Rn-nurse Resume Samples
4.7
(99 votes) for
Rn-nurse Resume Samples
The Guide To Resume Tailoring
Guide the recruiter to the conclusion that you are the best candidate for the rn-nurse job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.
Craft your perfect resume by picking job responsibilities written by professional recruiters
Pick from the thousands of curated job responsibilities used by the leading companies
Tailor your resume & cover letter with wording that best fits for each job you apply
Resume Builder
Create a Resume in Minutes with Professional Resume Templates
CHOOSE THE BEST TEMPLATE
- Choose from 15 Leading Templates. No need to think about design details.
USE PRE-WRITTEN BULLET POINTS
- Select from thousands of pre-written bullet points.
SAVE YOUR DOCUMENTS IN PDF FILES
- Instantly download in PDF format or share a custom link.
EE
E Eichmann
Erich
Eichmann
75958 Emmerich Glens
San Francisco
CA
+1 (555) 844 9706
75958 Emmerich Glens
San Francisco
CA
Phone
p
+1 (555) 844 9706
Experience
Experience
Houston, TX
Rn-prior Auth Nurse
Houston, TX
Jacobson-Stanton
Houston, TX
Rn-prior Auth Nurse
- Performs other duties as requested by Manager of Medical Services
- The PA nurse reports to the Manager of Medical Services. The LPN works under the direction of an RN
- Assists in the development of policies and procedures
- Identifies and communicates to HRCM team all potential catastrophic and high risk cases for case management referrals
- Maintains a courteous, professional attitude when working with facility staff, providers and their staff, the health plan and co-workers. Provides excellent customer service to internal and external customers
- Responsible to document ICD-9 and CPT coding and levels of care to reflect care and services provided for claim adjudication
- Works closely with P5 PA screeners
Boston, MA
Nurse Manager, RN
Boston, MA
Medhurst, Ortiz and Dietrich
Boston, MA
Nurse Manager, RN
- Manages clinical nursing staff, promoting a healthy work and learning environment
- Manages assigned Ambulatory Clinic staff promoting a healthy work and learning environment
- Knowledge of professional nursing theory and practice; knowledge of management theory and change process
- Makes suggestions
- Makes decisions
- Manages resources prudently
- Works independently
present
Dallas, TX
RN Nurse Case Mgr Senior Specialist
Dallas, TX
Von-Weber
present
Dallas, TX
RN Nurse Case Mgr Senior Specialist
present
- Ensures effective and efficient budget management in providing the best utilization of resources
- Assists the manager with policy/procedure updates including NCQA, CMS and State of Texas contract revisions
- Monitors staff performance, as directed
- Provides monthly DM metric reporting for use in staff evaluations
- Assists with meeting facilitation
- Coordinates and completes staff check ins and audits to provide feedback to direct reports
- Implements procedures and policies established by Cigna-HealthSpring that enhance the quality of life for people receiving services
Education
Education
Bachelor’s Degree in Nursing
Bachelor’s Degree in Nursing
James Madison University
Bachelor’s Degree in Nursing
Skills
Skills
- Excellent presentation skills and ability to communicate in both written and oral formats
- Excellent oral and written communications skills
- Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member
- Able to work in a dynamic, fast-paced team environment and to promote team concepts
- Previous STAR+PLUS experience
- Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
- Home Health Case Management experience with Medicare or Medicaid populations
- Experience managing members with chronic disease processes
- Experience working with community resource organizations
- Experience with care management software applications
13 Rn-nurse resume templates
Read our complete resume writing guides
1
Rn-denial Management Nurse Resume Examples & Samples
- Review or proof all Medicare Denial and Rescind letters for the SNF team
- Create and issue Medicare letters when requested by the nurses
- Process QIO appeals when requested by the QIO, which includes creating and issuing the Medicare letters
- Document the appeal results, notify the facility, and notify the nurse and the RMD via email
- Three years acute or skilled nursing experience
- Utilization Review experience as it relates to denials and appeals
- Previous SNF and Medicare experience
2
RN Nurse Resume Examples & Samples
- Performs an evaluation of the request appropriateness for CareCentrix-sourced services based on the Medical Guidelines of the insurer. Researches/identifies all potential relevant clinical information pertaining to the request and creates an orderly record of the case. Receives/responds to incoming calls from referral sources, exchanges information in order to complete the clinical picture of the case, and assists in determining the Company's ability to authorize or refer for possible denial. Documents the outcome of case an easily tracked manner
- Relays referral and utilization information to the face to face clinical team who will deliver the services requested
- Communicates utilization issues to supervisor /manager for logging and resolution
- Participates in and contributes to ongoing utilization management activities and quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested. Assists team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates
- Acts as a resource to the RCC Clinical Review Team
- Participates in implementing / maintaining operational processes to ensure compliance to Company policies, legal requirements and regulatory mandates
- Reviews and adheres to all Company policies and procedures and the Employee Handbook
3
RN Nurse Appeals Medicaid Resume Examples & Samples
- Current active unrestricted RN license to practice as a health professional within the scope of licensure in Georgia required
- Experience with medical record audit
- Strong critical thinking, analytical and research skills
- Ability to adapt to change and work in a high volume environment
- Proficiency with MS Word, Excel and Outlook and Adobe
- Experience with Facets and Macess preferred
4
Nurse Graduate for our Acute RN Role Resume Examples & Samples
- Provides quality direct patient care and renal replacement therapies independently, in a professional, considerate and respectful manner under the supervision of a registered nurse
- Interacts and communicates with hospital partners in a collaborative, respectful manner, gives pre/post treatment report through appropriate reporting process to hospital primary RN/Staff under the supervision of a registered nurse
- Documents, evaluates and implements dialysis orders under the supervision of a registered nurse
- Demonstrates the ability to transfer skill set and work in other Hospital settings when required
- Enters ACOI Data accurate and in a timely manner
- Understand own professional limitations and seeks appropriate assistance when required
- RN license examination must be completed within 3 months (90 days) from hire and/or 5 months (150 days) from graduation. Failure to complete or pass RN licensing exam by above date, will cause a termination and/or transfer to a HD PCT position (if available)
5
Rn-clinical Support Nurse Family Birthing Center Resume Examples & Samples
- Two years (2) clinical nursing experience with one year in the area of clinical concentration
- Successful completion of unit specific orientation and competencies
- Demonstrating leadership, communication and problem solving skills
6
Call Center RN Nurse Resume Examples & Samples
- Assesses patient’s current health status and recommends appropriate level of care based on clinical judgment and protocols
- Assesses consumer’s understanding of their condition and identifies potential care and / or provider gaps
- Supports consumers in selection of best physician and facility to maximize access, quality, and to manage health care cost
- Manages utilization through education
- Minimum 5 years of applicable clinical experience
- 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
- Bachelor's Degree in Nursing (BSN)
- Previous experience in a telephonic role
7
RN Home Visit Nurse Resume Examples & Samples
- Travel to provide in-home patient care and continuous education to patients and family members
- Establish trust and build long term relationships with expectant mothers
- Provide clinical support to key physicians / hospitals upon request
- Ability to utilize Windows 7 programs to include Word, Email and Internet
- Ability to travel to patient homes within Manhattan, Bronx, Brooklyn, Queens and Staten Island area
- Home care experience
8
RN, Medicare Set-aside Nurse Resume Examples & Samples
- Thoroughly reviews all medical records and documents the medications, surgeries, therapies, equipment needs and other treatment within the medical abstract
- Applies objective, evidence - based guidelines to home health services, equipment and supplies prescribed as they relate to the approved diagnoses
- Aid MSA Production Supervisor in the professional development of the employees on their team
- Serves as a consultant and subject matter expert on catastrophic claims
- Current and unrestricted RN license
- Ability to navigate MS Office and a Windows based environment and the ability to create, edit, save, and send documents utilizing Microsoft Word, including the ability to navigate Outlook and conduct Internet searches
9
RN Gastroenterology Advice Nurse Resume Examples & Samples
- Utilize regional population stratification information and processes to identify appropriate members for enrollment into case management in collaboration with clinicians and health care team
- Independently and proactively complete chart reviews, screening calls and full assessments related to the anticipated level of care and document findings using standardized approved documentation tools
- Triage findings from member assessments, identifying needs and issues, engage patients to define a plan of care and appropriate level of self management and interventions. Determine Level of Care. Communicate findings and actions to involved care providers through succinct summaries that include findings, actions and further recommendations
- With the member/family and appropriate KP staff and providers, develop and document a patient-centered care plan that addresses short term goals that are specific, attainable and measurable
