a swat call
  • Collaborates and coordinates with physicians and other disciplines regarding individualized patient treatment/care plans by participating in team conferences, care planning/problem identification and team shift reports
  • Responsibilities of the Rapid Response Nurse as outlined in the code management and code blue policy. Provide ongoing education for responders and evaluation of documentation
  • Accurately documents care provided/observations according to policies and procedures
  • Assists in ensuring that resuscitation equipment is maintained according to established standards
  • Supports staff training in the area of emergency management
  • Performs initial and annual competency
34

Zzzregistered Nurse Rn-nights Resume Examples & Samples

  • The RN Charge Nurse assesses, plans, coordinates and evaluates residents’ care along with members of the interdisciplinary team
  • The RN Charge Nurse documents the resident’s condition and nursing needs accurately and in a timely manner. Reports pertinent observations and reactions regarding residents promptly to Supervisor and Physician as necessary
  • The RN Charge Nurse receives and records physicians’ orders
  • Communicates staffing problems and needs to the Nurse Manager. Provides input on staffing ratios and deployment
  • The RN Charge Nurse develops work assignments for RNs, LPN/LVNs and Nurse Aides as directed
  • The RN Charge Nurse supervises, directs and evaluates staff (i.e., RNs, LPN/LVNs, Medicate Aides/Medication Techs, Nurses Aides, etc.) as directed. Participates in counseling, disciplinary action and termination of staff to the extent permitted by state practice act
  • The RN Charge Nurse assures compliance with policies and procedures
  • The RN Charge Nurse reports problems and complaints timely in the Nurse Manager
  • The RN Charge Nurse gives feedback and participates in performance appraisals as assigned
  • The RN Charge Nurse supervises nursing assignment, which includes directing assigned nursing staff to the extent permitted by state practice act
  • The RN Charge Nurse completes all appropriate assessments relative to the resident’s status
  • The RN Charge Nurse maintains positive working relationships between nursing and other departments
  • The RN Charge Nurse services on and participates in committees as assigned
  • The RN Charge Nurse assures that inventory and supplies are maintained in a clean and safe manner on the unit, are utilized economically and communicates need for housekeeping, maintenance or nutritional services assistance
  • The RN Charge Nurse completes records and reports as needed
  • The RN Charge Nurse provides direct care and/or assists with care as directed and consistent with their scope of practice and competency. Initiate the SBAR process and collaborate with the RN for assessment and recommendations
  • The RN Charge Nurse makes rounds with physicians and other team members as needed
  • The RN Charge Nurse coordinates resident assessments, recognizes the need to review and revise residents’ assessments as needed based upon resident condition
  • The RN Charge Nurse coordinates residents’ care activities and communicates changes to other team members and resident family/significant other
  • The RN Charge Nurse reviews, transcribes, communicates and implements physician orders, obtaining RN signature as required by State Regulations
  • The RN Charge Nurse initiates, recommends, communicates and implements changes in residents’ care plans
  • The RN Charge Nurse assists with or institutes emergency measures for sudden adverse developments in residents. Directs and administers cardiopulmonary resuscitation
  • The RN Charge Nurse documents care performed and observations of resident status in the clinical record promptly by utilizing standard clinical documentation guidelines as required by Kindred, and local, state and federal rules and regulations
  • The RN Charge Nurse participates in medication management to promote optimal safety and effectiveness for residents by
35

Call Center Nurse Rn-future Telecommute Potential Resume Examples & Samples

  • Assesses patient's current health status and recommends appropriate level of care based on clinical judgment and protocols
  • Assesses readiness to change, offering opportunities for intervention that will assist consumers in reaching their health care goals
  • Ability to work Monday - Friday during daytime hours for first 6 weeks for training
36

PRN Nurse RN Resume Examples & Samples

  • Exceptional verbal and written communication skills
  • Ability to set priorities and multitask while performing the duties of the Occupational Health Department, including patient care provision, regulatory oversight and policy implementation
  • Ability to practice independently within established standard operating procedures and protocols
  • Registered Nurse with a current and unrestricted license in Texas
  • Intermediate computer skills, including Microsoft Office suite
  • Familiar with electronic medical records technology and application use in a clinical setting
  • 2 + years of occupational medicine, emergency medicine, primary care/urgent care, critical care, or case management experience
  • Knowledge of State Worker’s Compensation law, OSHA requirements, FMLA, ADA, and other occupational health regulations
  • CAOHC Audiometric certification
  • NIOSH spirometry certification
37

PRN Nurse RN Resume Examples & Samples

  • Registered Nurse with a current and unrestricted license in PA
  • Current AHA or Red Cross CPR/AED certification
  • 3+ years of occupational medicine, primary care/urgent care, or case management experience
  • Willing to train
38

Utilization Mgmt Nurse Rn-telecommute Resume Examples & Samples

  • Perform utilization management, utilization review, or concurrent review (on - site or telephonic inpatient care management)
  • Translate concepts into practice
  • 3+ years of Managed Care and / or Clinical experience
  • Inpatient UM experience
  • Knowledge of Milliman Critera
  • Reside in a State in the Central Standard Timezone
39

