ANA I VELAZCO
Longwood,USA
Summary
Knowledgeable Case Manager with solid history of managing high caseloads and providing comprehensive support to diverse client populations. Proven ability to assess client needs and develop tailored action plans that drive positive outcomes. Demonstrated strong communication and problem-solving skills in high-pressure environments. Collaborates seamlessly with multidisciplinary teams and adapts to dynamic situations to ensure optimal client outcomes.
Overview
19
19
years of professional experience
Work History
Case Manager
Humana Healthy Horizons of Florida
06.2022 - Current
- Coordinated care plans with interdisciplinary teams to enhance patient outcomes.
- Assessed client needs and developed tailored service strategies for effective case management.
- Maintained comprehensive documentation in compliance with regulatory standards and best practices.
- Served as a resource for clients, providing guidance on available healthcare services and resources.
- Perform ongoing monitoring of care plans to evaluate effectives, document interventions and goals.
- Facilitated communication between clients and healthcare providers to ensure continuity of care.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Participated in regular professional development opportunities to stay current on best practices within the field of case management.
- Trained new case managers, raising team's overall competency and service delivery standards.
- Increased client satisfaction through diligent follow-up and personalized support.
- Fostered open lines of communication with clients'' families and support networks, involving them in the case management process as appropriate.
Care Coordinator
At Home Care Solutions
01.2021 - 06.2022
- Responsible for coordinating health care services for our clients.
- Responsible for creating a daily schedule for all shifts in HHAeXchange.
- Responsible for tracking and following up to ensure services are provided as scheduled.
- Responsible for communicating with field staff, patients, case manager and family members to maintain proper care coordination and continuity of care.
- Responsible for maintaining patient confidentiality following HIPAA guidelines.
- Responsible for hiring and process on-boarding enrollment for new H.H.A and C.N.A.
- Responsible for updating and keeping patient records current and discharge clients according to policy manuals and other pertinent documents.
- Responsible for reviewing and follow up clients reports and unverified visit.
- Coordinate services, and monitor care plan according to client’s personal needs
- Responsible for managing and processing new/old client admission and supervision.
- Responsible for representing employer in processing and record keeping of unemployment claims
- Responsible for maintaining and updating clients plan of care in the system.
Bilingual Customer Service Representative
Healthfirst
10.2020 - 12.2020
- Responsible for assisting members and providers with issues about members and their insurance in more than one family of product, i.e., Medicare and Medicaid.
- Responsible for receiving and addressing members and providers inquiries, resolution of complaints, client education, dis-enrollments, and escalation of issues that required additional intervention.
- Responsible for providing information in response to inquiries, concerns, and questions about insurance coverage and products.
- Transferring calls from members and providers to the appropriate department.
- Perform research on billing inquires and claims to provide payments information.
- Act as a liaison between various departments to address concerns.
- Handle and resolve customer’s complaints.
- Interact with members and their families to provide information in response to inquiries about products and services following HIPAA regulations.
- Multitasking between programs to complete required data entry of members demographics or members look up systems while talking.
- Familiar with using Salesforce, ePaces, and TruCare systems.
Manager
Troy & Greg Corp
10.2017 - 01.2020
- Responsible for managing and overseeing all operations in the assisted living facility.
- Managed the billing, budgeting, and all other financial related functions of the facility.
- Oversaw staffing, employee training, compliance with staffing legal regulations and scheduling of staff.
- Coordinated and supervised the delivery of health care services to facility residents.
- Reviewed plans of care to ensure resident's safety, overall health and wellbeing and the maintenance of a safe and peaceful home like environment.
- Ensured each resident's confidentiality and individual dignity was always maintained and respected.
- Responsible for ensuring the provisioning of care to ensure residents could live as independently as possible within functional limitations and to prevent institutionalization in nursing home facilities.
- Oversaw and managed dietary restrictions, food preparation by staff and dietician's menu compliance by residents.
- Maintained adherence with all state and federal regulations and governing bodies including AHCA, Medicare and Medicaid Insurances.
- Supervised the provisioning of and assistance with the activities of daily living to facility residents.
- Assessed residents and reported abnormal findings to doctors, family members, and legal representatives as needed.
- Coordinated facility resident's appointments and transportation with clinicians and community resources and ensured healthcare related services were provided and complied with clinician's orders.
Assistant Manager
Chipotle Mexican Grill
05.2010 - 08.2014
- Responsible for overseeing daily operations of the restaurant in coordination with the manager, including payroll, employee schedules, and inventory control, and purchases.
- Identified gaps, bottle necks in production/service line and development of action plans to correct deficiencies/delays.
- Responsible for identifying waste of resources and development of proposals for correction and, improvement in overall operations.
- Proposed marketing strategies to increase sales.
- Directly supervised of 35-40 employees at any given time.
- Handled complaints and issues between staff and customers and staff to staff and provided conflict resolution measures.
- Increased employee engagement and retention and boosted staff morale.
- Organized and conducted regular staff meetings and, performed annual evaluations as well as collaborated in the process of annual salary increases within allotted budget.
- Trained new staff and regularly retrained active staff.
Shift Manager
Boston Market Corporation
03.2007 - 01.2010
- Supervised shift activities within the restaurant, including staff’s working schedule, service line productivity, and supply and food inventory according to high/low seasons in a fast-paced setting.
- Maintained a professional and conducive environment for customers and staff members.
- Identified gaps, issues with staff and customers and provided recommendations to manager on action plans to improve services and overall activities of restaurant.
- Responsible for all monetary transactions during shifts.
- Addressed customer and staff complaints in a fast, effective manner to reduce or eliminate conflict escalation.
- Oversaw new hiring of staff.
Education
Bachelor of Arts - Psychology
Keiser University
Associate of Arts - Health Service Administration
Keiser University
Skills
- Team building
- Planning and coordination
- Problem-solving
- Fluent in English/Spanish
- Case management
- Case documentation
- Time management
- Organization and multitasking
- Cross-functional collaboration
- HIPAA compliance
- Empathy and compassion
- Positive attitude
LANGUAGES
English and Spanish
Timeline
Case Manager
Humana Healthy Horizons of Florida
06.2022 - Current
Care Coordinator
At Home Care Solutions
01.2021 - 06.2022
Bilingual Customer Service Representative
Healthfirst
10.2020 - 12.2020
Manager
Troy & Greg Corp
10.2017 - 01.2020
Assistant Manager
Chipotle Mexican Grill
05.2010 - 08.2014
Shift Manager
Boston Market Corporation
03.2007 - 01.2010
Associate of Arts - Health Service Administration
Keiser University
Bachelor of Arts - Psychology
Keiser University