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Yyyyyy x. yyyyyy

Highly accomplished RN / BSN eager to apply strong clinical skills, work ethic, and passion for providing superior care


945 East 98th Street Xxxxxx, XXXXXX xxxxxx (xxx-xxx-xxxx


Integral Leader who facilitates the delivery of responsible direct patient care for all ages based on industry and facility standards of practices. Ambitious Self-Starter who offers experience in public health, case management, nurse training, and technology (i.e. HEDIS, CMS, EPIC, QuadraMed). Top Performer who presents a knowledgeable demeanor and maintains calm and composure in high-stress scenarios. Excellent Communicator who builds relationships with healthcare teams, patients, and families, and who applies awareness of current care management trends and statistics to align with objectives.


Career Highlights Include:

  Evaluating care management plans while coordinating internal / external resources at Anthem / Simply Healthcare.

  Recognizing and using opportunities for health counseling with patients, families, and caregivers of Pro-Health.

  Delivering in-service training to the Department of Health & Mental Hygiene s health staff on current health issues, and additionally participating in comprehensive emergency preparedness trainings and / or key activities.

  Actively evaluating data collection for accuracy and compliance to standards within XXXXXXU s Langone Medical Center.

  Continually researching diverse policies and reviewing latest evidence-based practices via CDC, NIH, and WHO.

  Coordinating Influenza Vaccination Campaign for 500+ health and home care clinical and administrative employees for Xxxxxx City Health & Hospital Corporation throughout the 2013 and 2014 flu season.


Education & Professional Development


Bachelor of Science in Nursing (Dean s List 2011 2012) Xxxxxx University

Bachelor of Science in Integrated Information Systems Long Island University


RN (State of Florida License No. RN9433988) RN (State of Xxxxxx License No. 662999)


Basic Life Support (BLS) Certification CPR Certification OSHA / Infection Control Certification

Domestic Violence Certification Medical Error Prevention & Safety Certification HIV / AIDS Certification

IHI Leadership Managing Healthcare Operations Patient Safety Patient & Family Centered Care Quality Improvement


Professional Synopsis


Registered Nurse Case Manager Anthem Simply Healthcare 2016 Present


  • Assess, develop, and coordinate optimal care plans and manage care for members with complex and chronic needs.
  • Ensure member access to services per health needs, along with implementing care plans by leading authorizations / referrals, coordinating internal / external resources, and monitoring and evaluating care management plan effectiveness.
  • Promote membership compliance with Health Effective Data & Information Set (HEDIS) measures (i.e. annual dental visits, Diabetes eye exams, annual flu vaccine, breast cancer screening, COA completed, LDL, colorectal cancer screening).


Registered Nurse Case Manager Pro-Health 2016


  • Strategically steered initial assessment of patients and families to determine home care needs, including providing physical assessments and history of current and previous illness, as well as initiating and / or revising plans for care.
  • Counseled patients and families in meeting nursing and related needs, including providing healthcare instructions to patients per care plans, as well as reassessing patients within 48 hours following change in conditions or discharging.
  • Exhibited sharp analytical abilities toward managing financial resources and eligibility under third-party payer sources.
  • Taught patient, family, or caregiver self-care techniques as appropriate with medication, diet, and other instructions.


Registered Nurse Public Health Nurse Department of Health & Mental Hygiene 2014 2016


  • Identified cases while optimizing student wellness, including engaging in case-finding, referrals, and case management.
  • Complied with Office of School Health communicable disease control procedures while preventing further outbreaks.
  • Create individualized health care plans or interventions in alignment with students health needs, goals, and objectives.
  • Delivered health education programs, and promptly reported suspected physical abuse, sexual abuse, and / or neglect.


Registered Nurse Chart Reviewer Xxxxxx University Langone Medical Center 2013 2014


  • Abstracted patients EMR for cardiac practices from CMS database into EPIC as part of centers system deployment.
  • Expertly deciphered essential medical diagnosis, medical procedures, and diagnostics (i.e. stent placement, pacemaker placement, cardiac catheterization, NST, ECG) while comprehensively reviewing medical records to ensure patients information in EPIC met requirements for Meaningful Use and Health Effective Data & Information Set (HEDIS) measures.


Registered Nurse Administrative Nurse Technology Specialist Xxxxxx City Health & Hospital Corporation 2013


  • Played a vital role in driving healthcare success by participating in training nurses in clinical competencies for community nurses, as well as collaborating in the active development of nurse trainings (i.e. instructor-led, eLearning).
  • Delivered Blackberry technical- and usage-based support in coordination with IT teams for community health nurses.
  • Used QuadraMed patient database to identify data required by clinicians (i.e. lab values, visit notes, hospital course).


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