- Provide care coordination and management services for members with identified needs: Creatively using available and appropriate resources, including KP staff and providers, to support the unique needs of each member; Facilitating access to internal and external services; Monitoring the effectiveness of the interventions; and reinforces the treatment plan. Advising and coaching patients and families; Succinctly document interventions in KP HealthConnect as needed by other providers to ensure coordination of care and services
- Strengthen and improve Case Management Services: Establish strong relationships with clinicians and other health care team members. Communicate data on population case managed, utilization and outcomes. Education of staff/clinicians. Development and distribution of education, tools and materials for member coordination. Contributing to ongoing process improvement including related procedures, policies, patient support and documentation tools
- Act as a liaison between the patient and appropriate care delivery team
- Within the last eight (8) years a minimum five (5) years of nursing experience in acute care or ambulatory care/clinic/extended setting is required with two (2) of those five (5) years being spent in a case management/care coordination role
- Minimum two (2) years of experience in case management, care coordination, or population care
- Microsoft Word, Excel, and Health Connect experience
- Quality management methodology and utilization management experience
- Current or future bachelor's degree in nursing or related field
10
RN Nurse Supervisorpt FTE Weekend Resume Examples & Samples
- Comprehensive background in nursing and knowledge of current healthcare issues and trends
- Demonstrates knowledge and sensitivity to diversity issues and respect for individual differences
- Demonstrates ability to effectively listen and communicate verbally and in writing
- Demonstrates analytical and problem-solving ability
- Demonstrates customer orientation
11
Field RN Case Manager Nurse Resume Examples & Samples
- Provides care coordination/case management through physician practices for members to improve clinical quality and clinical documentation. No direct patient care
- May conduct telephonic member needs assessments according to state and national guidelines, policies, procedures, and protocols
- May interact with patients via telephone; Schedule appointments, Follow up calls to assess understanding of services, answer questions and ascertain that additional procedures have been completed
- Review member charts prior to a physician appointment and create alerts/triggers to highlight Star opportunities for the practice
- Partner with the practice's administrative and clinical staff while managing patient appointments and data between visits
- Create and maintain a professional and supportive relationship with the patient, provider and office staff
- Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
- Assists the member to access community, Medicare, family and other third-party resources as appropriate
- Collaborates and communicates with the member’s health care and service with our interdisciplinary delivery team to coordinate the care needs for the member
- Provides education to members regarding health care needs and available services
- Works to facilitate member compliance with their care/treatment plan and to ensure continuity of care
- Identifies barriers to optimal care and outcomes or clinical concerns and communicate with members and providers to formulate action plan to address
- Documents all care coordination activities and interventions in the member’s health plan clinical record
- Maintains a focus on timely, high-quality customer service
- Maintains the confidentiality of all sensitive information
- Conduct and/or participate in community and provider practice events to educate on diabetes
- Current, unrestricted RN license in the State of Georgia
- Reliable transportation, valid and unrestricted driver’s license, proof of insurance and ability to travel to provider offices or other locations within service delivery area
- Minimum of 3 years clinical experience in a hospital, acute care, home health, direct care or case management
- Computer/typing proficiency to enter/retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications including MS Office and Excel
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Must be able to travel to provider offices within service area (Metro Atlanta)
- Ability to travel within the state of Georgia up to 25% of the time
- Certified Diabetic Educator (CDE)
- Experience with HEDIS
- EMR (electronic medical records) experience
- Experience with navigating and analyzing reports in Microsoft Excel
- Prior Physician Office experience
- Home care/field based case management
- Experience in intensive care (ICU),emergency department (ER) nursing, or Home Health
- Experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs
- Chart Review experience to identify gaps in care
12
RN, Radiology Nurse Manager Resume Examples & Samples
- Bachelor’s Degree in Nursing or related field. If bachelor’s is not in nursing then must have a master’s degree in nursing
- Minnesota RN license
- 3 years Clinical nursing experience in Critical Care, Interventional cardiology/radiology and/or Cath Lab with 3 years of leadership experience
- Advanced Degree in nursing or related field
- Supervisory/Management experience
13
Outpatient Nurse Manager, Rn-north Portland Resume Examples & Samples
- Clinical Supervision: Collaborates w/ physician partners & admins & brings the professional nursing & clinical perspective to leadership team to improve quality, safety, access, & affordability. Ensures support staff working to full scope &/or certification. Collaborates w/ leadership team to identify opportunities to optimize scope of practice & ensure resource stewardship. Ensures RN's & support staff have the required knowledge & skill to perform assignment. Assists w/ providing on-going clinical skills development including the supervision of onboarding processes. Collaborates w/ Reg’l nursing srvs to implement Reg’l & Nat’l nursing strategies in accordance w/ KP's Nat’l Nursing vision, models, & values. Monitors health outcome metrics, including established Nat’l & Reg’l nurse sensitive metrics & recommends, implements & evaluates improvement strategies. Collaborates w/ leadership team & Reg’l nursing srvs to ensure clinical quality & patent safety assurance processes are conducted, trends identified & remediation strategies implemented. Collaborates w/ physician partners & Reg’l nursing srvs to ensure applicable clinical accreditation requirements met. Anticipates changes in healthcare trends & collaborates w/ Reg’l nursing srvs to effectively implement evidence based changes in nursing practice. Assess urgency of clinical situations for the purposes of determining appropriate prioritization & needed actions to assure patient safety. Provides clinical oversight of applicable nursing Care Mgmt srvs. Collaborates w/ leadership & Reg’l nursing srvs to develop recommendations, implement, & evaluate improved processes & systems w/in multi-disciplinary care teams & across the continuum of care
- Operations: Supervises & coordinates all staff activities necessary to provide excellent patient focused care. Acts as liaison between the physician partners, care team, support Depts to ensure effective communication for overall patient care srvs, including Reg’l communication cascade to frontline staff. Selects, coaches, develops & performance manages staff & affiliated clinicians in collaboration w/ physician partners & in compliance w/ requirements of EEO/AA goals, union contracts, & personnel policies of the organization. Co-leads unit based teams (UBTs). Ensures the UBTs continuously focus on identifying & implementing ways to meet/exceed quality, safety, & srv targets & implement Reg’l initiatives. Supports the development, implementation, & sustainability of standard workflows for support staff & clinicians. Monitors & controls expenditures, overtime, & staffing levels
- Master's degree in nursing, business or related field
- Ability to lead and implement change management and process improvement activities
14
RN Home Visit Nurse Resume Examples & Samples
- Ability to travel to patient homes within Fresno / Clovis areas
- 1+ years of labor and delivery
- Obstetrical nursing experience (high risk perinatal, antepartum highly preferred)
15
RN Nurse Case Mgr Resume Examples & Samples
- Current, unrestricted RN license in the state of WA required
- Computer skills: MS Office - Word, Outlook, Excel
- Experience working in the community preferred
- Managed care experience is preferred
16
RN Habilitation Nurse Resume Examples & Samples
- Assessing health needs and completing a nursing assessment of individuals with developmental disabilities in State Operated Group Homes
- Notes orders, completes reports for medical and team meetings
- Providing ongoing training for Direct Support staff
- Knowledge of nursing theories, practices and processes
- Nursing assessment
- The ideal/preferred candidate will possess at least one (1) year experience in providing professional hands-on nursing services to individuals with developmental disabilities; and at least one (1) year of experience in professional community nursing
17
RN, Nurse Informaticist Resume Examples & Samples
- Leadership: Partners w/ the Dir of Clinical Informatics to provide strategic representation of the Informatics Dept w/in hospital leadership committees & task forces. Mentors & develops colleagues in leadership & technical skills. Participates in the recruitment of staff. Supports the work of the KPHC Application Teams. Demonstrates leadership practices, which influence others so that the mission, vision, goals, & objectives of the various clinical teams & the KPHC teams are achieved. Utilizes systems thinking & role modeling so that demonstrated expertise is available to colleagues. Provide systems thinking expertise in facilitating review of KPHC changes & downstream impacts. Plays a key role in helping to establish & maintain professional clinical relationships w/in the hospital system & ensure credibility among stakeholders. Serves as a role-model for KPHC to clinical staff & Mrgs (nursing, ancillary Depts, physicians, support staff, case Mgmt, etc.), which will include working directly w/ customers to solicit feedback from a variety of venues: presentations, training sessions, small groups, & demonstrations of system software