Care Trans Nurse RN Resume Examples & Samples

  • Identify new opportunities for growth partnering, e.g. promote new service offerings e.g. Vitality To You (V2U), offer solutions for target populations, e.g. advanced payment models; provide rationale for increased patient bed-side access to complete risk assessments and initiate care plan
  • Plan and manage business activities based on an updated quarterly business plan with quantifiable goals. Update hospital and community accounts, associated contacts and corresponding marketing action plans (MAP) as directed by Division Leadership. Maintain a set visitation schedule to assigned hospitals
  • Complete pre-admission assessment accurately either personally or telephonically to gather clinical and financial information and identify optimal service location
  • Follow Pre-Admission Policy and Clinical Acceptance Criteria to make placements decisions and reserve bed in PCC as evidence of decision
  • Visit patient/family bedside to complete assessments for risk identification and initiation of appropriate care plan
  • Leverage clinical/RN capabilities and facts/determination of the patient case to identify and communicate risk factors and collaborate with hospital liaison to consider possible hospital stay extensions, when indicated, to reduce re-hospitalizations
  • In collaboration with Discharge Planner and center, schedule patient transition to center and if applicable, obtain pre-authorizations from managed care organizations for beneficiaries
  • Communicate patient risk and recommended interventions to the nursing center inter-disciplinary team and Transitional Care Nurse (SNF to Home) either electronically or telephonically
  • Document thoroughly, completely and timely, in PCC, patient status, clinical and financial documentation reviews and reservation so center can prepare to admit
  • Maintain a working knowledge and adhere to applicable federal/state regulations including, but not limited to, laws related to patient confidentiality, release of information and HIPAA
  • Interact in a manner which is professional, respectful, positive, customer-focused and which promotes trust
  • Maintain professional growth and development
40

Clinical Quality Nurse, RN Resume Examples & Samples

  • Works with an interdisciplinary team to document and report quality measures to meet state regulatory requirements specific to the dual eligible Special Needs Population (SNP)
  • Identifies population-based member barriers to care and works with the QMP team to identify local level strategies to overcome barriers and close clinical gaps in care for the dual eligible SNP population
  • Tracks and reports individual member quality of care concerns or trends of concern to the Health Plan Quality Director
  • Coordinates and performs onsite clinical evaluations through medical record audits to determine appropriate coding and billing practices, compliance with quality metrics, compliance with service delivery and quality standards
  • Supports Quality Improvement Projects (QIP) by identifying and collecting relevant data, monitors progress and analyzes outcomes
  • Updates QIP documentation regularly
  • Educates providers and office staff on proper clinical documentation, state-mandated quality metrics specifications, provider profiles and medical record review criteria, to drive quality improvement
  • Documents and refers providers' non-clinical / service issues to the appropriate internal parties, to include Provider Relations and the Plan Chief Medical Officer by analyzing provider records and maintaining database
  • Works with providers on standards of care, and advises providers on established clinical practice guidelines, and appropriate documentation consistent with state specific measures and technical specifications
  • Develop and implement improvement projects and using data to develop intervention strategies to improve outcomes
  • Current, unrestricted RN of LPN license in the state of New Jersey
  • 2+ years of experience in quality improvement, this includes developing and implementing performance improvement projects
  • Experience analyzing data, reporting and writing quality documents
  • Proficient in Microsoft Excel
  • Managed Medicaid and / or Medicare experience
  • Microsoft Access experience
  • Health care and insurance industry experience, including regulatory and compliance
  • Knowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements, and the managed care industry
  • STARS experience
41

Care Trans Nurse RN Resume Examples & Samples

  • Identify new opportunities for growth partnering by promoting new service offerings, offer solutions for target populations, provide rationale for increased patient bed-side access to complete risk assessments and initiate care plan
  • Educate hospital staff, including Emergency Department physicians, of nursing centers' clinical capabilities and appropriate patients for return to skilled nursing facility
  • Monitor business contacts, referrals, admissions, re-admissions and dispositions and communicate changes in trends or referral patterns to appropriate staff and management
  • Perform all duties and responsibilities in accordance with state-specific Nurse Practice Act(s) and in accordance with basic principles and guidelines of professional nursing
42

Safety & Health Nurse RN Resume Examples & Samples

  • Administers medical treatment and assistance to all employees for occupational and non-occupational illnesses and injuries in the area
  • Provides for and/or assistance in such areas as new hire physicals, insurance claims (group and workers compensation), company benefits, hazard communication, weekly, monthly and yearly reports related to safety and health matters, and maintains the necessary records
  • Provides for safety inspections and reports in the processing areas and elsewhere when requested
  • Administers first aid treatment as necessary to injured processing and production employees
  • Maintains individual and daily logs of employee visits including nature of injury or illness, department, treatment administered and time
  • Provides for physicals on newly hired employees by reviewing medical history sheets, getting a base line audiogram, temperature, blood pressure, etc
  • Compiles the weekly safety and health report and monthly total report
  • Maintains contact with employees on leaves of absence regarding status and progress
  • Maintains Hearing Conservation Program to meet OSHA standards to include baseline and annual audiograms, recordkeeping, issuing hearing protection and explaining program to employees
  • Orders medical supplies
  • Keeps OSHA log up-to-date
  • Completes required paperwork on all Workers’ Compensation and OSHA recordable accidents
  • Works with Sanderson’s claims supervisor and the insurance company’s adjuster to administrate employee worker’s compensation claims
  • Assists in keeping the health department informed of any problem areas
  • Issues medical supplies and hearing protection as needed
  • Serves on the Safety Committee and suggests topics for safety training, reporting any violation of safety rules and unsafe acts
  • Assists with the safety contest including team assignments and disqualifications
  • Makes in-plant safety inspections and reports findings
  • Visits production facilities periodically to promote safety program, assists with health problems and performs inspections
  • Performs related work as required
43

