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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Woodcrest Ln Phone: PHONE NUMBER AVAILABLEArlington, TX Street Address Email:EMAIL AVAILABLELicensed Vocational NurseDedicated, compassionate nursing professional with extensive experience as a Licensed Vocational Nurse (LVN) and former Charge Nurse. Strong leadership abilities, with proven expertise in supervising staff, overseeing operations and coordinating nursing facility services. A comprehensive background in healthcare environments encompassing the areas of cross-functional nursing, leadership, staff development and physician support. Excellent interpersonal skills, with proven expertise in providing direct patient care; providing emotional support to patients; and interacting with peers, staff and patients families. Exceptional problem-solving abilities, with demonstrated proficiency in comprehensively assessing medical situations to determine appropriate solutions, supporting treatment plans to support healing and ensuring compliance with industry standards and policies. ACLS, BLS and IV certified, with strong proficiency in charting software and EMR systems such as PCC, Intergy, EPIC, Salesforce, Meditech, NextGen, E-Clinical Works, QNXT, Member360, Smart UM.Areas of ExpertiseQuality Patient CareMedical Records ManagementPatient RelationsService Plan DevelopmentStaff SupervisionBehavioral HealthPatient EducationMember AssessmentClinical ManagementCross-Functional NursingChartingRegulatory ComplianceProfessional ExperienceSOLVING IT RECRUTING Blue Cross Blue Shield 11/30/2021 CurrentMedical Reviewer Acute, Therapies, ReferralsPerforming discharge care coordination and review activities for determining efficiencyEffectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Network Management Divisions.Review service requests, collect clinical and non-clinical data, verify eligibility, determine benefit levels in accordance to contract guidelinesConducting initial and concurrent review, prepare reports on quality of care, identify and report cases, and provide information regarding utilization management requirements and operational procedures to members, providers and facilities.PIONEAR RECRUTIING Molina HealthcareCase Manger II 4/12/2021 11/30/2021Responsible for health care management and coordination of healthcare members in order to achieve optimal clinical, financial and quality of life outcomes.Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors members progress and services to ensure consistent cost-effective care that complies with policy and all state and federal regulations and guidelines.Provides case management services to members with chronic or complex conditionsProactively identifies members that may qualify for potential case management services.Conducts assessment of member needs by collecting in-depth information from information system, the member, members family/caregiver, hospital staff, physicians and other providers.Identifies, assesses and manages members per established criteria.Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.Performs ongoing monitoring of the plan of care to evaluate effectiveness.Documents care plan progress in information system.Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes.Measures the effectiveness of interventions to determine case management outcomes.
Promotes integration of services for members including behavioral health and long-term care to enhance the continuity of care for members.
Conducts face to face or home visits as required.
Maintains department productivity and quality measures.NURSEDASH AGENCYNURSEFLEET AGENCE 3/28/2020 - CurrentWork in COVID and Non COVID facilities on short- and long-term contracts.Make choices, decisions and act in the residents best interest.React and remain calm in difficult situations.Handle multiple priorities.Possess written and verbal skills for effective communication and level of understanding.Demonstrate good judgment, problem solving and decision-making skills.Working in different fast past facilities such as, assisted living, home health, independent living, hospital and long-term care environment.Administration of medicationsDocumentation of medication administrationFacilitate Care Plans as dictated by residents medical professionalsCATASYS 04/2020 4/2021CARE COACHEngage, enroll, and maintain members in active participation in the Ontrak program as well as to coordinate member care.Utilizes motivational interviewing, enhancement, and relapse prevention guidelines in telephonic communication with clients.Usage of the Ontrak treatment program and usage of the eOntrak electronic documentation platform.Provide exemplary customer service to and member-centric focus for, all clients.Communicates or requests information from providers in complete compliance with confidentiality standards and in a manner that generates cooperation.Works jointly with the Clinical Operations Coordinator and Community Care Coordinator to support member referral, engagement, and enrollment into the Ontrak program.Supports enhancement of the digital tools eOntrak by providing feedback to the development team and performing ad hoc system testing as indicated.ORB HEALTH 02/2017 -3/2020CHRONIC CARE MANAGEMENT NURSEAssess clients needs for services and cooperatively develop an integrated patient centered care plan and goals with the client/family and other providers.Coordinate transitional care from an inpatient service to other settings as per care plan.Work collaboratively with team members to provide outreach and engagement.Work closely with in-office providers to manage the day to day calls involving symptom control, medication management, and provide patient and family education.Receive