Lyra Sicad
Ashland,MA
Summary
A skilled medical professional with a strong background on documentation, clinical settings, and discharge planning. A dependable nurse who is able to focus on completing tasks efficiently and accurately.
Overview
2026
2026
years of professional experience
Work History
Utilization Review RN
MetroWest Medical Center
11.2023 - Current
- Completes Admission Reviews, Concurrent Reviews, and Discharge Reviews for each patient admitted to facility.
- Performs InterQual assessments as required by facility to determine appropriate admission status for patients on Observation, and as needed by insurance provider.
- Collaborates with Patient Access personnel to ensure accurate registration of each patient according to Physician orders.
- Completes reports and other tasks daily as required by Central UR.
RN Case Manager
MetroWest Medical Center
03.2022 - 10.2023
- Activates a process for each patient and uses case management plan in managing care, in collaboration with physicians and other healthcare members and payors.
- Assesses each patient's physical, psychosocial, coping abilities, available resources, and support systems, in preparation for hospital discharge.
- Facilitates patient transition to an appropriate level of care and services, whether to home or in a facility upon hospital discharge.
- Reviews and submits clinical documentation to appropriate insurance organizations to support prior authorization determination and support inpatient level of care.
- Interacts directly with insurance liaisons to facilitate submission of clinical documentation and other information needed for insurance coverage and approvals.
MDS/EMR Coordinator
Bethany Health Care Center
08.2004 - 03.2022
- Manages the schedule of MDS (Minimum Data Set) assessments for a 101-bed Skilled Nursing Facility, which includes State-required OBRA assessments and PPS (Prospective Payment System) assessments for Medicare reimbursements.
- Coordinates the completion of an interdisciplinary, accurate, and timely MDS assessment, and submits each MDS assessment to the State database according to CMS regulations.
- Assist Nurses in the completion of required quarterly and annual Resident assessments according to facility policy. Identifies and reports any change in a Resident's condition that would warrant a Significant Change in Status Assessment (SCSA) to the Clinical Team. Reviews and updates the interdisciplinary Comprehensive Care Plan according to changes in Resident's condition.
- Participates in interdisciplinary Care Plan meetings with the Clinical Team, Resident, and family for a discussion and review of the overall medical condition, addressing questions and concerns the Resident or Family may have regarding the provision of care, rehab, and dietary needs, Medicare coverage, discharge plans, etc.
- Monitors the facility's Quality Measures and provides a monthly report to the QAPI Committee, reflecting the quality of care that the facility provides, and as a basis for quality improvement.
- Provides ongoing education and guidance to Nurses and Certified Nursing Assistants regarding accurate coding of different ADL categories for accurate MDS coding and accurate MMQ reimbursement.
- Point-of-contact for managing and updating the Electronic Medical Record (EMR) system PointClickCare as needed. Creates User Defined Assessments (UDAs), order templates, task templates, and makes changes on the PointClickCare system according to the facility's need.
- Provides access, education, and guidance to system users including Nurses, Certified Nursing Assistants, Social Workers, and Activity Professionals regarding the use of the different modules of the software.
Staff Nurse
St. Elizabeth's Medical Center
08.2003 - 08.2004
- Facilitated the admission of cardiac patients into the Telemetry Unit, providing care according to physician orders, monitoring for any change in condition, and prompt reporting of these changes for appropriate treatment.
Charge Nurse, Dementia Care Unit
Bethany Health Care Center
02.2002 - 08.2003
- Nurse-in-charge on 3-11 Shift for the care and management of cognitively-impaired residents, providing direct care, medication administration, and treatment administration.
Nurse Reviewer
NG Review Center, Inc
- Conducts review classes to graduate nurses on different systems of the body, including Cardiovascular, Musculoskeletal, Pediatric, and Maternal and Child in preparation for the Nursing Licensure Examination in the Philippines.
- Conducts review classes to licensed nurses in preparation for the Commission on Graduates of Foreign Nursing Schools (CGFNS) examination (as a pre-requisite for any US State- licensure application), and for those preparing to take the NCLEX examination.
Education
Bachelor of Science - Nursing
West Visayas State University
Philippines03.1996
Skills
- Detail-oriented
- Organized
- Ability to Prioritize
- Motivated
- Hard-worker
- Computer-literate
Timeline
Utilization Review RN
MetroWest Medical Center
11.2023 - Current
RN Case Manager
MetroWest Medical Center
03.2022 - 10.2023
MDS/EMR Coordinator
Bethany Health Care Center
08.2004 - 03.2022
Staff Nurse
St. Elizabeth's Medical Center
08.2003 - 08.2004
Charge Nurse, Dementia Care Unit
Bethany Health Care Center
02.2002 - 08.2003
Nurse Reviewer
NG Review Center, Inc
Bachelor of Science - Nursing
West Visayas State University
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