- Change Leader / Educator: Conducts educational in-srvs, collaborates w/ members of the health care team & to provide education as needed. Participates in centralized nursing education & education of other clinicians as needed. Represents professional nursing practice to assure that designed workflows are appropriate & will effectively manage system-wide cross-functional teams to support collaboration & encourage acceptance of & enthusiasm for changes associated w/ implementation & optimization of the Epic system. Recognizes the impact of change & strategically plans communication & education & functions as a clinical expert to assure clinical adoption across the system. Coordinates the subject matter experts to test complex system changes or system integration issues , direct training materials content, anticipate workflow impact & solutions
- Documentation Process Mgmt: Understands the technical capabilities of our current systems to facilitate clinical process redesign & continued improvement. Guides the creation of processes, w/in the system capabilities, to collect record & share patient info, reduce redundancy, & standardize clinical practice & documentation. Maintains current understanding of regulatory compliance & actively participates in improving processes reviewed by accrediting organizations. Collaborates closely w/ other KPHC module areas to form an integrated approach in establishing a process for managing the complex documentation tools in the KPHC environment. To sustain efficient current & future functionality, provide leadership & direction for operational stakeholders & info for new version upgrades, system integration issues, optimization of current functionality, & incorporation of new modules in the KP HealthConnect business & clinical systems
- Minimum two (2) years of clinical RN experience
- Minimum six (6) months of employment, attains certification in specialty areas
- Experience implementing an electronic medical record, preferably Epic
- Minimum three (3) years of experience using at least one (1) of the Epic suite of application products or completion of Epic certification in an application(s), preferred
- Minimum five (5) years of experience at Kaiser Permanente, preferred
- Demonstrated experience leading a large multidisciplinary project to successful completion, preferred
- Demonstrated experience with office software, e.g., Power Point, Excel, Word and/or MS Project, Visio, preferred
- Direct experience implementing business information systems in the Northwest region, preferred
- Nursing Informatics certification or degree
- Knowledge of functional areas and/or systems analysis, preferred
- Knowledge of research and analyses/design, preferred
- Demonstrated skills in conflict resolution, preferred
- Public speaking skills, preferred
18
Nurse Epsdt / MCH Coordinator RN Resume Examples & Samples
- Receiving the orders from the Primary Care Physician who is documenting referrals and follow-through that need to be completed for EPSDT AIHP Compliance (referral coordination with Behavioral Health, Vision Services, Hearing Services, Dental Services, Immunizations, etc.)
- Conducting medical analysis of the EPSDT reports received from each subcontracted health plan
- Trends the data for any variance within the given quarter, compares health plan to health plan and documents the results in a 12 page Excel spreadsheet
- Conducting audits for District Nurses
- Preparing graphs and data from the EPSDT reports for presentation at the quarterly DDD Medical Management Meetings as directed
- Performing MCH statewide management of all pregnant members as directed by AHCCCS
- Knowledge of Managed Care concepts and general nursing theories and practices
- Knowledge of Early & Periodic Screen Diagnostic & Treatment (EPSDT) and Maternal & Child Health (MCH) programs as governed by AHCCCS
- Knowledge Federal and state laws and agency rules, regulations
- Knowledge of pediatric and maternal health care delivery systems
- Strong analytical and clinical skills and experience with developing, analyzing, and implementing health treatment plans
- Verbal and written communication and interpersonal relationships skills
- Familiar with using computer systems, including Excel spreadsheets and data compilations/graphs
- Ability to organize, prioritize, multi-task and be detail oriented while managing a heavy workload
- A Bachelor's of Science in Nursing (BSN) from an accredited college or university. Two (2) years of experience working as a registered nurse in behavioral health, home care, hospice or long-term care is highly desirable. Knowledge of the current Medicaid and Behavioral Health service delivery system a plus
- Employment is contingent upon completion of a post-offer medical/physical examination and the agency’s ability to reasonably accommodate any restrictions
- Apply for and show proof of receipt of a valid Arizona Fingerprint Clearance Card that meets Level One requirements
19
Regional Nurse Manager, RN Resume Examples & Samples
- The primary role of the regional nurse manager is to provide clinical coordination and direct patient for infusion services for AxelaCare’s patients, coordinating the daily activities of referral, intake, staff / agency assignment and patient management. Additional responsibilities may include patient discharge teaching; on call nursing support; patient visits; nursing agency in - services and other duties as required. Service delivery will occur in patients’ home or alternate site per patients’ request
- Infuse medications on a regular basis in patients’ home including monitoring and tracking vital signs, performing procedures such as IV placement, phlebotomy and medication administration via peripheral infusion device or PICC line, implantable port or central venous catheters and as ordered by a licensed physician or licensed practitioner
- Function as clinical educator and resource
- Active, unrestricted RN license in the state of Arizona
- 3+ years of experience in home health with proficiency in infusion therapy
- 2+ years of experience supervising or managing a team within the preceding 5 years
- Direct knowledge and experience administering Title - 22
- Reliable vehicle, current and unrestricted driver's license and proof of auto insurance
- CRNI, critical care certification or ER certification
- ER / ICU experience is desirable
- Knowledge or experience in HIPAA, OSHA, The Joint Commission or other accrediting bodies
20
Nurse Director of Behavioral Health RN Resume Examples & Samples
- Current RN licensure in the State of Florida from an accredited school of nursing, BSN, MSN preferred
- CPI Training (w/in 90 days of hire)
- Level 2 fingerprinting
- Minimum of five years of clinical management experience, preferred
21
Rn-nurse Concierge Resume Examples & Samples
- Associate in Nursing is required; BSN highly preferred
- At least two years RN experience
- Must be self-motivated and self-starter
- Must have strong clinical skills in patient assessment, care planning and patient education
22
RN Nurse UM / CM Resume Examples & Samples
- Current, unrestricted RN license in the state of VA required
- Medicaid/managed care and case management experience is preferred
- Must have excellent oral and written communication skills
23
RN Regisered Nurse Behavioral Health Resume Examples & Samples
- Current American Heart Association Basic Life Support Card on hire
- Must maintain current competencies and certifications required by the department
- Current licensure as a Registered Nurse in the State of California and appropriate nursing/practice/experience
- 2 years RN experience in a Mental Health Unit is required
24
Wound Care / ET Nurse Wocn RN Resume Examples & Samples
- Nurse Licensure Compact (NLC) documents the following: The mutual recognition model of nurse licensure allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state’s practice law and regulation. Nurses must legally reside in a NLC state to be eligible to have a multi-state license. See list of Nurse Licensure Compact States
- Graduate of an accredited Baccalaureate School of Nursing
- Minimum of two (2) years experience as a registered nurse in a clinical care setting with one (1) year of home health experience preferred
- Nursing skills as defined by generally accepted nursing standards
- Ability to assess patient status and identify requirements relative to age specific needs
- Must be familiar with general use and functions of the computer, such as, user names and password concepts; internet; e-mail; navigation of computer desktop, including starting programs, using files, and windows, effectively use navigation buttons and tool bars; ability to self-manage online HR services and online training programs
25
Rn Breast Center Nurse Resume Examples & Samples
- Nurse demonstrates competencies in the diagnosis and treatment of cancer, assessment of patient and family educational and emotional needs and the coordination of services
- Collaborates with the medical staff to provide individualized care to their patients
- Responsible for collecting outcome data related to the program and evaluating the effectiveness of the program
26
Santa Barbara RN CCT Nurse Resume Examples & Samples
- Responds to patient care and/or critical care transport unit calls according to program protocols
- Provides high quality routine and emergency nursing care of the patient in the transport environment in accordance with established CCT program policies, protocols, standards of care, standing orders, and under the medical control of the sending physician
- Provides patient care within the Registered Nurse scope of practice as defined by the Board of Registered Nursing and per CCT standardized procedure, utilizing critical thinking skills to manage the critically ill or injured adult or pediatric patient
- Documents all assessment findings, therapeutic interventions performed and patient responses on the CCT Patient Care Record
27
RN Float Nurse Resume Examples & Samples
- Internal and external audits
- Policy and procedure committee
- PTO back up and high case load back up
- Reviewing retro review of cases for inpatient and outpatient
- Assist with many clerical clinical responsibilities
- Assist with UM / QI programs
- 3+ years clinical experience in UM, audits, quality improvement and training of clinical staff
- Ability to communicate complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
- Medicare, Managed Care experience
- Experience in MCG and or Interqual programs
28
RN Habilitation Nurse Resume Examples & Samples