Nurse RN Resume Examples & Samples

  • 50% Case Management of employee injuries
  • 15% Function as a liaison between healthcare professionals, work comp insurance contacts, employees, and other management personnel to facilitate communication
  • 5% Ensure proper implementation and execution of the post-offer, pre-placement physical process and ensure compliance with the Americans with Disabilities Act (ADA) and ADAAA
  • 5% Ensure compliance with Cargill's Medical Privacy Policy
  • 5% Collaborate with HR on the following programs: FMLA, STD, Medical Leave process
  • 10% Ensure OSHA mandated programs and record keeping are completed to comply with regulations
  • 5% Oversee department budget, including supplies, equipment, and contracted professional services
  • 5% Create, develop, organize, and coordinate activities related to health and wellness education, and all other duties as assigned
  • Current RN License (must show proof of RN license to practice in the state of South Carolina before starting on-site)
  • Exceptional verbal and written communication skills as well as computer skills in Excel, Word, Powerpoint, and web based software programs
44

Admissions Nurse RN Resume Examples & Samples

  • Performs a complete nursing assessment on patients as soon as possible after admission, but within 8 hours from the time of admission. Documents this information within the Admission Assessment Record
  • Ensures the data collected from the admission assessment forms the basis of an individualized plan of care. Goals and interventions are developed related to the diagnosis and comorbidities of each patient and by collaborating with patient/family
  • Within the admission assessment, completes a thorough skin assessment. Captures all wounds by photograph, and accurately describes measures and stages wounds
  • Identifies teaching needs related to the diagnosis and comorbidities of each patient from the admission nursing assessment and by collaborating with patient/family, as well as the Interdisciplinary Team. Begins the education process
  • Provides a comprehensive orientation to patients/family regarding the rehabilitation process and time frames
  • Initiates/performs a complete patient Functional Independence Measure (FIM) assessment and records in accordance with the division policy
  • Communicates all pertinent information regarding the patient’s status to the primary nurse, as well as the attending physician, Nurse Manager/Charge Nurse as appropriate
  • Assists with wound care program. Maintains wound care protocol by chart reviews and weekly update rounds as needed
  • Attends all mandatory in-services, keeps abreast of current departmental and hospital-wide policies and procedures and maintains ongoing communication with departmental managers to ensure delivery of safe, effective patient care in compliance with regulatory standards
  • Positively contributes to the functioning of the unit by providing calm direction and reassurance to ancillary staff, other departments, patients and families. Demonstrates flexibility, team building, and promotes an efficient and positive work environment. Immediately refers problems to the Nurse Manager
  • Identifies and initiates own professional growth, actively pursues professional development through continuing education and self-study
  • Certified BLS completion and maintenance required; for new hires, see CPR Requirement Guidelines for New Hires
45

Clinical Quality Nurse, RN Resume Examples & Samples

  • Identifies population - based member barriers to care and works with the QMP team to identify local level strategies to overcome barriers and close clinical gaps in care for the dual eligible SNP population
  • Educates providers and office staff on proper clinical documentation, state - mandated quality metrics specifications, provider profiles and medical record review criteria, to drive quality improvement
  • Documents and refers providers' non - clinical / service issues to the appropriate internal parties, to include Provider Relations and the Plan Chief Medical Officer by analyzing provider records and maintaining database
  • Proficient in Microsoft Excel required
46

Nurse Rn-rd Shift Resume Examples & Samples

  • Maintains and adheres to the Occupational Health Services Policy and Procedure Manuals and Medical Evaluation Guidelines
  • Performs occupational health services in the provision of supportive or restorative care under physician standing orders
  • Provides first aid/emergency care/stabilization for injured/ill team members and secures appropriate transportation as required
  • Provides first aid treatment for injuries and illnesses
  • Provides nursing care for occupational and non-occupational conditions based upon the Medical Evaluation Guidelines
  • Administers over-the-counter and prescription medications as ordered according to Standing Medication Orders and as ordered by the company physician
  • Schedules and/or perform assessments and testing according to company policy, including but not limited to, health assessments for post-hire, injury/illness, respirator/HazMat surveillance, drug and alcohol testing
  • Collaborates with other health, safety, production and human resources team members in a comprehensive approach to the team member’s health
  • Communicates information regarding work-related injuries and illnesses to the RN Supervisor and/or Medical Case Manager and Third Party Administrator (TPA)
  • Assists with follow-up, maintenance, and documentation of workers’ compensation cases
  • Conducts daily plant walk-through to ensure team-member and team-leader compliance with prescribed modified/restricted duty job requirements
  • Maintains Occupational Health Services records and reporting systems according to OSHA, State, company, and legal requirements. Records maintained include but are not limited to, post-hire assessments, team member health records, OSHA records, audiometric testing, and individual health surveillance records
  • Maintains confidentiality of team member health records according to company policy and HIPPA
  • Assists with team member health promotion, education and training programs
  • Plans and develops objectives of plant’s Health and Safety Services Determine need for further medical treatment of occupational injuries and coordinate treatment
  • Recommends preventative and corrective measures
  • Orders and maintains a supply of personal safety equipment and health services supply
  • Trains associates on wellness programs
  • Performs OSHA recordkeeping
  • Ensures compliance with safety regulations
  • Prepares reports of medical statistical data
  • Maintains accurate records and reports
  • Collects accurate accident/illness information
  • Minimum academic preparation includes completion of accredited school of registered nursing program and current license to practice as a registered nurse in Iowa
  • Bachelor’s in Nursing preferred
  • Two years+ experience required in the performance of nursing skills relative to Occupational Health Nursing preferred
  • Current CPR/First Aid Responder certification
  • Knowledge of personal computers and proficient in computer related software skills i.e. Microsoft Office, Excel
  • Ability to write and document reports
47

