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Click here or scroll down to respond to this candidateSandra Roy p.1SANDRA ROY, RNPHONE NUMBER AVAILABLE EMAIL AVAILABLE Howard, SDHighly skilled and dedicated healthcare professional with extensive experience spanning clinical review, utilization management, case management, telephonic care, clinical safety analysis, emergency nursing, pediatric care, and emergency dispatch. Seeking opportunities to utilize skill set in a part-time clinical review position. Demonstrated expertise in conducting comprehensive patient assessments, developing effective care plans, and ensuring optimal patient outcomes. Proven track record of meeting production goals while maintaining the highest quality assurance standards. Adept at collaborating with multidisciplinary teams and staying current with industry regulations and best practices. Knowledgeable in compliance and regulation standards related to nursing practice, ensuring adherence to ethical and legal guidelines in patient care delivery. Effective communicator capable of conveying complex medical information to patients and their families, promoting understanding and compliance with treatment plans, and fostering positive patient outcomes. BLS & ACL certified (2024)TECHNICAL AREAS OF EXPERTISE:Healthcare Administration Communicating Complex Information Clinical Safety Case Management Emergency Nursing Comprehensive Medical Reviews Clinical Educator Documentation & Compliance Crisis Management CASE MANAGEMENT & RELATED EXPERIENCE:Clinical Review & Utilization Review Nurse: eviCORE, Remote 2012-2017 Conducted comprehensive reviews and interpretations of patient records, comparing details against established criteria to assess medical necessity and appropriateness of care. Evaluated effectiveness and quality of care plans by thoroughly examining relevant medical documentation. Decided on approval or referral to physician consultants and processed decisions accordingly. Ensured accurate and timely submission of all relevant documents to appropriate parties. Consistently achieved assigned production targets while maintaining high QA standards. Clinical Review & Utilization Review Nurse: KeyPro, Maitland, FL 2010-2012 Consistently met assigned production goals while upholding high quality assurance standards. Collaborated with healthcare providers to facilitate optimal patient care and resource utilization. Provided detailed and accurate documentation of clinical reviews and decisions. Stayed current with healthcare regulations, guidelines, and best practices to ensure compliance and enhance review processes.Case Manager: CSI (contracted to KeyPro), Maitland, FL 2010 Leveraged extensive clinical experience to develop and communicate comprehensive care plans for Medicare and Medicaid members. Identified and analyzed gaps in treatment plans, providing recommendations for corrective actions to ensure optimal patient outcomes. Demonstrated strong interpersonal skills and empathy in providing support and guidance to members navigating their healthcare journey over the phone.Telephonic Case Manager: United Healthcare OptumHealth, Atlanta, GA 2009-2010 Evaluated members' health status post-discharge, identified gaps and barriers in treatment plans, advised on care plans, and provided patient education to enhance self-care. Informed members about disease processes and promoted healthy lifestyle changes through education and support. Documented all interactions and interventions accurately and in compliance with regulatory requirements. Sandra Roy p.2Clinical Safety Analyst: Medfocus (contract at Abbott Laboratories), Northbrook, IL 2008 Utilized advanced analytical skills to review data from patient adverse events in active oncology phase I, II, and III. Reported adverse events to regulatory authorities, study directors, and clinical research associates, and prepared detailed narratives for the FDA. Verified the accuracy of CRFs, CIOMS, and database information. Updated Excel spreadsheets with subject information and meticulously monitored for emerging trends. RN EXPERIENCE:Duties required strong clinical skills, quick decision-making abilities, and excellent communication and teamwork capabilities and included: assessment and triage, patient education, documentation and compliance, crisis management, coordination of care, and monitoring of vital signs. iRecover USA: Addiction Recovery Nurse 2022Favorite Nurses Temp Agency: Emergency Department Nurse 1992-2019 Lake Forest Hospital: Emergency Department Nurse 2007-2008 Childrens Hospital of Wisconsin: Emergency Department Nurse 2006-2007 Highland Park Hospital: Emergency Department Nurse 2003-2005 Loyola University Medical Center: Emergency Department Nurse 2000-2003 Swedish Covenant Hospital: Emergency Department Nurse 1999-2002 Lutheran General Hospital: Adolescent & Pediatric Unit 1992-1999 Highland Park Hospital: Emergency Department Nurse 2003-2005 ADDITIONAL PROFESSIONAL EXPERIENCE:Childrens Care Corner, Howard, SD September 2019-April 2024 Provided comprehensive care for infants, toddlers, and preschoolers, ensuring safety and well-being. Monitored and supported the physical, emotional, and social development of each child. Created and implemented age-appropriate activities to promote growth and learning. 911 Dispatcher: Miner County, Howard, SD August 2019-December 2023 Dispatched appropriate emergency resources to callers based on nature of the incident. Assessed and identified hazardous road conditions, ensuring timely notification of relevant authorities. Informed livestock owners about animals on the road to prevent accidents and ensure safety. EDUCATION:National Louis University 1999Bachelor of Science in Healthcare Administration (with honors) Wheeling, WV St. Johns School of Nursing 1974Diploma in Nursing Huron, SD |