- Assessing health needs and completing a nursing assessment of individuals with developmental disabilities
- Completing quarterly nursing assessments on assigned caseload and completes documentation
- Completing utilization review on caseload and document on-going medical needs
- Attending Individual Service Plan (ISP), Individual Educational Plan (IEP), Discharge Planning meetings
- Assessing nutritional status/needs of member, and makes referral to Dietitian, Primary Care Physician or health plan, as appropriate
- Knowledge of members' condition and medical/physical changing care needs
- Knowledge of nursing assessment
- Skills communicating clearly and concisely in writing and verbally
- Ability to make independent decisions regarding member health problems
29
RN Nurse Case Mgr Senior Specialist Resume Examples & Samples
- Managing the day-to-day operations of the DM team for the Texas line of business
- Oversees caseload assignments/priorities
- Ensuring contracting metrics are met
- Assist with the implementation of workflows; Monitoring processes to ensure adequate acknowledgement, research and resolution to daily encounters for staff development
- Coordinates and completes staff check ins and audits to provide feedback to direct reports
- Monitors staff performance, as directed
- Provides monthly DM metric reporting for use in staff evaluations
- Assists with meeting facilitation
- Attends applicable committees, as assigned
- Keeps current on regulatory and company-wide changes impacting the DM program
- Assists the manager with policy/procedure updates including NCQA, CMS and State of Texas contract revisions
- Communicates with all levels of staff within Health Services, matrix partners; externally with customers, medical providers, vendors
- Demonstrates leadership in sensitivity to culturally diverse situations with staff, matrix partners, clients and customers
- MSN or BSN preferred
- Certification as a case manager
- Five or more years of direct supervision of licensed healthcare staff in a home health or case management or MCO environment
- Exceptional time / project management skills
- Demonstrated strong organizational and leadership skills
- Demonstrates problem-solving and analytical skills
- Ability to operate personal computer, proficient with Microsoft office products
- Demonstrated ability to act as a change agent in a fast pace business environment
- Ability to build solid working relationships with staff, matrix partners, customers and providers
- Demonstrated process improvement experience
- Excellent analytical and organizational skills required
- Excellent oral and written communications skills
- Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments
- Ability to make decisions on what needs to be done based on clearly established guidelines
- Able to work in a dynamic, fast-paced team environment and to promote team concepts
- Excellent presentation skills and ability to communicate in both written and oral formats
30
RN Nurse Case Mgr Senior Specialist Resume Examples & Samples
- Leads, directs, and monitors the delivery of all service coordination functions
- Implements procedures and policies established by Cigna-HealthSpring that enhance the quality of life for people receiving services
- Provides leadership and collaboration with other Health Services Sr. Specialists to assure compliance with local, state and federal regulations, nursing practice standards as well as standard operational structure across the Texas
- Ensures effective and efficient budget management in providing the best utilization of resources
- Provides effective staff management (hiring, development, training, performance feedback, etc.) that assures utilization of personnel to best meet the needs of the people receiving supports and services
- Supports Health Services training that assures the best possible delivery of health related supports and services
- Ensures the completion of accurate service coordination documentation to provide continuity of care and record storage
- At least two years experience in management or administration
- Must have strong computer skills using MS office products including Word, Excel, Power Point, and Outlook
- Excellent verbal, written, communication and presentation skills
- Strong knowledge of the Medicare/Medicaid Managed Care business
- Ability to meet deadlines and manage multiple priorities
- Effectively adapt and respond to complex, fast-paced, changing environment
- Experience managing process workflows
- Home Health Case Management experience with Medicare or Medicaid populations a plus
- Experience managing members with chronic disease processes
- Experience working with community resource organizations
- Experience with care management software applications
31
Rn-prior Authorization Nurse Resume Examples & Samples
- Perform prior authorization process by performing clinical review of requests requiring medical review and entering authorizations into the system
- Provides clear and accurate documentation on rational for approving request or reason for sending to the Medical Director for additional review
- Handle telephone requests timely and accurately
- Develop and update health plan resources and forms to assist staff in their day to day functions. Provide resources and training to prior authorization technicians upon completion
- Assist Case Management and Concurrent Review staff with complex cases
- Assist with the design and updating of PA grids and desktop processes
- Assist in reviewing and making revisions to department policies to assure compliance with regulatory agencies
- Participate in interdepartmental projects as needed
- RN with current License in state of Arizona
- Minimum of three (3) years of experience with hospital/provider office nursing
- Minimum of three (3) years experience in Managed Care
- Previous Prior Authorization experience preferred
- Knowledge of AHCCCS and Medicare regulations
- Knowledge of CRS
- Computer literate (proficient in MS Office, Excel, Word)
- Strong service orientation and professionalism
32
RN, Nurse Phone Triage Resume Examples & Samples
- Other Duties as Assigned: Utilizes current nursing practices to provide patient care while focusing on the needs of the patient and exemplifying service excellence, care, concern, respect and cooperation. As a member of a health care team, functions in the role of patient advocate by being in the position of initial contact for patient-related issues. Additional duties as assigned
- Written Communication and Comprehension:Writes clearly using appropriate grammar, symbols, and medical terminology. Able to decipher and comprehend documentation of others
- Leadership: Appropriately optimistic and inspiring. Influencing others to act on their own behalf or for the broader good of the group
- Age and Cultural Specific Care: Able to adjust treatment, instruction, and education to meet the patient's age and cultural background
33
RN Medicare Set-aside Nurse Resume Examples & Samples
- Uses nursing knowledge to analyze medical records and to identify future medical treatment as documented in the medical records
- Executes clear, concise and thorough medical records abstracts for the purpose of inclusion in a Medicare Set - Aside or Future Medical Cost Projection
- Applies critical - thinking skills and has collegial discussions with claims adjusters, treating physicians or case managers to enhance patient outcome, minimize risk and control costs
- Maintain proper documentation in Client Profiles by updating screens, attaching emails, using the diary system, creating appropriate letter templates ad well as documenting all work done and time spent on case for billing
- Reviews files completed by MSA Specialists to ensure quality standards are met
- Current and unrestricted LPN or RN license
- Nursing Case Management experience
34
Rn-population Health Nurse Resume Examples & Samples
- Experience working with chronic medical conditions such as diabetes, COPD, CVA, CHF, ESRD, etc
- Experience working as a member of a multi-disciplinary team
- 1 year experience in case management, knowledge of health-related information, education, resource and referral services or 5 years general clinical experience
- Must have a working knowledge of current treatments and their physical and psychosocial sequelae
- Knowledge of individual and family development over the life span Knowledge of the influence of cultural and spiritual values on health care
- Basic knowledge of applicable laws and regulations, and accreditation guidelines, e.g. CMS (HCFA) IMQ, EMTALA is required
- General knowledge of available health care and community resources appropriate for populations served
- Knowledge of geriatrics including common health & functional changes in the aged, and various chronic disease processes
- Must have excellent verbal and written communication, interpersonal, problem-solving, conflict resolution, presentation, time management, positive personal influence and negotiation skills
- Must have strong clinical assessment and critical thinking skills necessary to develop a comprehensive plan of care appropriate to patients with complex medical, emotional and social needs
- The demonstrated ability to work constructively with a broad spectrum of health care professionals
- Basic computer skills are required Must be effective both as a team member and leader
35
Health Resource Rn-mercy Nurse Resume Examples & Samples
- Has ability to demonstrate high level of nursing process; including assessment, planning, implementing and evaluating the client's needs
- Has ability to provide client education in physical, emotional and environmental health needs
- Will be required to orient new staff with training to the computer system
- Has ability to work independently with limited supervision using the Nurse triage protocols, the Nurse Practice Act, Mercy Medical Center policies, nursing standards and professional judgment
- On specific occasions will staff booths and displays with call system information to promote community relations or to promote client information
- Completion of training in call system during probationary period
36
Rn-nurse Residency Resume Examples & Samples
- Specially trained preceptors who understand the needs of the graduate nurse
- Mentoring and coaching from nurses and nurse leaders who are experts in their field
- Networking with staff from all disciplines and within Sumner Regional Medical Center
- Transcript demonstrating a minimum GPA of 3.0
