Experienced nursing professional since 2019 providing quality care to patients in variety of medical settings. Delivers excellent communication and task prioritization skills for effective patient care coordination. Proven ability to stay organized and prioritize tasks in fast-paced environment. Currently holding a Philippine Registred Nurse License, studying Certification IV in Mental Health (through Scholarship ) and Cert III in Fitness. Will further studies and do conversion for AuRn this year. From experience at Next Step Inpatient Withdrawal Unit was able to sharpen ideas and practice in handling patients with variety of Mental Health issues co morbid with AOD use.
• Take calls from providers calling form hospitals, clinics and or pharmacy catering services for pre certification of specialty medications, outpatient procedural services and give them appropriate information to help expedite services.
• reviews clinical documentation to determine the medical necessity of requested services byproviders and members.
• Assists Medical Director in the organizational determination for services that do not meet medical necessity as well as in the assessment as well as preauthorization of service as per the Medical Management Department's policies and procedures
• Authorizes services regarding the authorizations and implementation of approved services through Pre-cert and functions
• Reviews service requests submitted by and its medical necessity.
• Facilitates provider contact as needed to coordinate\ member's care needs.
• Coordinating with facilities, Medical Management staff, providers and members.
• Identifies patient service requirements by establishing personal rapport with potential and actual patients and other persons in a position to understand service requirements.
• Maintains nursing guidelines by writing and updating policies and procedures.
• Maintains nursing operations by initiating, coordinating, and enforcing program, operational, and personnel policies and procedures.
• Assures quality of care by developing and interpreting hospital and nursing division's philosophies and standards of care; enforcing adherence to state board of nursing and state nurse practice act requirements and to other governing agency regulations; measuring health outcomes against standards; making or recommending adjustments.
1. Certification of Completion of HLT33115 - Certificate III in Health Services Assistance (Assisting in Nursing Work in Acute Care)
2. Manual Handling
2. CPR and first Aid
3. Working with Children Certificate
4. Police Clearance
1. Certification of Completion of HLT33115 - Certificate III in Health Services Assistance (Assisting in Nursing Work in Acute Care)
2. Manual Handling
2. CPR and first Aid
3. Working with Children Certificate
4. Police Clearance