Alma Morales
Borger
Summary
Compassionate Registered Nurse Team Lead with proven ability to lead teams alongside management, in high-pressure environments while maintaining productivity and efficiency. Excel in communication, and problem-solving, ensuring optimal member outcomes and team performance.
Overview
21
21
years of professional experience
Work History
LTSS RN Team Lead
WellPoint
Grand Prairie
12.2024 - Current
- Guided the team in adherence to current processes and workflows to ensure consistent quality of care.
- Maintained knowledge of current healthcare trends through ongoing education and training to enhance team expertise.
- Educated members, families and nursing facility staff on benefits and resources available in their area.
- Maintained strict access to patient information to comply with HIPAA laws and prevent information breaches.
- Participated in interdisciplinary meetings to discuss member progress and develop discharge plans for successful transitions to the community.
- Provided education and guidance with completion of MFP assessments.
- Assisted the team manager with audits of quarterly assessments and other communication charted for accuracy and completeness according to established criteria.
- Scheduled and coordinated meetings and calls to address team questions and concerns. to discuss questions, concerns, and challenges individually with team.
- Fostered respectful relationships to promote an environment that is conducive for learning, and growth.
- Partnered with NF Manager to review quarterly and MFP assessments.
- Served as a resource to the team by addressing questions and concerns related to policies and processes.
- Collaborated with leadership team to complete internal appeal assignments
- Provided support to the nursing facility service coordinator, to assist members in transitioning from the nursing facility to the community.
- Performed additional duties as assigned, including generating reports abd researching member cases as needed.
- Ensured compliance with organizational policies and processes
- Maintained licensing and certifications
NF Service Coordinator
WellPoint
Grand Prairie
09.2023 - 12.2024
- Coordinated service requests and scheduled appointments for members and providers.
- Communicated effectively with healthcare providers to ensure service delivery.
- Managed member inquiries and resolved issues promptly and professionally.
- Assisted members in understanding their benefits and relocation options.
- Handled inquiries from members, family, and nursing facility staff regarding services offered.
- Monitored email and phone communication to provide prompt responses and solutions.
- Provided timely feedback to management on any issues or concerns from nursing facility staff or member.
- Worked closely with other departments within the facility to ensure successful completion of goals regarding the member.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Maintained confidential patient documentation to prevent data compromise and comply with HIPAA regulations.
- Built and maintained strong relationships with members by successfully resolving issues and responding promptly to phone or in person inquiries.
- Discussed MFP program and community benefits with potential participants and outlined procedures to facilitate smooth engagement in program processes.
- Consulted and collaborated with other professionals to provide continuity of patient care.
- Guided clients through transition to independent living within community.
- Maintained all education and training updated.
Star Plus Program Specialist
Amerigroup
Grand Prairie
12.2021 - 09.2023
- Assisted members above the age of 21 with chronic illnesses, comorbidities, and disabilities to live in the community.
- Collaborate with the Service coordinator, members, families, caregivers, physicians, and agencies in starting and maintaining services for the member.
- Assisted members in finding resources in the community.
- May also assist in problem-solving issues with providers, claims, and services.
- Assisted with referrals for adaptive aids, durable medical equipment, and supplies as requested per their assessment and as needed.
- Provide information regarding their Medicare and Medicaid benefits depending on the member's plan and eligibility.
- Educated members and families regarding services and plans in place.
- Maintained professional and respectful communication with members, families, vendors, and agencies.
- Maintained communication with service coordinators in a timely and efficient manner.
Registered Nurse
Professional Case Management
Amarillo
10.2011 - 12.2020
- Identify members for high-risk complications and coordinate care in conjunction with the member and the health care team.
- Educate patients and families on diagnosis, treatments, and possible outcomes.
- Inform physicians of changes in patient conditions and nursing needs.
- Maintained accurate member histories to support ongoing development of individual care plans.
- Assist patients with multiple chronic illnesses including COPD and asthma.
- Accurately document all elements of nursing assessments, treatments, and medications.
- Coordinated care with physicians, nurses, and hospice teams to enhance quality of patient care.
- Performed various office tasks such as faxing, printing, and copying. such as faxing, printing, copying, emailing, and ordering paperwork and supplies monthly.
Pediatric Home Health Nurse
Epic Health Services
Amarillo
07.2014 - 02.2015
- Provided compassionate nursing care to medically fragile children in the home setting.
- Identified health issues during home care visits and notified physician and registered nurse of status changes to facilitate timely interventions.
- Handled a variety of nursing tasks, including assessments, medication administration, and cared for/administered feedings/medications via mic-key button. All in line with physician's orders.
- Educated family members, and caregivers on conditions and treatment protocols to aid in compliance and improve outcomes.
- Followed all policies and procedures when handling personal and medical information to comply with HIPAA laws.
- Educated family members and caregivers on conditions and treatment protocols to enhance compliance and support positive health outcomes.
- Maintained accurate, detailed reports and records, including comprehensive patient intake documentation for effective care coordination.
Home Health Nurse
Home Care Connections
Amarillo
05.2008 - 01.2009
- Provided patient care and treatment for acute/chronic disease management.
- Explained diagnoses, treatment options, medications, and procedures to patients, ensuring understanding of key points through verbal and written communication.
- Documented assessments, vital signs, changes in status, wound care, medication administration, and other relevant data to support comprehensive patient care.
- Communicated promptly and accurately with patients, families, physicians, and team members to coordinate effective care.
Charge Nurse
Coronado Healthcare Center
Pampa
09.2005 - 04.2008
- Charge nurse is responsible for daily assessments and vital signs.
- Administered medications and treatments per physicians orders, maintaining accountability for accurate narcotic count.
- Ensured clarity and precision in patient charting for effective communication. which included Medicare charting.
- Protected patient and family confidentiality by handling medical and non-medical information discreetly.
- Administered medications and treatments per physicians' orders, maintaining accountability for accurate narcotic count.
- Medications ordered and received per facility protocol.
- Collaborated with multidisciplinary teams to implement effective treatment plans for optimal patient outcomes.
- Oversaw and prioritized delegated duties among staff to maintain workflow efficiency and patient care standards.
Education
BACHELOR OF SCIENCE - NURSING
Western Governors University
Salt Lake City, UtahASSOCIATE OF APPLIED SCIENCE - NURSING
Amarillo College
Amarillo, TexasVOCATIONAL CERTIFICATE - LICENSED VOCATIONAL NURSING
Frank Phillips College
Borger, TexasSkills
- Patient assessment
- Care coordination
- HIPAA compliance
- Patient advocacy
- Interdisciplinary collaboration
- Time management
- Prioritization
- Organization
- Multitasking
Timeline
LTSS RN Team Lead
WellPoint
12.2024 - Current
NF Service Coordinator
WellPoint
09.2023 - 12.2024
Star Plus Program Specialist
Amerigroup
12.2021 - 09.2023
Pediatric Home Health Nurse
Epic Health Services
07.2014 - 02.2015
Registered Nurse
Professional Case Management
10.2011 - 12.2020
Home Health Nurse
Home Care Connections
05.2008 - 01.2009
Charge Nurse
Coronado Healthcare Center
09.2005 - 04.2008
BACHELOR OF SCIENCE - NURSING
Western Governors University
ASSOCIATE OF APPLIED SCIENCE - NURSING
Amarillo College
VOCATIONAL CERTIFICATE - LICENSED VOCATIONAL NURSING
Frank Phillips College