- 18+ years of age eligible to work in the USA
- Two letters of reference from clinical faculty members
- Completed essay describing your vision, 5-year goal plan, why you chose nursing, and why you are interested in SRMC's residency program
37
Nurse / Patient Trainer / LVN / PN / RN Resume Examples & Samples
- The demand for Training Services is influenced by many factors outside of the direct control of Alere. Therefore, Alere cannot guarantee that the trainer will receive a guaranteed or minimum number of assignments during any specific period of time
- The patient should be trained only on the meter that has been assigned to them. Comparison of the serial number on the delivery order that on the meter must be completed prior to training the patient. No substitutions can be made without approval from Alere
- Direct experience/exposure to anticoagulation managment or allied health is preferred
38
RN Telehealth Nurse Resume Examples & Samples
- Performs comprehensive telephonic patient assessment, evaluation and advice while meeting production standards
- Follows established clinical protocols/guidelines and provides appropriate patient instructions
- Directs patient to appropriate levels of care based on assessment within HealthCare Partners (HCP) guidelines
- Documents authorizations for vendors and/or outside services as appropriate
- Instructs patients on procedural preparations
- Provides health education to patients and their families
- Documents and maintains records of telephonic interactions
- Completes medical documentation of telephonic assessment and disposition in Telehealth Record
- Notifies pharmacies of new prescriptions and authorizations of refills as ordered by the clinician or via pharmacy protocols
- Acts as a lead nurse as assigned
- Performs representative duties in the absence of a representative (see Patient Support Center Representative job description)
- Initiates and completes a CSR as appropriate
- Completes documentation of end-of-shift report
- Participates in quality monitoring process
- Translates oral information into concise and accurate written documentation using standard medical guidelines and abbreviations
- Manages own work queues
- Recognizes financial, medical and legal risks based on data collected during customer interactions and follows appropriate procedures
- Demonstrates customer service-oriented behavior at all times
- Acts as a mentor as requested by supervisor
- Expedites emergency calls as needed
- Accesses Language Line for non-English patients as needed
- Attends regular staff meetings and seminars as scheduled
- Over 3 years and up to and including 5 years of experience
- 1 year critical care or emergency room experience
- Must pass Patient Support Center screening test
- ACD telephone skills
- Ability to type 25 wpm
- Excellent verbal and written communication skills in standard English
- Telephone etiquette
39
RN Diabetes Nurse Perdiem Fountain Valley Resume Examples & Samples
- Registered Nurse from accredited nursing program
- Certified Diabetes RN
- BSN with Public Health Nurse Certification Preferred
- Certified Pump Trainer/Heart Failure Nurse Certification Preferred
- At least two years experience in a Supervisory capacity in the area Public Health, preferred
40
RN Behavioral Health Nurse Pm-am w Resume Examples & Samples
- LANGUAGE SKILLS
- CERTIFICATES, LICENSES, REGISTRATIONS
- WORK ENVIRONMENT
41
Rn-discharge Nurse Resume Examples & Samples
- Completion of all RN credentialing procedures and requirements
- Experience in discharge planning preferred
- Experience in a Health Care setting with knowledge of community resources preferred
- Good communication and writing skills
- Must have current active license or eligible in good standing
42
Nurse Manager RN Resume Examples & Samples
- Current RN license in state of practice
- One year experience in Medicare in a Nursing home environment preferred
- Must be familiar with current laws, regulations, and guidelines that pertain to long-term care
- Must maintain a high level of professionalism and a cheerful disposition and willingness to handle difficult situations
43
RN Nurse Clinical Consultant Resume Examples & Samples
- Serves as conduit to educate and enable care coordination between stakeholders resulting in an optimal healthcare experience and customer satisfaction
- Provides clinical expertise and strategic consultation for account retention activities and enterprise approved non-standard benefit requests
- May assist with development of customized analyses and illustrations to be used in key stakeholder presentations
- In partnership with the Market and/or National Medical Executive and other key matrix partners, assist with the identification and support of Total Medical Cost (TMC) initiatives that result in trend reduction and overall value to the customer
- Collaborates cross-functionally to promote operational efficiencies and a seamless client experience that may include cultural training, readiness assessments, vendor integrations and clinical audits
- As part of the Cigna Collaborative Care (CCC) clinical management team, works with multiple teams of internal business partners and external constituents, leveraging clinical knowledge and industry perspective to drive CCC program success in quality, affordability and experience of care
- Provides analysis and interpretation, prepares key talking points and presents performance results for Cigna Collaborative Accountable Care groups at the direction of or in lieu of the Market Medical Executive
- Possesses an understanding of local market industry innovations and supports the Market Medical Executive in market specific value-based network initiatives
- Required Bachelor’s degree, Advanced Degree preferred
- Excellent time management, organizational, research, analytical, communication and interpersonal skills with demonstrated ability to build strong relationships and influence diverse teams
- Demonstrates Flexible, Consultative Critical Thinking and Action planning
44
Rn-employee Health Nurse Resume Examples & Samples
- 5-7 years medical/surgical nursing required
- Previous occupational health nursing and workers’ compensation experience preferred
- Experience in Emergency Dept, orthopedic nursing, case management desirable
- Advanced physical assessment and case management skills required
- Knowledge of occupational health, safety, ergonomic and workers’ compensation preferred
- Effective written and oral communication skills: Teaching, counseling and participation in presentations required
- Organization skills and ability to set priorities is essential
- Demonstrates flexibility to reprioritize activities due to constant interruptions
- Must be able to work alone, without other medical resources immediately available
- Knowledge of OSHA law, FMLA, and ADA preferred
- Computer skills helpful (i.e. use of database, word processor)
45
RN Admissions Nurse Resume Examples & Samples
- Must possess a nursing diploma (associate's or bachelor's degree in nursing)
- Must be currently licensed/registered in applicable State. Must maintain an active Registered Nurse (RN) license in good standing throughout employment
- Must be able to provide hands-on assessment care to patients during the admissions process
- Must be able to effectively communicate assessment findings with physician
- Must be able to knowledgeable and competently deliver quality nursing care to patients
- Must be able to evaluate patients' needs assessment and initiate care plans upon patient admission and readmission
- Must be able to accurately receive, document, and transcribe physician orders
- Must be able to communicate orders to others timely to ensure timely receipt of medications and order implementation
46
RN Nurse Case Mgr-pine St., NY Resume Examples & Samples
- Current, unrestricted RN license in the state of NY required
- Certification as a Case Manager (CCM) is preferred
- Medicaid/managed care, home health and case management experience is preferred
47
RN Pre-op Holding Nurse Resume Examples & Samples
- Provides assessment, planning, intervention and evaluation activities for patients receiving OR treatment regimens. Incorporating current clinical knowledge with established nursing practice, he/she performs nursing interventions utilizing the nursing process, while working with adolescent, adult and geriatric patients
- The Pre-Op Holding Nurse continuously evaluates the patient's response to nursing interventions and modifies the nursing care plan to address the needs of the pediatric, adolescent, adult and geriatric patient
- Collaborates with other disciplines to revise the patient care plan according to the changing needs of the patient and taking into account age related factors for the pediatric, adolescent, adult and geriatric patient
- Contributes to performance appraisal by providing data in the assessment of clinical performance
- Participates in the evaluation of models of patient care and procedure cards
- Participates in the identification of unsafe patient care practices and assumes responsibility for intervention
48
RN Infection Prevention & Control Nurse Resume Examples & Samples
- Collaborates in the integration of regulatory requirements, accreditation standards, guidelines, and current infection prevention and control practice into policies and procedures
- Provides expertise and consultation to administration, committees, managers and staff on issues regarding infection prevention and control, communicable diseases and epidemiology
- Shares findings, recommendations, and policies of the Infection Prevention and Control program with appropriate individuals
- Participates in professional organizations, e.g., American Journal of Infection Control (APIC) and/or Society for Healthcare Epidemiology of America (SHEA)
- Serves as an educational resource for all employees on infection prevention and control and epidemiology, providing expert knowledge and guidance
- Assists all services to integrate applicable infection prevention and control principles into their ongoing educational programs including orientation of all new employees
- Evaluates compliance with the Joint Commission and OSHA standards where applicable
- Incorporates evidenced based research finding into clinical practice especially as it relates to SPH
- Supports the Association for Practitioner's in Infection Prevention and Control and Epidemiology code of ethics and the medical center policy on Medical Ethics
