MARGARITA KAPLINSKAYA

120B W. Hillsdale Blvd

San Mateo, CA 94403
(650) 219-5806
Relocation to South Florida if possible by Middle of Jully 2010
Objectives: To obtain a LVN / Case Management position
Summary of Qualifications:
Eighteen years of professional nursing experience
Two years experience as Managed Care Case Manager
Four years experience as Assistant Director of Nursing
Four years teaching experience in Medical Assistant (Front/Back Office) and Medi
cal Terminology
Four years experience in developing curriculum and instructions for Medical Assi
stant (Front/Back Office) and Medical Terminology courses
Awarded LVN license, IV Certification with RN pending
Skilled in ventilator, G and J tubes, trach and wound care
Colostomy/Urostomy care, acute rehab care
Good nursing assessment skills
Strong administration and documentation skills
Works in a close team environment
Communicate compassionately with patients and family members
LN,CNA,RNA supervision experience
Efficient self-starter
Excellent computer skills
Bilingual
Professional Experience:
Kindred Healthcare, Inc.
05/2010-Present Hacienda Care Center
Nuring Manager:
Plan and guide the professional development of the nursing staff, monitor and ev
aluate the staff and make recommendations for training or work modification to t
he DON Perform personnel management functions such as establishing personnel qua
lifications, drafting procedure manuals, initiating in-service programs and inst
alling record and reporting systems Act as liaison between nursing units, admiss
ions and the DON; plan and facilitate meetings and committees to handle resident
care issues Perform studies to evaluate effectiveness of nursing services relat
ive to objectives and costs; ensure annual competency evaluations and performanc
e reviews are completed in a timely manner; proactively address survey and/or st
andards of care issues
07/2003 * 04/2010 Tunnell Center of Rehabilitation and Healthcare
ADON:
Improve function of staff by evaluation, counseling, immediate correction and ap
propriate disciplinary action
Assist in orientation of new personnel, monitor their skills
Guide and observe staff who may need assistance with procedures
Promote safety of staff and patients through continuous monitoring for complianc
e with infection control program, policies and procedures
Competent of performing employee evaluations
Competent of performing RAPs
PM Supervisor
Coordinate patient care and admission process,
Improve function of staff by evaluation, counseling, immediate correction and ap
propriate disciplinary action
Managed Care Case Manager:
Review patientâ s chart and meet with patients
Verify authorization, level and exclusions with insurance company
Contact Rehab Department to make sure services provided based on insurance autho
rization and level
Contact insurance company on weekly basis to update patientâ s progress
Inform patient, Business office and Rehab department regarding level changes
Participate in IDT daily meetings
Conduct weekly Managed Care meetings with the participation of CM, nursing, SS,
Rehab department
Notify patient and issue denial letter from the insurance company
Follow Medicare guidelines and Kindred Policy and Procedure regarding management
of HMO patients.
LVN:
Provided day-to-day care for elderly residents
Medication administration, wound care, daily nursing assessment and notes
Managed patient care regime in skilled nursing environment
Experienced in managing high flow of admissions and discharges a day
Supervised of up to five CNA's per shift
Developed healthy work relationships
Successful team building
01/2009- present, Health Link Home Care Services? and American Care Quest Homehe
alth
Providing medical and health services to patients at their places of residence.
Work with both patients and their families, assessing the home environment and d
etermining the needs of patients. Work with many different types of patients, su
ch as people recovering from accidents, post ops, wound care . Administer medica
tions, monitor patients, and instruct patients on appropriate home care. Teachin
g, counseling to both patients and their families, involve on the psychological
well-being of the patient.
05/2008- 01/2009, Pacific Partners Management Services
Telephonic Case Manager
Summary:
Performing effective and efficient inpatient utilization reviews according to es
tablished protocols and clinical criteria, determining the appropriateness and m
edical necessity for acute care, and evaluating the appropriate level and locati
on of care.
DUTIES AND ESSENTIAL JOB FUNCTIONS
Performed daily inpatient utilization reviews telephonically for all members in
assigned acute hospitals, skilled nursing facilities, or rehabilitation faciliti
es. These daily reviews document clinical summaries, proposed clinical intervent
ions/ testing, pertinent test results, and discharge plans.
Communicated with attending physicians, hospitalitist, health plan medical direc
tors, other physician reviewers, and hospital and health plan case managers to e
nsure that inpatient services are provided in a timely manner at the appropriate
level and expeditious discharge planning and/or transfer to a lower level of ca
re.
Assured that discharge planning is handled in an efficient and timely manner to
include durable medical equipment, other medical equipment, benefit confirmation
, preferred contracted vendors and referrals to community resources.
Coordinated memberâ s care with provider, health plans, family, and PPMSI Case Manage
ment/ Utilization Management staff so that complex issues are resolved expeditio
usly and efficiently.
Processed pre-certifications and authorizations for medical necessity and health
plan benefits for inpatient, DME, medical transport, SNF, home health and ancil
lary services.
Daily, for each member at all assigned facilities documented admissions, concurr
ent notes and review decisions in the Access Express utilization review system.
05/2000 * 02/2004, Erudite Community School, Inc
Medical Assistant Program Instructor:
Developed curriculum and instruction for complete Medical Assistant (Front and B
ack Office) Program
Submitted and received approval from California Bureau Private Postsecondary Voc
ation Education to award Certificates of Completion of Medical Assistant Program
Taught Medical Assistant program
Trained new faculty
Served as an active member of Schoolâ s Accreditation Committee
11/1998 - 07/2003, UCSF Medical Center Endoscopy Unit
Hospital Assistant:
Performed multiple complex duties involving with patient care
Equipment, procedural set up, supplies maintenance
Cleaning scopes followed infection precautions
Assisted doctors on procedures, ability to use biopsy forceps during procedures
Interviewing patients, preparing patients for various procedures, taking and rec
ording patients physical and medical condition
03/1997 - 01/2008 Baker, Anderson & Christie, Inc
Nurse Assistant/LVN:
Worked as a private duty CNA/LVN
AIDS hospice
Provided care for elderly residents
04/1998 - 11/1998 Portamedic CO
Examiner
Performed intake and post examination duties: data entry, blood drown
Education:
2002 LVN Refresher course, CCSF
1998 Phlebotomy Certificate Program, SF State University
1997 CNA Education and Training Services, SF
1992 School of Massage, Belarus
1988 Medical College of Nursing, Russia
References:
Available upon request