MYSS HOYE
Forney,TX
Summary
Highly competent Registered Nurse Case Manager with 8+ years of experience dedicated to quality care of diverse patients. Skillfully blend critical thinking and proficient computer skills with advanced background in acute care settings. Work effectively with all levels of healthcare providers, physicians and administrators to address patient needs.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Registered Nurse Case Manager
Prime Healthcare
Mesquite, TX
12.2017 - Current
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Authored initial assessments of patients and family to develop plans for individual home and post acute care needs.
- Actively engaged in on-call rotations to deliver continuous quality care to patients.
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Coordinated with interdisciplinary professionals to develop plans of care, administer tests and monitor patient status.
Care Coordinator
Parkland Health & Hospital System
Dallas, Texas
01.2015 - 10.2016
- Establishes & maintains an efficient, cost effective care management process
- Determining patient financial and medical eligibility & medical necessity
- Developing, implementing and monitoring individual patient plans of care
- Communicating these plans to patients, families, and staff
- Ensure quality patient care throughout the healthcare continuum
- Compliance with program/ policies and procedures
- Responsible for maintaining knowledge and skill set related to utilization review, care coordination, performance improvement and professional licensure and certification
Case Manager & Utilization Review
UT Southwestern Medical Center
Dallas, TX
04.2012 - 01.2015
- ENT, Heart & Lung Team, Plastic Surgery, Surgical Oncology, Bone Marrow Transplant, Collaborates with other disciplines, physicians and payors to assess, develop, implement and monitor comprehensive plan of care to ensure continuity of care and cost effectiveness
- Collaborates with physicians and staff regarding medical necessity for admission, continued stay or alternative treatment facilities and/or levels of care
- Collaborates with Social Work and others to arrange discharge planning referrals per physician orders
- Relates utilization assessment to payors that are needed to justify continued stay review and to obtain pre-certification
- Utilization Review
- Discharge Planning
Case Manager
OptumHealth, AT&T
Richardson, Texas
10.2010 - 04.2012
- Making outbound calls to assess members' current health status
- Identifying gaps or barriers in treatment plans
- Providing patient education to assist with self management
- Interacting with Medical Directors on challenging cases
- Coordinating care for members
- Making referrals to outside sources
- Coordinating services as needed (home health, DME, etc)
- Educating & encouraging members to make healthy lifestyle changes
- Documenting and tracking findings
Registered Nurse
Baylor University Medical Center
Dallas, Texas
09.2008 - 05.2010
- Care of high risk antepartum patient
- Help to improve patient outcomes with evidence based practice
- Supervise care delivered by the patient care team, coordinate care plans, educate patients, new parents and staff, and collaborate with other disciplines
- Assisted physicians during treatments and examinations
Registered Nurse
Ochsner Medical Center
New Orleans, Louisiana
08.2007 - 08.2008
- Management of care for laboring patient & initiating inductions
- Fetal Heart Rate Monitoring
- Initial assessment of Newborn and Neonatal Resuscitation
- Care of high risk laboring patients including Pre-Eclampsia, Preterm Labor, Epilepsy, etc
- Care and recovery of cesarean section, cerclage and dilatation & curettage patients
Registered Nurse
Dallas Methodist Health System
Dallas, Texas
07.2006 - 08.2007
- Responsible and accountable for prescribing, delegating and coordinating patient care Accountable that patient care meets standards of safety, effectiveness, patient rights and guest relations
- Supervise care delivered by patient care team
- Coordinate plan of care
- Provide education for patients and staff
- Collaborate with other disciplines within the hospital
- Provide direct patient care for specific patient age groups
Education
Bachelor of Science - Nursing
The University of Texas At Tyler
Tyler, TX05.2006
Skills
- Verbal and Written Communication
- Decision Making
- Time Management
- Medicare Compliance
- Patient Advocacy
Certification
Registered Nurse License- Tx License 728483
American Heart Association Healthcare Provider – Adult, Infant, & Child CPR and First Aid Skills
Timeline
Registered Nurse Case Manager
Prime Healthcare
12.2017 - Current
Care Coordinator
Parkland Health & Hospital System
01.2015 - 10.2016
Case Manager & Utilization Review
UT Southwestern Medical Center
04.2012 - 01.2015
Case Manager
OptumHealth, AT&T
10.2010 - 04.2012
Registered Nurse
Baylor University Medical Center
09.2008 - 05.2010
Registered Nurse
Ochsner Medical Center
08.2007 - 08.2008
Registered Nurse
Dallas Methodist Health System
07.2006 - 08.2007
Bachelor of Science - Nursing
The University of Texas At Tyler