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Maria de Lurdes Semedo
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United Kingdom
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Language
English
Fluently
French
Good
Portuguese
Fluently
Ready for
My experience
2017 - 2019
job
Clinical Case Manager
HCA Corporate.
Clinical and financial pathway assessment, management and monitoring;
Utilisation Review
Care coordination and discharge planning;
Daily discharge MDT meetings; monitor referrals status for internal and external agencies;
Confirm existence of pre-authorizations for inpatient and Day Case care;
Liaise with health insurance companies to obtain authorization for unplanned admissions and extended admissions; provide
verbal and written medical reports; justify the medical necessity for inpatient care and negotiate funding;
Liaise with patients and families to provide updates regarding care coverage and authorizations status; Liaise with Consultants for continuity of care and discharge planning;
Daily meeting with business office and financial department as a facilitator of patient's financial pathway;
Monthly meetings with CFO and senior clinical management team as required to discuss and action complex cases;
Clinical review of ITU/HDU admissions review to adjust intensity of care delivered and guarantee funding;
Orthopaedic and Cardiac Length of Stay tracker review;
Shortfall tracker reviews.
6 Acute private hospitals across London, 1 in Manchester. I am currently based at The Princess Grace Hospital and cross
covering other company's facilities whenever necessary
Utilisation Review
Care coordination and discharge planning;
Daily discharge MDT meetings; monitor referrals status for internal and external agencies;
Confirm existence of pre-authorizations for inpatient and Day Case care;
Liaise with health insurance companies to obtain authorization for unplanned admissions and extended admissions; provide
verbal and written medical reports; justify the medical necessity for inpatient care and negotiate funding;
Liaise with patients and families to provide updates regarding care coverage and authorizations status; Liaise with Consultants for continuity of care and discharge planning;
Daily meeting with business office and financial department as a facilitator of patient's financial pathway;
Monthly meetings with CFO and senior clinical management team as required to discuss and action complex cases;
Clinical review of ITU/HDU admissions review to adjust intensity of care delivered and guarantee funding;
Orthopaedic and Cardiac Length of Stay tracker review;
Shortfall tracker reviews.
6 Acute private hospitals across London, 1 in Manchester. I am currently based at The Princess Grace Hospital and cross
covering other company's facilities whenever necessary
Management, CFO, Monitoring, Facilitator, Office, Health, Insurance, Assessment, Manager
2016 - 2017
job
Coordinating Nurse
International SOS.
Case management, remote monitoring and medical evacuation of deployed American militaries and families
Monitor transmission load throughout the day to ensure appropriate case direction and handling, ensuring safety, medical
appropriateness, client specific considerations and cost effectiveness Effective and efficient medical management of cases,
meeting contractual deliverables and internal policies and procedures.
Liaise with medical and operational staff to facilitate the efficient running of medical assistance cases Contact international
medical professionals or obtain medical reports for members treated or hospitalised.
Source and/or organise the referral and/or admission of members to doctors and medical facilities. Review of the medical
treatment received or recommended to members to ensure it is medically appropriate to authorise cover decisions under the client's terms and conditions.
London assistance centre; variable case load, on average 10-15 case handling per day
Monitor transmission load throughout the day to ensure appropriate case direction and handling, ensuring safety, medical
appropriateness, client specific considerations and cost effectiveness Effective and efficient medical management of cases,
meeting contractual deliverables and internal policies and procedures.
Liaise with medical and operational staff to facilitate the efficient running of medical assistance cases Contact international
medical professionals or obtain medical reports for members treated or hospitalised.
Source and/or organise the referral and/or admission of members to doctors and medical facilities. Review of the medical
treatment received or recommended to members to ensure it is medically appropriate to authorise cover decisions under the client's terms and conditions.
London assistance centre; variable case load, on average 10-15 case handling per day
Management, It, Monitoring, International, Safety, Direction
2015 - 2016
job
Referrals for specialist care
RGN.
London
February 2015 to June 2016
Acute and elective surgical, medical, orthopaedic and trauma patients
Admission, assessment and care planning;
Pre and post operative care
Pain management;
Wound management;
Phlebotomy and cannulation;
Discharge planning
Referrals for specialist care
Care delivered across multiple NHS England facilities- Medical assessment units; surgical assessment units; respiratory,
gastro and medical wards; trauma, general surgery, orthopaedics and vascular units.
February 2015 to June 2016
Acute and elective surgical, medical, orthopaedic and trauma patients
Admission, assessment and care planning;
Pre and post operative care
Pain management;
Wound management;
Phlebotomy and cannulation;
Discharge planning
Referrals for specialist care
Care delivered across multiple NHS England facilities- Medical assessment units; surgical assessment units; respiratory,
gastro and medical wards; trauma, general surgery, orthopaedics and vascular units.
Management, Assessment
1999 - 2013
job
Senior Staff Nurse/ Nurse in charge/ team leader
HOSPITAL GARCIA DE ORTA.
Nurse in charge/ team leader
Member of the clinical and on-clinical risk assessment commission Mentor
Spinal, orthopaedic, trauma and medical patients
Mentorship of newly qualified staff nurses
Mentorship of nursing students
Mentorship of Nursing Auxiliaries
Risk assessment, pacifications and implementation Allocations
Staffing
Ward round
Pharmacy and stock request
Pre and Postoperative care
Pain and wound management
Referrals to multidisciplinary Team
Discharge planning
Acute hospital with multiple medical and surgical specialties with 545 bed capacity
Member of the clinical and on-clinical risk assessment commission Mentor
Spinal, orthopaedic, trauma and medical patients
Mentorship of newly qualified staff nurses
Mentorship of nursing students
Mentorship of Nursing Auxiliaries
Risk assessment, pacifications and implementation Allocations
Staffing
Ward round
Pharmacy and stock request
Pre and Postoperative care
Pain and wound management
Referrals to multidisciplinary Team
Discharge planning
Acute hospital with multiple medical and surgical specialties with 545 bed capacity
Mentor, Management, Implementation, Assessment, Mentorship
My education
2009
-
2012
Institute of Labor and Enterprise Lisbon University Institute
BSc, Anthropology
BSc, Anthropology
2007
-
2008
Polytechnic Institute of Setúbal
Intermediategraduate, Management (Minor in Research)
Intermediategraduate, Management (Minor in Research)
1994
-
1998
Higher School of Nursin Callouste Gulbenkian Lisbon
BSc, Nursing
BSc, Nursing
Institute of Labor and Enterprise Lisbon University Institute
Masters, 1st year (Minor in Development Studies)
Masters, 1st year (Minor in Development Studies)
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