Alexander Lugones
Haines City
Summary
Results-driven Registered Nurse with extensive expertise in case management, transitions of care, and quality assurance. Committed to enhancing healthcare outcomes through strategic care coordination, comprehensive patient education, and impactful quality improvement initiatives. Eager to transition into a leadership role to utilize proven skills in healthcare management and elevate patient care delivery. Proficient in fostering collaborative environments that prioritize patient well-being and operational excellence.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Manager of Transitions of Care
Devoted Medical
08.2022 - Current
- Supervise and mentor a team of over 30 Case Managers, providing guidance on motivational interviewing, clinical instruction, and time management.
- Lead performance management meetings, conduct audits, and drive process improvement efforts aimed at enhancing team effectiveness and reducing hospital readmissions.
- Develop and implement Standard Operating Procedures and workflows to promote efficient transitions of care and uphold high standards of quality.
- Collaborate with interdisciplinary healthcare partners through cross-functional meetings to optimize care coordination.
- Execute Performance Management strategies for continuous improvement.
Transitions of Care Case Manager
Devoted Medical
04.2021 - 08.2022
- Delivered comprehensive case management services for recently discharged patients, addressing gaps in care such as home health needs, durable medical equipment, and disease education.
- Played an integral role in developing and structuring the Transitions of Care protocol.
- Managed complex, high-risk patient populations, including DSNP members, in accordance with CMS guidelines to prevent readmission.
Complex Case Manager
Blue Cross and Blue Shield
06.2020 - 04.2021
- Coordinated care for members with complex or catastrophic conditions, facilitating alignment among PCPs, specialists, and home health providers.
- Developed and monitored individualized Plans of Care to improve member adherence and self-management.
- Provided staff training and maintained compliance with CMS and NCQA documentation standards.
Health Coach
Blue Cross and Blue Shield
07.2019 - 06.2020
- Educated members on chronic condition management including hypertension, diabetes, coronary artery disease, and neurological disorders.
- Organized team meetings and conducted staff training to reinforce effective self-management and care coordination practices.
RN Care Advisor
Evolent Health
12.2018 - 07.2019
- Performed Health Risk Assessments and enrolled members in case management programs focusing on transitions, catastrophic care, and condition management.
- Provided medication, symptom management, and dietary education for chronic conditions, coordinating care with PCPs and specialists.
- Participated in utilization management rounds to identify and intervene in high-cost cases.
Clinical Stars LPN
United Healthcare South Florida
05.2016 - 11.2018
- Administered Medication Therapy Management (MTM) programs, promoting medication adherence and educating members on proper usage.
- Partnered with pharmacies to resolve discrepancies and ensure accurate prescription fulfillment.
Chronic Disease Management Nurse
Borinquen Medical Centers of Miami
05.2014 - 04.2016
- Provided education and support to patients managing diabetes, hypertension, and hyperlipidemia, emphasizing diet, exercise, and medication adherence.
- Led group visits and partnered with the Adult Medicine department to achieve quality benchmarks including HEDIS and PCMH standards.
- Directed a colorectal cancer screening initiative, successfully screening over 3,000 patients.
- Conducted risk management peer-to-peer case studies.
Education
Bachelor of Science - Nursing
Chamberlain College of Nursing
05.2021
Associate of Science - Nursing
Miami Dade College
05.2018
Licensed Practical Nurse -
Robert Morgan Education Center
05.2013
Skills
- Case Management
- Transitions of Care
- Performance Management
- Chronic Disease Management
- Medication Reconciliation
- Quality Improvement
- Public Speaking
- Staff Training
- Microsoft Office
- Team leadership
Certification
- Registered Nurse License, FL, Compact, 2024
- Registered Nurse License, IL, 2026
- Certified in Diabetes Education and Management
- Transitions of Care Specialist Certification
Personal Information
Title: RN, BSN
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Manager of Transitions of Care
Devoted Medical
08.2022 - Current
Transitions of Care Case Manager
Devoted Medical
04.2021 - 08.2022
Complex Case Manager
Blue Cross and Blue Shield
06.2020 - 04.2021
Health Coach
Blue Cross and Blue Shield
07.2019 - 06.2020
RN Care Advisor
Evolent Health
12.2018 - 07.2019
Clinical Stars LPN
United Healthcare South Florida
05.2016 - 11.2018
Chronic Disease Management Nurse
Borinquen Medical Centers of Miami
05.2014 - 04.2016
Associate of Science - Nursing
Miami Dade College
Licensed Practical Nurse -
Robert Morgan Education Center
Bachelor of Science - Nursing
Chamberlain College of Nursing