Nurse, Rn, Asst Manager, Patient Safety / qi Resume Examples & Samples

  • RESPECT FOR PATIENT CONFIDENTIALITY
  • Patient and staff safety
  • Improving quality of patient care
  • Improving the quality of infection control standards
  • Improvement of intra and extra departmental communications
  • Education and inservices for all OR staff
  • Delivery of quality nursing care,
  • Communicates identified patient safety issues to Nurse Manager or Director as appropriate
  • Evaluates staff ensuring that aseptic technique is maintained
  • Works with manager of TSS to improve and disseminate information related to blood products and autograft tissue
  • Is an advocate for the hospital patient safety goals as part of the daily perioperative nursing practice
  • Works with HMC Infection Control team to improve infection control practices in the Operating Room
  • Seeks appropriate consults when necessary
  • Advocates on behalf of patient regarding issues of safety and quality of care
  • Charge nurse skills are effective
  • Performs delegated duties in absence of Nurse Manager
  • Ensures unit specific projects and assignments are completed in a timely manner without need for prompting
  • Serves as a role model and mentor to all operating room staff
  • Alerts Nurse Manager to actual or potential problems in a timely manner
  • Acts as break nurse when necessary
  • Effectively solves problems intra and interdepartmentally
  • Continually seeks to improve own professional nursing practice
  • Maintains current licensure
  • Is centrally focused on issues related to patient safety, quality of care and OR operational functions
  • Is a role model in providing clear and courteous communication with staff and other departments
  • Is CNOR certified
  • Arrives on time and stays until end of scheduled shift
  • Available to staff for consultation and assistance
  • Reports issues to appropriate persons consistently and in a timely fashion
  • Manages the OR ‘Front Board’ effectively and efficiently
  • Demonstrates calm, efficient demeanor; is tactful and positive
  • Demonstrates proficiency in the preparation of sterile field
  • Demonstrates proficiency in knowledge of instrumentation, supplies and equipment for all surgical services
  • Demonstrates knowledge of sterilization methods, including gravity and pre-vac steam, gas, Steris and Sterrad
  • Performs draping as necessary depending on type of case
  • Provide OR safety orientation (see handout) to students from each school each quarter
  • Meet student on day of experience
  • Revise/update orientation tools prn
  • Create orientation folders
  • Track new hire progress; ensure documentation is adequate
48

Student Nurse, RN Bridge Resume Examples & Samples

  • Current Nursing Student at accredited Nursing Program
  • GPA of 3.0 or above in nursing core curriculum
  • Flexibility to work full time during the summer between your Jr. and Sr. year of nursing school
  • Ability work flexible hours during your Sr. year of nursing school
  • Desire to work in a hospital setting with high acuity patients
  • Demonstrated ability to assess situations quickly and provide solutions
49

Urgent Care Nurse RN Resume Examples & Samples

  • Responds appropriately to emergency situations (Cone Health Codes) and demonstrates knowledge of how to respond. Always uses appropriate safety devices and techniques (examples: using safe lift equipment and needle safe devices; pushing carts; correctly lifting copy paper)
  • Ability to present information to a group
  • Ability to communicate effectively through both oral and written formats
  • Takes responsibility for own actions, including the impact of own decisions on patients and others. Also takes responsibility for actions of any direct reports, avoiding blame or excuses. Takes appropriate action when anyone in the organization violates standards or regulations, viewing it as unacceptable to "look the other way"
  • Accepts responsibility for effective two-way communication using clear and well organized oral and written techniques. Demonstrates self-awareness of non-verbal messages, keeping verbal and non-verbal messages consistent. Incorporates recognition of cultural impact on understanding and effectively uses interpreters and language translation devices
  • Working knowledge of personal computer and communications technology
  • Demonstrates an unwavering commitment to do what is ethically "right". Consistently tells the truth unless doing so would violate confidentiality or compromise the safety or
50

Nurse Rn Clinical Coordinator Resume Examples & Samples

  • Serves as a professional resource to other members of the health care team
  • Considers ethical issues in professional nursing practice
  • Treats co-workers, patients and families with dignity and respect
  • Is open and responsive to the diverse backgrounds and experience of other people, and promotes and environment that is sensitive to cultural diversity
  • Maintains attendance and punctuality record in accordance with departmental standards
51