- Serves as a liaison to Public Health officials regarding communicable diseases and other epidemiological significant findings
- Communicates with Center for Disease Control (CDC) staff regarding participation in the National Nosocomial Infection Study
- The IC&P Nurse incorporates the principles of fiscal responsibility when evaluating equipment and supplies related to infection prevention and control practice
- Travel to Sepulveda Campus, Northern and/or Southern clinics as needed
49
Nurse Charge RN Resume Examples & Samples
- Must hold and maintain a current license to practice as a Registered Nurse (RN) in practicing state
- Must hold and maintain a current CPR certification. Licensed nursing staff are required to obtain their CPR certification within 90 days of hire
- Demonstrate understanding that state and Federal rules and regulations govern the practices within the facility
- Demonstrate working knowledge of infection control principles and practices
50
RN Nurse Field Case Manager Resume Examples & Samples
- Collaborates with the member/family, physician, and health care providers/suppliers to discuss and prioritize the plan of care and prescribed treatment plan in accordance with evidenced based medicine and identified long and short term goals
- As the members risk level improves provides a current plan of care and reviews it with an LVN on the team to transition the member for less frequent outreach also providing the LVN with signs and symptoms to watch for that would indicate escalation of condition that would require physician intervention
- Acts as a preceptor for new employees as assigned
- Represents the team as a subject matter expert in process improvement teams as assigned
51
Nurse Manager, RN Resume Examples & Samples
- Participates in nursing and organizational policy formulation and decision-making
- Master's required
- Certification in nursing administration and/or certification in a clinical specialty desired
- Five years clinical experience required; 3-5 of pediatric NICU experience required
- Management experience preferred
- Demonstrates a commitment to leading in adherence with the principles of the American Nurses Credentialing Center’s Magnet model, exemplifying the transformational nursing leadership component of this model
- Experience with LEAN methodology (or similar) for continuous improvement; well-developed change management skills
52
Nurse Manager, RN Resume Examples & Samples
- Assumes responsibility for staffing and scheduling personnel. Assignments reflect appropriate utilization of personnel
- Fosters peer review
- Accepts feedback
- Takes calculated risks
- Takes direction
- Recognizes the importance of process
- Willingness to accept change
- Knowledgeable regarding hospital services
- Provides statistical evidence of quality
- Uses effective written and verbal communication
- Demonstrates competent management, problem-solving and leadership skills
- Answers customers’ questions
- Gives feedback
- Identifies customers
- Interviews
- Manages resources prudently
- Motivates group
- Responsible for staff
- Schedules time efficiently
- Sets priorities
- Active registered nurse licensure for Pennsylvania
- Current AHA Healthcare Provider (HCP) Certification required
53
Nurse Manager, RN, BSN Resume Examples & Samples
- Participates in nursing and organizational policy formulation and decision making
- Five years clinical experience required, preferably at least one year in pediatrics
- Knowledge of professional nursing theory and practice; knowledge of management theory and change process
- Active registered nurse licensure for appropriate state (based upon location of practice site) required. Certification in nursing administration and/or certification in a clinical specialty desired
- Current AHA Health Care Provider (HCP) Certification required
54
Rn-prior Auth Nurse Resume Examples & Samples
- Receive, review and verify prior authorization requests
- Responsible for all prior authorization phone lines
- Utilize Milliman USA Guidelines for prior authorization requests and length of stays
- Reviews prior authorization requests with Medical Director and other team members as needed and appropriate
- Collaborates with attending physician as necessary to obtain clinical information to assist in the prior auth request determination
- Recommends, coordinates and educates providers and their offices on the need for complete patient information to make determination
- Ensures the hospital, provider or facility have the appropriate in network vendor as needed by referring to the correct customer service number for the company group
- Responsible for timely and accurate documentation in the computer system
- Documentation will be compliant with established standards with established standards which are monitored through Inter-rater reliability audits
- Responsible to document ICD-9 and CPT coding and levels of care to reflect care and services provided for claim adjudication
- Works closely with P5 PA screeners
- Identifies and communicates to HRCM team all potential catastrophic and high risk cases for case management referrals
- Committed to ALOS, bedday reductions and other departmental targets
- Successfully achieves 90% on all inter-rater reliability testing
- Participates in internal audit reporting as necessary
- Active participation in team meetings
- Assists in the development of policies and procedures
- Maintains a courteous, professional attitude when working with facility staff, providers and their staff, the health plan and co-workers. Provides excellent customer service to internal and external customers
- The PA nurse reports to the Manager of Medical Services. The LPN works under the direction of an RN
- Performs other duties as requested by Manager of Medical Services
- One to two years experience in utilization review, high risk management, concurrent review, quality assurance, discharge planning or other cost management programs preferred
- Experience using Milliman Guidelines or other hospital criteria preferred
- Two years experience in direct patient care required and working knowledge of utilization management/case management preferred
55
RN Annual Wellness Nurse Resume Examples & Samples
- Develop, implement, and evaluate clinical practice guidelines/care paths for patients
- Collaborate with all of the health care team, to assist in the provision of quality patient care, and facilitate the identification of potential care problems
- Assist as a liaison with patients and their families to physicians, staff, and other health care professionals, to coordinate patient care across all settings, and ensure high quality outcomes
- Welcome calls from patients and families, answering questions concerning care, and follow-up as necessary
- Proactively act as a patient advocate, working to overcome patient barriers, and resolve concerns
- Provide educational information and resources to patients, to assist patients and family with coping, and foster self-care activities
- Review literature, methodology, outcomes, and implications of nursing/medical research, and disseminate findings
- Establish and maintain a knowledge base of on-going clinical research activities
56
RN Registgered Nurse Special Procedures Days Resume Examples & Samples
- Minimum 2 years of nursing experience in Special Procedures/Interventional Radiology, Cardiac Cath Lab or ICU required
- Charge Nurse/Supervisory experience preferred
- Current American Heart Association Basic Life Support card. (BLS)
- Current American Heart Association Advanced Cardiac Life Support Certification (ACLS)
57
Rn-clinical Data & Audit Nurse Resume Examples & Samples
- Leads various data analyses to examine and define potential clinically related issues and track productivity and quality measures. Identifies, evaluates, recommends and documents clinical business needs and objectives, operational processes and procedures, problems and requirements
- Reviews, analyzes, and interprets data for compliance, and related reporting for clinical service teams
- Reviews plan utilization metrics, researches and prepares reports to provide insight to utilization patterns and recommendations for improvement
- Produces documentation, including project plans, trend analysis, analytical reports, decision backup, information research reports, training plans, business justifications, graphics, workflow and business process models
- Maintains a repository of performance and audit metrics, and generates management reports illustrating statistical data, text, workflows, and graphics
- Prepares for and manages annual plan specific audits including identifying potential correction requests
- Assists Manager with development and implementation of the correction plans identified with each audit
- Prepares annual, monthly and ad hoc reports and requests for data using ICE approved forms and plan specific formatting
- Supports Clinical Supervisors in tracking of monthly Care Manager audit results
- Works with analytics, data analyst and UM leads to develop reports using accurate data extraction in Tapestry and other systems as appropriate
- Will be the point of contact for plan representatives. Works collaboratively with physicians, staff and other affiliated providers to assure continuity and appropriateness of care. Works with other departments to identify and document business requirements, workflow, policies and procedures
- May also be assigned lower level management functions and back up supervisors on clinical team
- At least one 1 year recent experience in clinical setting such as a comprehensive case management, chronic disease management, utilization management, or population health
- Exceptions considered for Masters in Case Management completion
- Previous experience working for a Health Plan, medical group, IPA or patient-centered medical home strongly preferred
- Must have recall of clinical knowledge and critical thinking ability
- Ability to manage multiple projects and priorities
- EMR experience- EPIC preferred
- CCM or ACM preferred
58
Per Diem-rn Field Nurse Resume Examples & Samples
- Conducts in-person and hands-on assessments and re-assessments of applicants and enrollees
- Completes internal and external documents and information for data submissions to local Departments of Social Service (LDSS) and the Department of Health (DOH) prior to established dates due; creates and modifies plans of care that include authorized services, need based non-covered services, family, and caregiver support to meet identified treatment goals within specified timeframes