triage and respond to telephone calls from patients requiring medical guidance.Provides patients with clear instructions and education utilizing appropriate guidelines.Educates the patient on properly contacting physician office for urgent care matters / or 911 when appropriate or unsure.Directs patient to keep follow-up appointments with physician office and to maintain self-home care based on physician direction and outcomes of nursing assessment.Utilizes the in-office staff, and Clinical Call Center to meet the needs of the patient and family.Documents calls according to established guidelines.Communicates with physician, Nurse Practitioner, RN, Social Worker or other health care providers regarding patients status.Collaborates with the Nurse Practitioner, and or physician when patient requires intervention or follow-up.Participates in education and in-service programs.ANGELS OF CARE 05/16- 5/2021LVN FIELD COORDINATORDelivered direct one-on-one patient care to pediatrics within a home environment, which involved working under the direction of an RN to follow plans of care, reporting changes in patients physical/mental conditions, and assisting patients with completing daily self-care and activities.Accurately charted daily clinical notes and charted allscripts and POC systems.Performed tasks pertaining to wound vac, IV Therapy, Labs, TPN and Catheter Change.Skill set: G-button, Trach and vent.JORDAN HOME HEALTH 3/16 12/2017LVN FIELD COORDINATORDelivered direct one-on-one patient care within a home environment, which involved working under the direction of an RN to follow plans of care, reporting changes in patients physical/mental conditions, and assisting patients with completing daily self-care and activities.Accurately charted daily clinical notes and charted allscripts and POC systems.Performed tasks pertaining to wound vac, IV Therapy, Labs, TPN and Catheter Change.CIGNA HEALTH SPRING 01/2015 -12/2015Case Manager- -nursing facilityEffectively coordinate services when a member transitions into a nursing facility.Collaborate with members, caregivers and providers to facilitate the development of service plans, including services provided through the facility.Comprehensively review members service plans when there are significant changes in conditions.Visit and interact with members living in nursing facilities to review their service plans and address any service and support related questions.Conduct telephonic state mandated, health risk and other member assessments.Apply clinical judgment to identify behavioral health needs.Act as a liaison, effectively facilitating the coordination of resources, healthcare providers and institutions.ICD 9 and 10 TrainingHEDIS TrainingHEART TO HEART HOSPICE 2014 2015Licensed Vocational Nurse, On-call Hospice NurseEstablish a professional and caring relationship with patients and their families.Support staff, physicians, discharge planners, social workers and other healthcare professionals by providing hands-on care, on-going clinical management and education regarding hospice care.ETHICUS HOSPITAL 2013 4/21/2015Licensed Vocational Nurse, med surg floorProvide supervision to Certified Nursing Aides and other staff members to ensure delivery of consistently high-quality care to residents.Consult with Registered Nurse (RN) regarding symptoms, reactions, and changes in patients conditions.Provide appropriate pain management techniques, educating patients and their families in various important aspects of pain management.Assist with the rehabilitation and treatment of patients in accordance with their medical care plans.Address psychosocial, cultural, ethnic and religious/spiritual needs of patients and their families.MILLBROOK REHAB & SKILLED FACILITY 2013 2014Licensed Vocational NurseProvided supervision to Certified Nursing Aides and other staff members to ensure delivery of consistently high-quality care to residents.Provided quality healthcare services to geriatric and disabled individuals as per resident care plans.Delivered safe and effective routine and personal care services for up to 68 long-term care residents with complex medical diagnoses, including serving as a designated team leader supervising non-professional staff.GENTLE HOME HEALTH 2009 2013Licensed Vocational NurseDelivered direct one-on-one patient care within a home environment, which involved working under the direction of an RN to follow plans of care, reporting changes in patients physical/mental conditions, and assisting patients with completing daily self-care and activities.Accurately charted daily clinical notes and charted allscripts and POC systems.Performed tasks pertaining to wound vac, IV Therapy, Labs, TPN and Catheter Change.CREDENTIA NURSE STAFFING 2009 2013Travel Nurse (med-surg, rehab, long term care, sub-acute, ltac)PROFESSIONAL HOME HEALTH CARE 2005 2007Medical AssistantHi x Services 2005 -2007computer support techConfigured computer equipmentMaintain all terminals and peripheralsLocating and ascertaining the nature of network errors using appropriate softwareTroubleshootingEducation & TrainingReferral Agent, Texas Section 811 PRA Program (2021)Bachelor of Science, Universal Studies, University Texas of Arlington (May 2017)National Honors Society, University Texas of Arlington (August 2014-May 2017)Health Tech, Catapult Healthcare (2017)Vocational Nursing Diploma, (840 Hours of Clinical Experience) Grayson County CollegeMedical Assistant Program, Remington CollegeLicensed Vocational Nurse (License No. 223090)CertificationsBasic Life Support (Expires 7/ 31 / 2024)Advanced Cardiac Life Support (Expires 7/31/2024)EMR SystemsIntergy, EPIC, PCC, Salesforce, Meditech, NextGen, E-Clinical Works, QNXT, CCA, Smart UM, CVS access, Member 360, Pega |