Concurrent Rev Nurse RN Resume Examples & Samples

  • Serve as a point of contact for member to assist in navigating them through the continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access
  • Evaluate members in the Hospital, Skilled Nursing Facility, LTAC, Acute Inpatient Rehab for benefit determination, medical necessity and appropriate level of care
  • Participate in weekly case review
  • Plan implement, coordinate and monitor Case Management activities that focus on acute and non-acute services, outpatient services and or community resources for all lines of business
  • Determine member’s discharge status and identify and coordinate any additional needs and service that require ongoing Care Coordination services
  • Collaborate with Medical Directors, Managers, Co-workers and other departments
  • Responsibilities are not all inclusive (e.g., project work may be requested in addition to other responsibilities)
  • Moderate to heavy keying required
  • Bachelor’s degree in related field (i.e. Nursing Healthcare, Business)
  • Previous experience with InterQual
52

Specialty Nurse, RN Resume Examples & Samples

  • Performs ongoing assessment and evaluation of patient progress and revision of interdisciplinary plan of care related to diabetic/endocrine patient needs
  • Identifies patient/family need for further resources and initiates appropriate teaching and/or referrals for diabetic/endocrine patients
  • Assists direct care nurse in formulating the patient care plan and setting priorities based on the needs of patient and family. Supports the nurse in teaching performed
  • Responds to patient phone calls and participates in phone triage
  • Three years of pediatric and related clinical experience
53

Care Management Nurse, RN Resume Examples & Samples

  • Performs ongoing telephonic and/or embedded case management activities of assessment, problem identification, planning, implementation, coordination, monitoring and evaluation of pediatric patients
  • Collaborates with patients, families and members of the multidisciplinary care team to develop a patient/family-centered plan of care to meet identified patient care goals and outcomes
  • Develops, implements, evaluates and revises case management care plans according to case management eligibility criteria, contractual guidelines and patient/family physical and psychological needs throughout the continuum of care
  • Identifies system issues that serve as barriers to care. Participates in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem-solving process
  • Promotes patient wellness and autonomy through advocacy, communication, education and identification and referral to community resources or other case/disease management programs
  • Collaborates with health care professionals throughout the care continuum to facilitate the transition of the patient to the most appropriate level of care
  • Demonstrates knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning, complex case management and disease management activities
  • Confers with Physician Advisor regarding complex cases requiring physician input regarding the treatment plan or physician-to-physician collaboration in the care of the pediatric patient
  • Performs assigned work safely, adhering to established department safety rules and practices in a timely manner
  • Acts as the liaison regarding care management programs, services and activities by working with providers, payors, consultants and other staff
54

Transport Nurse, RN Resume Examples & Samples

  • Must have critical care experience
  • Transport and pediatric critical care experience preferred
  • Bachelor's in Nursing preferred
  • Must maintain or be eligible for licensure in the states of DE, PA and NJ
55

IV Therapy Nurse, RN Resume Examples & Samples

  • Evaluates problems that affect delivery of IV fluids
  • Enforces department policies in regard to IV starts and dressing changes
  • Monitors venous access lines daily; assists in changing dressings as indicated
  • Serves as a resource person for staff nurses
  • Documents appropriate data on the patient record
  • Utilizes expertise of other professionals in providing learning opportunities
  • Participates in presentation of IV therapy class
  • Collaborates with Staff Development Clinical Instructors to provide educational resources for staff
56

Plasma Center Nurse RN Resume Examples & Samples

  • Routinely makes decisions determining donor eligibility
  • Coordinates with Center Management team and Quality to ensure successful operation standards are met (Internal)
  • Maintain general cleanliness of work area and assist other work areas as needed to ensure a clean and professional environment
  • Attend monthly staff meetings, and other team meetings as needed
  • Willingness to travel preferred. (less than 10%)
57

Care Trans Nurse RN Resume Examples & Samples

  • Conduct pre-admission assessments to gather clinical and financial information in order to provide a quick response to patient referrals from hospital case managers, physicians and managed care organizations
  • Collaborate with Discharge Planner(s) to prioritize referrals and identify patients for transition
  • Encourage meaningful collaboration with hospital-based case managers on risk factors and care plans, expanding concentration of marketing focus on external relationship development beyond bed availability
58

Nurse RN Resume Examples & Samples

  • 30% Triage and treatment of employees with work related and personal injuries/ illnesses
  • 10% Cargill Conditioning Program
  • 10% Filing / Administrative Duties
  • 5% Facilitation of weekly onsite Physician clinic
  • 10% Pre-placement medicals
  • 5% Drug & Alcohol Screening / Follow-up
  • 10% Health Surveillance Program
  • 10% Wellness / Health Promotion Activities
  • Current active registration with CARNA
  • Able to work second shift hours
  • Able to multitask
  • Autonomous decision maker
  • First aid and Triaging experience
  • Ability to work with others of diverse backgrounds
  • Occupation Health Certifciations
  • Audiometric Technician for Alberta
  • BAT and DOT Cert
  • ITLS Certificationification
59

