Angela C. Moreno-Cruz
Hialeah
Summary
Compassionate and patient-centered Registered Nurse with twenty years of experience in maternity, pediatric, critical care, and educator. Proven record of delivering excellent patient care, routinely earning high satisfaction scores. Childbirth Education and Registered nurse with strong leadership and problem-solving skills, seeking to contribute to a fast-paced environment.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Registered Nurse Case Manager
Jackson Memorial Hospital
05.2022 - Current
- Administered medications and treatments as prescribed by physicians.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Educated and supported home healthcare providers with training, guidance, mentoring and resources required to achieve objectives.
Nurse Case Manager for CMS / Utilization Review
Centene Sunshine Healthcare
01.2020 - 05.2022
- Optimized resource utilization by identifying opportunities for cost containment without compromising care quality.
- Obtained authorizations from multiple insurance carriers for various levels of care.
- Promoted patient education by providing resources and information on treatment options and healthcare rights.
- Collaborated with physicians to clarify treatment plans, ensuring alignment with evidence-based practices.
- Gathered and recorded patient health information and data to assess, identify and manage characteristics that affect care outcome.
- Observed, monitored, and reported changes in patient condition to supervising RN or physician in accordance with policies and procedures of medical facility.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Case Manager/ Utilization Review
Conifer Health Solutions
01.2016 - 12.2018
- Based out of Tampa FL. Worked remote from home.
- Evaluated the progress of each patient and provided updates to insurance providers.
- Performed utilization reviews in accordance with state and federal regulations.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
- Collaborated with insurance companies to verify coverage, clarify benefits, and facilitate authorization for medical services, reducing delays in patient care delivery.
- Served as a vital liaison between patients, healthcare providers, and insurance companies, fostering effective communication and coordination among all parties involved in the care process.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
Registered Labor & Delivery Nurse, OR Nurse and Childbirth Instructor
Palmetto General Hospital
08.2008 - 12.2016
- Care for antepartum, intrapartum and postpartum patients in Labor & Delivery Unit.
- Perform clinical tasks according to hospital policies.
- Assess patient status and notify physicians of clinical changes. Interact with departments regarding patient care.
- Educate patients/families on health care needs, conditions, options etc.
- Leveraged computerized documentation systems to monitor, record, and communicate patient condition.
- Educated expecting parents in child-birthing and breastfeeding classes once a month at two different Tenet Hospitals.
- Maintained up-to-date knowledge of obstetric advancements and evidence-based practices through ongoing professional education.
- Assisted doctors in monitoring baby and mother health during labor.
Adjunct Clinical and Lecture Instructor
Florida National University
05.2015 - 12.2015
Education
Master of Science - Education
Chamberlain University
Chicago, IL07.2026
Bachelor of Science - Nursing
Chamberlain University
Chicago, IL08.2018
Associate Arts - undefined
Miami Dade College
Miami, Florida12.2010
Associate Science - Registered Nurse
Miami Dade College
Miami, Florida04.2007
Skills
- Skilled in various EMR programs and Microsoft applications
- Discharge planning
- Staff education and training
- Multitasking
- Strong organizational abilities
- Skilled in English and Spanish communication
References
upon requested
Certification
- Licensed Registered Nurse - since 2007
- BLS 2008
- ACLS 2008
- NRP 2009
- S.T.A.B.L.E. 2011
- Advance Fetal Heart Monitoring
- Breastfeeding 2012
- Certification by the from Healthy Start Coalition as Child Birthing Educator in 2009.
Languages
English
Bilingual or Proficient (C2)
Spanish
Bilingual or Proficient (C2)
American Sign Language
Beginner (A1)
Timeline
Registered Nurse Case Manager
Jackson Memorial Hospital
05.2022 - Current
Nurse Case Manager for CMS / Utilization Review
Centene Sunshine Healthcare
01.2020 - 05.2022
Case Manager/ Utilization Review
Conifer Health Solutions
01.2016 - 12.2018
Adjunct Clinical and Lecture Instructor
Florida National University
05.2015 - 12.2015
Registered Labor & Delivery Nurse, OR Nurse and Childbirth Instructor
Palmetto General Hospital
08.2008 - 12.2016
Bachelor of Science - Nursing
Chamberlain University
Associate Arts - undefined
Miami Dade College
Associate Science - Registered Nurse
Miami Dade College
Master of Science - Education
Chamberlain University