Aeinna Krizelle Canlas
Hayward,CA
Summary
Professional with strong background in nursing and case management, specializing in patient advocacy and care coordination. Adept at developing comprehensive care plans, managing complex medical cases, and working collaboratively with multidisciplinary teams to achieve optimal patient outcomes. Known for adaptability, reliability, and results-focused approach in dynamic healthcare environments. Skilled in patient assessment, discharge planning, and resource utilization.
Overview
6
6
years of professional experience
1
1
Certification
Work History
RN Case Manager
St.Rose Hospital
03.2024 - Current
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Enhanced patient care by developing comprehensive care plans and coordinating with interdisciplinary healthcare teams.
- Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Coordinated care conferences with interdisciplinary team members, ensuring all perspectives were considered in the development of comprehensive treatment plans.
- Promoted adherence to treatment plans by conducting regular follow-up visits and providing ongoing support to patients.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Implemented evidence-based practices to improve overall clinical performance and patient outcomes.
- Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
- Conducted thorough assessments of patients'' needs, enabling more accurate diagnoses and targeted interventions.
- Improved patient satisfaction scores by providing timely follow-ups and addressing concerns promptly.
- Evaluated the effectiveness of implemented interventions periodically, adjusting treatment plans as needed to promote optimal patient outcomes.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
- Educated patients and caregivers on healthcare protocols and processes.
- Conducted comprehensive assessments of patient needs to inform effective care planning.
- Improved interdisciplinary communication, establishing standardized protocols for sharing patient information.
- Monitored patient progress closely, adjusting care plans as necessary to meet evolving health requirements.
- Advocated for patients with insurance companies, securing coverage for necessary treatments and medications.
- Analyzed case management data to identify trends and develop strategies for continuous improvement in patient care.
- Provided skilled, timely and level-headed emergency response to critically-ill patients.
- Facilitated therapeutic communication, conflict resolution and crisis intervention by redirecting negative behaviors and helping patients regain or improve coping abilities.
- Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Implemented care plans for patient treatment after assessing physician medical regimens.
Home Health RN Case Manager
Various Agencies
04.2022 - Current
- Managed complex caseloads efficiently by prioritizing tasks, delegating responsibilities to support staff, and maintaining detailed records.
- Expedited wound healing using advanced wound care techniques such as negative pressure therapy or hydrocolloid dressings when appropriate.
- Reduced hospital readmissions through diligent monitoring of patients'' progress and timely interventions in-home settings.
- Promoted a safe living environment for patients by conducting thorough home safety evaluations and recommending necessary modifications or equipment upgrades.
- Improved medication adherence through thorough education on drug administration, interactions, and potential side effects.
- Increased patient satisfaction by providing compassionate care, addressing concerns, and advocating for their needs.
- Empowered patients and their families to take an active role in care decisions, fostering a sense of self-efficacy and improving long-term health outcomes.
- Collaborated with external healthcare providers to facilitate seamless transitions between acute care settings and home environments.
- Conducted comprehensive assessments to identify patient risks, establish baseline health status, and determine appropriate intervention strategies.
- Streamlined communication with physicians, ensuring accurate documentation and prompt updates on patient conditions.
- Enhanced patient outcomes by developing personalized care plans and coordinating interdisciplinary team collaboration.
- Prevented complications from chronic illnesses like diabetes or heart failure through targeted patient education initiatives tailored to individual needs.
- Served as an expert resource for families by providing guidance on disease management techniques, self-care strategies, and available community resources.
Utilization Review Specialist
San Jose Behavioral Health
10.2018 - 03.2022
- Proactively addressed potential barriers to care during the review process, connecting patients with appropriate resources such as financial assistance programs or support groups.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and organizational policies regarding privacy and data security.
- Demonstrated strong analytical skills by interpreting complex medical records and synthesizing relevant information for utilization review purposes.
- Reduced healthcare costs for the organization by identifying areas of improvement in clinical documentation and resource allocation.
- Supported the development of standardized policies and procedures for utilization review across multiple departments within the organization.
- Collaborated with interdisciplinary teams to create effective discharge plans that promoted optimal patient outcomes while minimizing hospital readmissions.
- Identified trends in healthcare usage among patients, providing valuable insights to inform strategic planning efforts within the organization.
- Contributed to organizational success by participating in quality improvement initiatives related to utilization management processes.
- Assisted with audits to ensure compliance with federal regulations governing Medicare and Medicaid reimbursements, safeguarding against potential penalties or sanctions from government agencies.
- Conducted training sessions for staff members on best practices in utilization review, fostering a culture of continuous learning and improvement.
- Ensured accuracy of billing and reimbursement processes by reviewing medical records for proper coding and documentation practices.
- Promoted patient satisfaction through careful attention to individual needs during the review process, addressing concerns promptly and professionally.
- Managed a high volume of cases efficiently by prioritizing tasks and maintaining strict deadlines for completion of reviews.
Education
Bachelor of Science - Nursing
Angeles University Foundation
Angeles City 04-2008
Skills
- Discharge planning
- HIPAA compliance
- Multidisciplinary approach
- Care coordination
- Utilization review
- Case evaluation
- Clinical assessment
- Community resources
- Quality improvement
- Healthcare regulations
- Case management
- Critical thinking
- Compassionate and caring
- Interdisciplinary collaboration
- Strong clinical judgment
- Accurate documentation
- Patient and family advocacy
- Patient care assessment
- Direct patient care
- Delegation and motivation
- Clear patient communication
Certification
RN License # 95282362
Timeline
RN Case Manager
St.Rose Hospital
03.2024 - Current
Home Health RN Case Manager
Various Agencies
04.2022 - Current
Utilization Review Specialist
San Jose Behavioral Health
10.2018 - 03.2022
Bachelor of Science - Nursing
Angeles University Foundation
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