Skilled Visit Nurse RN Resume Examples & Samples

  • Maintaining a clear communication with other members of the patients' multi-disciplinary team
  • Training family members
  • Associate’s or bachelor’s degree in nursing from a state accredited RN program
  • Current state issued and unrestricted RN license
  • Ability to work independently and with minimal supervision
60

Call Center Nurse Rn-future Telecommute Potential Resume Examples & Samples

  • Highly organized, self - directed worker with an ability to function in high volume environment
  • Live within a commutable distance of our Maryland Heights, MO office location (50 minutes or 50 miles)
  • Coaching, motivational interviewing and / or decision support experience
61

Call Center Nurse Rn-evenings Resume Examples & Samples

  • *This is a work from home position after training has been completed, contingent on meeting all standard quality and performance criteria***
  • Collaboratively plans care with member
  • This position will require active and unrestricted Nursing licensure in multiple US States. Selected candidate must be willing and able to obtain and maintain multiple state licensure. (Application fees and filing costs paid for by UHG)
  • Active, unrestricted RN license in the state of Missouri
  • Proficient level of experience with Microsoft Office applications, and strong technical aptitude
  • Home health experience
  • Triage experience
  • Emergency room experience
  • Highly organized, self-directed worker with an ability to function in high volume environment
62

Registred Nurse, / RN, Nicu Resume Examples & Samples

  • Current Basic Cardiac Life Support (BLS) certification
  • Advanced Life Support (NRP) certification as required by specific hiring department criteria
  • A Registered Nurse who has one (1) year of full-time equivalent or more prior NICU experience as a Registered Nurse
63

Nurse, RN Weekend Supplemental Resume Examples & Samples

  • Utilizes the nursing process as the basis for patient care practice
  • Completes Nursing Admission Assessment with patient and family at time of admission
  • Makes accurate multi-system assessments and clearly documents in patient records on a continuous basis
  • Makes nursing diagnosis list (patient problems) which serves as the basis for plan of care and evaluates and revises nursing diagnosis list based on patient assessments
  • Assesses and implements appropriate nursing care based on nursing assessment of age, developmental stage and physical condition
  • Provides effective patient/family education based on individualized learning needs
  • Identifies discharge needs and facilitates discharge planning
  • Performs nursing duties as delegated through Physicians orders or as outlined in plan of care to provide quality care to patients
  • Performs nursing duties in accordance with the nursing standards of care and the policies and procedures of Scott & White and the Nursing Department
  • Implements the medical plan of care appropriately as delegated through physician orders and within the parameters of this job description
  • Administers medications and treatments safely, accurately and in accordance with established policies and procedures
  • Manages and coordinates the activities required for delivery of quality patient care as part of the healthcare team
  • Directs and coordinates nursing care, establishes priorities and delegates nursing activities according to patient needs and staff's capabilities and qualifications
  • Participates as a member of assigned patient care team, facilitates communication and coordination of interdisciplinary activities and makes appropriate referrals
  • Clearly communicates in a timely manner data obtained during nursing assessments, reports and interdisciplinary rounds to other health team members
  • Assists team members in providing care to patients or administers direct care when professional nursing skills and judgment are required
  • Maintains composure and functions effectively in emergency and stressful situations
  • Participates in education, research and performance improvement activities to enhance and maintain personal and departmental qualifications and standards of performance
  • Willingly participates in performance improvement and research activities when indicated
  • Shares nursing expertise with staff and students in a professional and supportive manner
  • Participates in self evaluations when requested, setting realistic goals
  • Fulfills continuing education, licensure and/or certification requirements to maintain required qualifications
  • Takes personal responsibility to understand, complete and maintain the professional and technical licensures/certifications required of the position and furnishes Scott & White with the necessary documentation to substantiate compliance
  • Completes unit-specific and age-specific competencies annually
  • Location/Facility – Scott and White Hospital, Temple, Texas
  • Advanced Certification per Unit Requirement
64

Fall Residency Clinical Nurse RN Resume Examples & Samples

  • Graduate Nurse/Registered Nurse, with less than one year of experience from date of graduation to hire date and has not worked in an acute care setting
  • Current BCLS upon hire
  • Hired into the Nurse Residency Program for 1-year residency program and agrees to 1-year work commitment upon successful completion of the Nurse Residency Program
65

Nurse RN Weekends Resume Examples & Samples

  • Delivers patient care through the nursing process of assessment, planning, intervention, and evaluation
  • Develops an individualized plan of care utilizing the nursing and medical diagnoses
  • Initiates a patient education plan according to the individualized needs of the patient, including patient and family instruction, health promotion, disease management and discharge planning
66

Nurse RN Weekend Option Worker Resume Examples & Samples

  • Assesses patient's condition, including biophysical, psychosocial, age specific needs, and safety needs
  • Documents patient's status according to organizational policies and procedures
  • Collaborates with other health care team members in formulating plan of care to ensure optimum patient outcomes and continuity of care
  • Provides supervision and guidance to Licensed Practical Nurses (LPN) and other non-licensed clinical support staff in delivering interdisciplinary patient care
67