- Communicate with patients, family, and medical personnel to facilitate a desired outcome
- Collaborate with providers to ensure appropriate outcomes
- Practice and adhere to departmental and State guidelines and clinical standards of care
- Manage electronic patient files to document patient records, treatments, and progress
- Attend educational workshops; review professional publications to keep updated on industry trends; establish personal networks and participate in professional societies to maintain professional and technical knowledge
- Active NY RN License
- Bachelor’s Degree Preferred
- Current, Active Drivers License: Required
- Clinical Experience: 1- 3 years MLTC Home Care experience, preferred
59
Rn-nurse Clinical Coordinator Resume Examples & Samples
- Performing nursing facility assessments
- Identifying strategies and interventions to prevent future rehospitalization on targeted population
- Identifying and/or presents resources required to diagnosis and/or treat in place
- Assuming after hours call coverage on a rotational basis
- Providing ongoing care coordination coaching and support to facility staff
- Participating in periodic meetings with lead supervisor, project medical director, and project management team
- Participating in ongoing training and education around a standardized set of interventions
60
RN Nurse Ltss Medical Mgmt, Pine St., NY Resume Examples & Samples
- Telephonic case management experience preferred
- Authorization experience preferred
- Knowledge of Medicaid/managed care and/or LTSS preferred
- Computer skills: MS Word, Excel, Outlook
- Other technical skills: FACETS, Care Compass, Maccess a plus
61
RN Field Nurse Resume Examples & Samples
- Performs nursing assessments and develops, implements and evaluates plans of care in conjunction with the physician, patient and caregivers per agency policy and procedure
- Evaluates the effectiveness of the plan of care, the patient’s response to care and outcomes of care and revises the plan of care as needed
- Re-evaluates patient nursing needs to include on-going assessments using the OASIS data set at appropriate time points
- Provides skilled nursing services that require substantial and specialized nursing care including medication administration, wound care, therapeutic treatments, and skilled teaching as ordered and indicated
- Plans and implements patient health teaching and health counseling regarding the disease process(es), self-care techniques and prevention and involves the patient’s significant others in accomplishing health goals while promoting patient / family independence
- Participates in health promotion and disease prevention activities
- Initiates appropriate preventive and rehabilitative nursing procedures following the physician’s plan of care
- Coordinates services and scheduling with the Clinical Team Manager (CTM) and Clinical Team Coordinator (CTC) to include recommendations for additional home health care services for patients to within 24 hours of Start of Care (SOC)
- Assesses the patient's condition during every home health care visit; insures assessments are communicated to the Clinical Team Manager on a daily basis; nursing interventions are implemented to meet patient needs and changed conditions
- Performs care management duties on patients as assigned including: notifying the physician of changes in the patient’s condition or progress toward goals, obtaining needed physicians orders, reassessing the patient for recertification, supervision of LVNs and home health aides, attending and documenting case conferences, coordination of care by reporting of significant findings to others on the healthcare team, and planning for, notification of and documenting the discharge of the patient
- Recognizes and reports life threatening situations and responds appropriately
- Obtains and documents physician orders accurately and in a timely manner
- Implements patient care per physician's orders and Homecare Dimensions, Inc. policy and procedures. Monitors patient care for compliance with defined patient Plans of Treatment
- Documents patient interventions that reflect delivery of safe and high-quality home health care on a skilled nursing note written during the patient encounter. Turns in all documentation within 48 hours of the visit / shift (visits / shifts performed on Thursday, Friday or Saturday are due on Monday)
- Documents all communications with the patient, family, physician, CTM, pharmacy, other disciplines, and appropriate others as indicated on communication notes
- Gives accurate information to patients, patient families and home health care staff members regarding cost for home health care services. Provides information regarding equipment and supply needs to the CTM in a timely manner. Utilizes equipment and supplies effectively and efficiently
- Demonstrates knowledge and observance of the Patient's Bill of Rights
- Follows all infection control, standard precautions, and safety guidelines / standards per agency policy
- Prepares a written plan for the Home Health Aide to follow, if applicable
- Current licensure as a Registered Nurse in good standing with the Board of Nurse Examiners for the State of Texas
- One (1) to two (2) years’ experience as a registered nurse
- Ability to define problems, collect data, establish facts, and draw valid conclusions
- Ability to interpret an extensive variety of technical, medical, and regulatory instruction and deal with numerous contemporaneous issues and problems involving delivery of patient care
- Maintains certification in Basic Cardiac Life Support Course C. Familiarity with medical terminology and equipment. Additional education and / or experience may be required by individual state regulations
- Basic knowledge of governmental regulations, Medicare (Medicaid, as required), regulations, and company policies and procedures are required. Good organization, communication, human relations skills, and reliable transportation are required. Self-motivation, assertiveness and independent decision-making skills are essential
- Excellent computer skills and knowledge of word processing and excel highly desirable
62
RN On Call Nurse Resume Examples & Samples
- Provides hospice nursing care based on systematic assessment docusing on pain control and symptom management
- Initiates communication with attending physicians, other hospice staff members and other agencies as needed to coordinate care and use of resources for the patient/family
- Maintains regular communication with direct supervisor to review assignments
- Maintains up to date documentation at point of service so that problems, plans, actions and goals are accurately and clearly stated and charges are reflected as they occur in accordance with agency policy and Medicare regulation
- Administers medication in accordance with all federal and state laws and the policies of the Hospice along with LTC staff
- Maintains current patient records and documents in accordance with the policies of Ascend Hospice to ensure that problems, intervention, goals and outcomes are accurately and clearly states and charges are reflected as they occur
- Assess and collaborates with Medical Director to determine initial and on going eligibility of the hospice patient
- Can anticipate end stage disease process and related pain and symptom management
- Regularly re-evaluates patient's nursing needs
- Uses assessment data to determine care plan needs
- Initiates appropriate preventive and palliative nursing procedures
- Counsels the patient and family in meeting end of life needs
- Performs a comprehensive death note when appropriate
- Communicates with the physician regarding the patient's needs and reports any changes in the patient's condition
- Communicates with other members of the IDT to coordinate the care plan
- Participates in On-call duties as defined by the on-call policy
- Ensures that arrangements for equipment and other necessary items and services are needed
- Must have a State Certified RN license
- Experience in either Hospice or home health care, REQUIRED
- Must have excellent documentation skills and the ability to work independently
- Valid driver's license & reliable transportation
- Must be available to travel locally within assigned territory
63
Rn-fms Trvl Nurse Resume Examples & Samples
- Graduated from an accredited school of professional nursing
- Annual Physical
- Two professional references from current / former supervisors
- The RN must be able to demonstrate the knowledge and skills necessary to provide care appropriate to patients of all age groups. Must demonstrate knowledge of the principals of growth and development through the life span, possess the ability to assess data reflective of the patient’s status, and interpret the appropriate information needed to identify each patients needs in relation to age
64
RN Phone Nurse Medical Oncology Clinic Resume Examples & Samples
- Provides medical information for all 3rd party payors (Commercial Insurance, Medicaid)
- Develops and maintains knowledge base of pharmaceutical companies policies and procedures, third party payer requirements, and any changes that impact the approval process; maintains current knowledge of all federal and state regulatory mandates and requirements including but not limited to Insurance regulation and requirements, Medicare, Medicaid
- Successfully completes annual competency test and any additional competency testing required to validate required skills
- Performs retroactive reviews when necessary to verify medical necessity of ordered medication
- Communicates findings of reviews verbally or in writing through designated channels in a timely manner
- Acts as resource to provide information /education to UAMS staff on prior authorization review issues
- Participates in and contributes to departmental, hospital, and community in-service and continuing education programs
- Stays current in trends in the industry by referencing of professional literature or publications, including Web-based information
- Maintains current knowledge of JCAHO guidelines
65
Rn-new Grad / Nurse Residency Resume Examples & Samples
- *$5,000 sign on bonus
- In order for the application process to be considered complete, you are required to submit the following documents
- Application of Employment: Click on the link at the bottom of the page to apply
- College transcripts (will accept unofficial). Please send transcripts to 611 West Park Street, Urbana, IL 61801 ATTN: Human Resources, New Graduate RN
