RAJANI NAIR
Chennai
Summary
Active NCLEX-certified Registered Nurse with over 16 years of comprehensive experience spanning clinical nursing, academic healthcare teaching, and corporate clinical review operations. Demonstrated track record in utilizing Electronic Medical Records (EMRs), analyzing complex medical files, and auditing medical data for global organizations. Background includes hands-on experience as a corporate Clinical Reviewer for Cognizant and a certified training in medical transcription. Seeking a senior clinical operations, utilization management, or clinical auditor role within a progressive global healthcare organization.
CORE COMPETENCIES & CERTIFICATIONS
* Certifications: NCLEX-RN Certified (Active Registration)
* Specialized Training: Medical Transcription Certification
* Corporate Operations: Clinical Review, Utilization Management, Health Insurance Auditing, Claims Analysis
* Clinical Expertise: EMR Documentation, Patient Care Planning, Quality Assurance (QA)
*Certified Psychology Counsellor and Psychotherapist.
*Certified Zumba instructor, Nutritionist and Personal trainer.
* Soft Skills: Team Leadership, Advanced Medical Terminology, Cross-Functional Collaboration
Overview
1
1
Certification
22
22
years of professional experience
Work History
MNS (Military Nursing Services) OFFICER
Command Hospital (Central Command)
Lucknow, Uttar Pradesh
02.2018 - 09.2025
- Deliver immediate care to soldiers, battle casualties, ex-servicemen, dependents, and cadets.
- Prioritise assess, plan, evaluate, and deliver care to high standards.
- Contribute to multi-disciplinary teamwork and follow clinical governance for patient safety.
- To develop in line with the Knowledge, Skill, Framework (KSF) outlined for the role.
- Act as a mentor to the junior staff and subordinates..
- Take delegated responsibility for the management of the clinical team on a shift basis.
- Gain competence in clinical skills to enable delivery of quality patient care within the service.
- Maintain effective communication internally and externally to the organization
- Bed Capacity: 900 Bedded
- Department/Ward Allocation: Medical ICU
- Nurse Patient Ratio: 1:3
- Advanced therapies carried out: Endotracheal intubation, defibrillation, Plasmapheresis, mechanical Hemodialysis.
Clinical Reviewer/QM Nurse Consultant (Process-Specialist Data)
Cognizant Technology Solutions
Bangalore, Karnataka
02.2015 - 12.2016
- Reviewed medical records for US clients and providers to support claim outcomes.
- Coordinated multidisciplinary processes to uphold confidentiality of client documents at all times.
- Owned time-sensitive solutions that reduced turnaround delays for customers.
- Led mentoring sessions for junior reviewers to raise performance expectations.
- Directed effective communication across claim stakeholders and internal teams.
- Assessed clinical need under general technical direction for treatment and hospitalisation.
- Decided medical necessity using state regulatory rules and URAC utilisation standards.
- Owned utilisation review decisions using nursing judgement and evidence-based criteria.
- Set daily priorities to meet production and quality standards reliably.
- Managed work in business process outsourcing organisation operations and throughput.
- Oversaw major case reviews including fever, respiratory infections, and urinary tract infections.
- Supervised major review decisions for cervicalgia, stress fractures, and acute lumbago.
- Accounted for clinical review decisions for diabetes and hypertension claims.
- Guided a junior reviewer team through coaching, feedback, and skill-building.
- Led advanced therapies and equipment handling activities where assigned.
Clinical Reviewer
Hinduja Global Solutions
Bangalore, Karnataka
07.2014 - 01.2015
- Reviewed medical records for clients and healthcare providers across case files.
- Collaborated within multidisciplinary teams to keep client documents confidential.
- Conducted clinical necessity reviews using state rules and URAC standards.
- Assessed insurance holders against medical necessity requirements and documentation.
- Department/Ward Allocation: NA
- Nurse Patient Ratio: NA
- Advanced therapies carried out: NA
Clinical Instructor
VMRF (APOLLO)College of Nursing
Margao, Goa
07.2013 - 07.2014
- Provided clinical knowledge and experience to basic BSc nursing students under INC guidelines.
- Completed assigned theoretical syllabus within scheduled institutional timelines.
- Applied institution policies while delivering clinical teaching sessions to students.
- Department/Ward Allocation: NA
- Nurse Patient Ratio: NA
Senior Nurse
NUSI Wockhardt Hospitals
Margao, Goa
07.2012 - 07.2013
- Contribute to daily ward governance routines that prioritise patient safety checks.