Telephonic Case Manager Nurse Rn-telecommute From Iowa Resume Examples & Samples

  • Making referrals to outside sources
  • Educating members on disease processes
  • Making welcome home calls to ensure that discharged member receive the necessary services and resources
  • Current, unrestricted RN license in the State of Iowa
  • Multiple state licensure (in addition to Compact License if applicable) or ability to obtain multiple state nursing licenses required
  • 2+ years of RN experience in a hospital setting, acute care, direct care experience or experience as a telephonic Case Manager for an insurance company
  • Must reside in the state of Iowa
  • Flexibility to work Eastern or Pacific Time Zones
  • Bachelor's Degree
  • Experience in utilization review, concurrent review and / or risk management
  • Medicare experience
68

Telephonic Case Manager Nurse Rn-telecommute From Texas Resume Examples & Samples

  • Making outbound calls to assess members' current health status
  • Coordinating care for members
  • Encouraging members to make healthy lifestyle changes
  • Current, unrestricted RN license in the State of Texas
  • Must reside in the state of Texas
  • A background in managed care
  • Hedis / STARS experience
  • Experience working with the elderly/geriatric population
  • Bilingual Spanish
69

Field Nurse RN Resume Examples & Samples

  • Build strong client relationships by consistently delivering client interactions that develop trust and show value
  • Conduct quality assurance audits to aid clients with preparation for successful, compliant state surveys
  • Provide Quality Reviews and other Omnicare nursing consultant services
  • Deliver ongoing clinical training to facility staff
  • Assist with activities associated in onboarding new facilities such as collection of resident information and medical records; scheduling, attending, and some facilitation of facility staff training; informing pharmacy of facility needs;serving as single point of contact for facility throughout onboarding process
  • Excellent customer service skills, knowing the appropriate time to be consultative vs solve a problem or fill a need
  • Proven project and time management skills; ability to track and manage issues, ensure the right teams are engaged, and facilitate comprehensive and timely issue resolution
  • Ability to work independently and creatively solve problems when dealing with a multitude of variables
  • Track record of performing under pressure and adapting to changing dynamics
70

Field Nurse RN Resume Examples & Samples

  • Build strong client relationships byconsistently delivering client interactions that develop trust and show value
  • Evaluate regulatory compliance and determineclinical education needs for our clients as it relates to pharmacy services
  • Conduct quality assurance audits to aid clientswith preparation for successful, compliant state surveys
  • Identify and provide recommendations regardingdeficiencies and opportunities around drug inventories, storage, anddistribution
  • Provide Quality Reviews and other Omnicarenursing consultant services
  • Deliver ongoing clinical training to facilitystaff
  • Assist with activities associated in onboardingnew facilities such as collection of resident information and medical records;scheduling, attending, and some facilitation of facility staff training;informing pharmacy of facility needs; serving as single point of contact forfacility throughout onboarding process
  • Excellent customer service skills, knowing theappropriate time to be consultative vs solve a problem or fill a need
  • Proven project and time management skills;ability to track and manage issues, ensure the right teams are engaged, andfacilitate comprehensive and timely issue resolution
  • Ability to work independently and creativelysolve problems when dealing with a multitude of variables
  • Track record of performing under pressure andadapting to changing dynamics
71

Clinical Specialty Nurse RN Resume Examples & Samples

  • 1 - 2 years patient assessment experience in the acute care setting, emergency medicine, or urgent care environment
  • Excellent communication and documentation skills essential
  • Ability to multi-task and deliver patient care in a fast paced environment
72

Call Center Nurse Rn-future Telecommute Potential Resume Examples & Samples

  • *This is a work from home / telecommute position after training has been completed***
  • Active, unrestricted RN license in the state of West Virginia
  • Must live within a commutable distance of our Charleston, WV office location (50 minutes or 50 miles)
  • Ability to work Monday - Friday during daytime hours for first 5 weeks for training
73

Care Manager Sales Nurse Rn-selecthealth Resume Examples & Samples

  • Understands functions and processes of Care/Disease Management including documentation in the care management operating system
  • Understand employee populations for each self-funded employer group, including risk factors and utilization patterns
  • Monitor employee’s for possible Care/Disease Management program(s), assisting in evaluating and identifying those employees who would benefit from care/disease management
  • Follows care management processes for enrollment into care management and carries a limited care management case load
  • Provides reports on employee’s enrolled in care/disease management with specific details around progress to goals (including frequency of contact with employee), anticipated length of stay in care/disease management, anticipated further and medical costs (authorizations, inpatient admissions, post-acute care, medical equipment, etc.), and claims related information (medical and pharmacy)
  • Presents care/disease management reports related to employee engagement in care/disease management, outcome measures, return on investment, etc. Additionally, ties care/disease management reports to the SelectHealth Healthy Living program
  • Leads process improvement projects related to care/disease management for self-funded line of business
  • Provides information related to the Care/Disease Management Program for RFP’s and RFI’s, in partnership with Health Services
  • Utilizes computer skills with Microsoft Office and other applications to create and present reports and other information requested by employer groups
74