- Two instructor references -use the link, RN New Grad Instructor Reference, to submit a request to your instructors
- Applicants will be considered for positions relevant to the open positions available
- Some restrictions may apply – Please contact Carle Human Resources directly for questions
66
DEM Clinic RN Nurse Resume Examples & Samples
- Bachelors in Nursing Required
- 3 + years of clinical experience in Medical Oncology
- Chemo Certified (preferred)
- Internal transfer in job code 9020, 9013, or 9014
- Certified Diabetic Educator Preferred (CDE)
67
Nurse Resident RN Resume Examples & Samples
- 0 - 1 year experience
- Registered Nurses embody the vision, mission, and philosophy of Moffitt Nursing and are committed to and accountable for personalized patient and family centered care and the concepts of Duffy's quality caring model/caring factors. These frameworks of care include: collaboration and mutual problem solving, dignity and human respect, encouraging manner, attentive reassurance, appreciation of unique meaning, healing environment, basic human needs, information sharing, caring for self, and affiliation needs
- New-graduate nurses will initiate professional nursing practice careers in a supportive environment committed to mentoring, coaching and learning
- Build confidence through a structured, professional transition-into-practice experience that is customized to individual developmental needs
- Develop leadership skills that will positively impact the clinical practice environment and patient outcomes
- Create and enhance professional networks and relationships with peers during the residency, while honing and developing clinical and leadership skills in a world-class academic medical institution
- Scheduled eight-hour paid education days off the unit are offered for residents to participate in required class activities
- The entire residency program length is 12 months with the inclusion of the unit specific orientation that is either 12 or 16 weeks in length depending on the unit
- The Residency program also includes informal, one-on-one meetings at scheduled intervals throughout the program to provide additional support and to monitor the newly licensed nurse's progress
- Residents will also participate in evaluation of their own individual progress as well as evaluation of the overall program
- All Nurse Residents will be required to sign a Commitment Agreement, agreeing to work for a minimum of two (2) years in the Cancer Center as a Registered Nurse in good working standards complying with all polices and protocols of the Cancer Center. In the event the employee does not successfully complete the Nurse Residency Program or thereafter the commitment of two (2) full years of employment in the Cancer Center after completion of the program, employee agrees to refund the Cancer Center a pro-rated amount of the cost for the program. Additional details will be provided with an offer
- Florida RN License required
68
Nurse Advice RN Resume Examples & Samples
- Answer telephone inquiries regarding caller and/or patient needs
- Conduct and complete nursing assessment from which primary and secondary symptoms are derived
- Document all communications for medico-legal and statistical purposes by performing data entry at the time of inquiry
- Record significant health, allergy and medication history and functional capabilities
- Offer health care options following established guidelines
- Recommend preventive health promotions/services available
- Referral to primary providers, health care facilities and community resources
- Maintain confidentiality of all communications
- Understand the requirements for appropriate triaging of calls, assessing needs and providing appropriate health care options including facilitating referral to primary providers, health care facilities, and community resources
- Provide care management which includes, but is not limited to the following
- Health care advice per established guidelines and protocol
- Medical and pharmaceutical information
- Identify health risks and wellness opportunities
- Assist in the referral and investigation of quality and risk management issues. Demonstrate understanding of patient rights/confidentiality and legal and ethical issues pertaining to them
- Assist in the development of protocols
- Assist in identification of learning needs regarding the ability of the nurse advice line to assist in other areas of the multidisciplinary staff on the health care team and participate in development and implementation of inservices and resource materials to promote education
- Cross-reference calls to community resources, health class and/or physician referral, as appropriate
- Conduct outbound calls, as requested
- Previous case management or acute care experience in a healthcare setting required
- Requires 2-5 years acute or ambulatory nursing experience
- Ability to access and evaluate community resources to meet patient’s needs
- Knowledge of physical and psychological characteristics of illness and medical terminology
- Knowledge of age related developmental stages and needs
- Ability to work collaboratively on a team
- Ability to work independently and make decisions
- Ability to work effectively under pressure due to changing priorities, interruptions, high and low census, payor demands and discharge planning demands
- Ability to demonstrate leadership skills in facilitating constructive change
- Two (2) + years of case management or acute care experience in a healthcare setting highly desirable
- Seven (7) years acute or ambulatory nursing experience
69
RN, Care Transition Nurse Resume Examples & Samples
- A minimum of 5 years in clinical practice for population to be served is required
- Case Management/Resource Management and discharge planning experience preferred
- Milliman (MCG) Guideline and Interqual criteria experience highly preferred
70
RN Nurse Appeals Resume Examples & Samples
- Current active unrestricted RN license to practice nursing within the scope of licensure in applicable state(s) or territory of the United States required
- AS/BS in Nursing preferred
- Prefer experience with Facets, Macess, Medisys, WMDS, ECC, and/or FileNet
- Prefer experience researching Medicare clinical guidelines: NCD, LCD, Medicare Benefit Policy
71
RN Nurse Residency Resume Examples & Samples
- Implements and monitors patient care plans. Monitors, records and communicates patient condition as appropriate
- Assesses the physical and psychological status of patients, provides interventions/treatments and evaluates effectiveness of care to achieve desired patient outcomes
- Evaluates learning needs of patient and family and provides age-specific and culturally appropriate education. All other duties as assigned
- Minimum of six months comparable acute care experience required
72
RN / Nurse Resume Examples & Samples
- Specialized experience in a Long Term Care Unit
- Ability to lead peers through training, mentoring and development
- Nursing experience as a Registered Nurse in a long term care setting
- Experience working with Electronic Health Records
- Ability to effectively treat long term care residents
- Ability to maintain required licensure/credentials
- Knowledge of the nursing process to provide care for medical and psychiatric resident needs
- Customer/Personal Service - knowledge of principles and processes for providing customer and personal services, this includes needs assessment
- Judgment, Decision Making, and Problem Sensitivity - the ability to tell when something is wrong or is likely to go wrong; to include not only solving the problem, but recognizing there is a problem
- Organization Skills
- Documentation/Recording Information - entering, transcribing, recording, storing, or maintaining information in written or electronic form
- A strong work ethic based on a foundation of: self-motivation, loyalty, honesty, and integrity
- Must be able to work a flexible schedule, day, evening, graveyard (night) shifts, weekends, and holidays and back-to-back shift and double shifts as needed. Rotation of 24-hour call for facility needs
- Must be accessible to immediate telephone communication
- Ability to work with staff and residents of diversity to include social, economic, ethnic, and religious backgrounds in a long term care setting
- Must be able to follow prescribed policies and procedures even if they may conflict with "personal" preferences
- Work in a facility with locked and unlocked environments
73
RN / Nurse Resume Examples & Samples
- Experience in long term care or assisted living facility
- Experience with staff development
- Skill in initiating, performing and completing assigned duties in providing care to residents
- Skill in preparing and administering prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) performs treatments according to established policies/procedures
- Knowledge and ability to appropriately carry out assigned resident care based on the residents' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant resident information
- Knowledge and ability to recognize urgent or emergent resident care situations, seek assistance of the RN and/or MD/DON, and initiate appropriate emergency interventions as directed
- Ability to observe, identify and respond to the resident's needs for care, including medication, equipment-assisted care and patient/family education
- Superior verbal, listening and written communication skills with all health care providers, residents, families and general public
- Demonstrated ability to display professional conduct at all times when dealing with fellow staff members, patients, families and the general public
- Demonstrated ability to maintain confidentiality at all times
- Long-term care/nursing home experience is highly desirable
- Knowledge of professional nursing theory and practice
- Knowledge of the State Nurse Practice Act, Federal, state and VA codes related to nursing homes, Medicare reimbursement and case mix index, geriatric treatment and care issues, current and emerging nursing care treatments
- Knowledge of quality standards, procedures, and protocols
- Knowledge of specialized client care applicable to the work situation
- Effective problem solving skills
- Ability to effectively work with an elderly patient population of varying physical, mental and emotional abilities and staff from multiple work units in the facility to achieve quality care planning and delivery