- Support quality-of-care activities that fit clinical governance framework requirements.
- Work with multidisciplinary staff to promote safe patient outcomes daily.
- Nurse Patient Ratio: 1:3
Senior Nurse
Wockhardt Hospitals
Bangalore, Karnataka
05.2008 - 03.2009
- Responded to medical emergencies, applying critical thinking and clinical skills to deliver prompt, effective care.
- Supported patients with complex needs, employing empathy and communication skills to build trust and rapport.
- Implemented infection control measures, minimising risk and promoting a safe environment for patients and staff.
- Upheld professional nursing standards and ethical guidelines, demonstrating commitment to continuous professional development.
- Supervised junior staff, providing training and mentorship to enhance skills and improve patient outcomes.
Staff Nurse
NUSI Apollo Hospitals
Margao, Goa
08.2003 - 04.2008
- Managed emergency situations with professionalism, administering immediate care and coordinating with medical teams to ensure patient safety.
- Carefully monitored, recorded and reported changes in patient symptoms to deliver best care practices.
- Maintained a safe, clean, and comfortable environment for patients, adhering to infection-control policies.
- Monitored patient conditions closely, reporting and recording signs of deterioration for swift action.
Education
Degree - Nursing
Aditya College Of Nursing
Bangalore, Karnataka10-2011
Diploma of Higher Education - Nursing
Institute of Nursing Education
Panjim, GA01-2003
Higher Secondary Education -
Damodar Higher Secondary School
Gudi-Paroda, Goa04-2000
Secondary Education -
St. Joseph's Educational Institute
Chandor, Goa04-1998
Skills
- Critical care nursing
- Clinical governance
- Utilisation review
- Medical record review
- Patient safety
- ICU monitoring
- Emergency response
- Mechanical ventilation
- Infection control
- Nursing triage
- Team leadership
- Multidisciplinary coordination
- Medical confidentiality
- Report writing
- Microsoft Excel
- Teamwork
- Microsoft Office proficiency
- Report-writing
- Leadership excellence
- Informed decision making
- Critical decision making
- Strategic planning
- Assigning work
- Attention to Detail
- Service commitment
- Exceptional problem solver
- Incident reporting
- Responsive action
Certification
- Nursing Council Registration: General Nursing and Midwifery
- Name of Nursing Council: Maharashtra Nursing Council
- Registration Number: XXVIII-20656
- Date of Registration: 17/11/2003 (Active and valid)
- Nursing Council Registration: Post Basic BSC Nursing
- Name of Nursing Council: Karnataka Nursing Council
- Registration Number: 09V6116
- Date of Registration: 15/09/2009 (Active and valid)
- Nursing Council Registration: NCLEX-RN
- Name of USA Board: State of Michigan
- Registration Number: 4704311765
- Date of Registration: 14/05/2008 (Valid)
Employment References
- Sheeba Joshua, B, Associate Director-HR, verification@cognizant.com, Cognizant Technology Solutions, Bangalore
- Dr. Zubin de Loiola, Pereira, Medical Administrator, nusihospital@rediffmail.com, Apollo(NUSI) Hospitals, NUSI Hospital and Research Centre
Declaration
I hereby declare that this Curriculum Vitae is true and correct.
DATE: 03 Nov 2026
LOCATION: Chennai
NAME: Rajani Nair
Timeline
MNS (Military Nursing Services) OFFICER
Command Hospital (Central Command)
02.2018 - 09.2025
Clinical Reviewer/QM Nurse Consultant (Process-Specialist Data)
Cognizant Technology Solutions
02.2015 - 12.2016
Clinical Reviewer
Hinduja Global Solutions
07.2014 - 01.2015
Clinical Instructor
VMRF (APOLLO)College of Nursing
07.2013 - 07.2014
Senior Nurse
NUSI Wockhardt Hospitals
07.2012 - 07.2013
Senior Nurse
Wockhardt Hospitals
05.2008 - 03.2009
Staff Nurse
NUSI Apollo Hospitals
08.2003 - 04.2008
Degree - Nursing
Aditya College Of Nursing
Diploma of Higher Education - Nursing
Institute of Nursing Education
Higher Secondary Education -
Damodar Higher Secondary School
Secondary Education -
St. Joseph's Educational Institute