Plasmapheresis Specialty Nurse, RN Resume Examples & Samples

  • Performs appropriate assessment of patient/family upon arrival /admission
  • Performs ongoing assessment and evaluation of patient progress and revision of interdisciplinary plan of care related to patient needs
  • Identifies patient/family need for further resources and initiates appropriate teaching and/or referrals
  • Participates in responding to patient phone calls. Explains treatment regimens to patient/family after having discussed with the physician
  • Demonstrates ability to share clinical knowledge with other members of the health care team; works collaboratively with Nursing Education Department to share subspecialty knowledge with nursing staff
  • Utilizes specialized body of knowledge and technical skills in nursing practice related to subspecialty in accordance with the Nurse Practice Act, hospital policy and protocol
  • Participates in the development of standards of care for the specialty patient population
  • Demonstrates proficiency in the care of all ages: neonates, pediatrics, adolescents and adults
  • Recognizes and identifies own learning needs and responsibility for continual development; strives to increase knowledge and identifies goals for professional growth
  • Responsible for participation in departmental and hospital programs for quality/process assessment and improvement, identifying opportunities to improve services, making recommendations and implementing actions as appropriate and consistent with the goals of the Nemours Foundation
75

Assessment Nurse RN Resume Examples & Samples

  • Conduct enrollment assessments of prospective members and re-assessments of current members in their homes using the Uniform Assessment System (UAS); make enrollment decisions and continued eligibility determination by utilizing clinical expertise and critical thinking skills. As needed, will conduct assessments in settings other than home as needed, e.g. skilled nursing facilities
  • Complete assessment of service needs at the request of the Care Team, Member's Family/Caregiver to determine service level(s) or need to adjust Service levels
  • Complete Patient Review Instruments/Screens and all required nursing assessments for active members to determine adjustments/updates in Care Plan and/or to assist with nursing home admission
  • Liaison between the member and the Care Management Team; assesses home environment and psychosocial status
  • Maintain a paperless work environment, which includes compiling assessment package requirements and electronic archiving using Macess Exp Service Module
  • Communicates with home care agencies and Care Management Team providing feedback regarding home care issues and the performance of Contract Nurses and Aides
  • Provides grass roots, community-based training for frail population care including self-care techniques and prevention strategies
  • Ensures that prospective members and significant others/responsible parties understand and are in agreement with enrollment in a managed long-term care plan
  • Associate degree in nursing
  • Possess and maintain a valid New York State ID
  • Ability to travel within the NY Tri-State area, which primarily covers the 5 boroughs, Long Island and Westchester
  • Ability to travel to any area as needed within scheduling time frames - Car recommended for outer boroughs
  • U.S.-based work experience in one or more of the following areas
  • BS in nursing
  • Work experience using electronic patient health information (PHI) database usage (medical records database)
  • Work experience using multiple Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS), Federal Employee Program (FEP)
  • Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population, as well as, negotiate initial service plans so that members and families are in agreement
76

Pacer Nurse, Rn-first Shift Resume Examples & Samples

  • Ensure that all pacemaker and ICD patients are being followed in office and remotely per protocol
  • Interrogate and conduct various technical tests on implanted cardiac devices per protocol
  • Assess patient for signs and symptoms related to device function and perform reprogramming as necessary
  • Forward all documentation to physician for review. Execute any orders received
  • Conduct patient and family education
  • Maintain patient PaceArt files
  • Attend various vendor educational seminars in order to keep up with new equipment and techniques
  • Perform and assist in trans-telephonic monitoring
  • Two or more years experience in a cardiology setting with cardiac rhythm recognition
77

Inpatient Care Nurse, RN Resume Examples & Samples

  • Assesses and coordinates simple discharge planning (short-term rehabilitation, homecare etc) with physicians, caregivers and ancillary providers to support the member’s continuity of care needs
  • Identifies members at high risk for complicated medical treatment plans, and/or repeat admissions potential and refers them to the appropriate case and disease management teams
  • Coordinates authorization and/or delivery of post-acute care services, including, but not limited to referrals to case and disease management, home health, medical equipment, skilled nursing facilities and other community based services
  • Required Beginner Microsoft Excel Proficient in Microsoft Office such as Excel, Word and Outlook
78

Nurse Rn-care Coordinator Resume Examples & Samples

  • Exceptional time management, and verbal and written communication skills
  • Ability to work as a team and collaborate with a variety of individuals
  • Registered Nurse with a current and unrestricted Missouri license (has not been censured or forced to relinquish due to impropriety) and Kansas license (or ability/willingness to obtain upon hire)
  • 2+ years of experience in a family medicine, urgent care, emergency medicine, or equivalent setting
  • Must reside in the Kansas City area
  • Ability to work shift as assigned/requested
  • Must be willing to travel to any of the four main Cerner campuses in Kansas City
  • Experience using Cerner EMR experience
79

Medicare Set-aside Nurse, RN Resume Examples & Samples

  • Support Client programs that require nurse review and / or sign off of work products
  • Coordinates workflow and workload to generate timely reports to clients meeting both quality assurance and production metrics established by the management team
  • Performs other functions as assigned by management
  • Workers’ Comp, Medicare Set - Aside (MSA) writing and / or Life Care planning experience
  • Medicare Set - Aside Consultant Certification (MSCC)
  • Additional certification such as Certified Case Manager (CCM), Life Care Planner (LCP), Certified Insurance Rehabilitation Specialist (CIRS), Certified Rehabilitation Registered Nurse (CRRN),Certified Disability Management Specialist (CDMS)