Angel Arzuaga
Pinellas Park,FL
Summary
Developed critical thinking and problem-solving skills in fast-paced healthcare environment. Demonstrated ability to manage patient care, collaborate with interdisciplinary teams, and ensure compliance with healthcare regulations. Seeking to transition into new field where these skills can contribute to effective team performance and organizational success.
Overview
7
7
years of professional experience
Work History
RN Case Manager
Ultimate Health Plan
10.2021 - 12.2024
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- 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.
Lead RN Reviewer
Cohere Health Care
06.2020 - 10.2021
- Enhanced patient satisfaction through effective communication, empathy, and timely response to their needs.
- Collaborated with interdisciplinary teams for comprehensive patient care plans, resulting in better health outcomes.
- Mentored new nursing staff, contributing to supportive work environment and improved retention rates.
- Trained new nurses in proper techniques, care standards, operational procedures, and safety protocols.
- Provided emotional support to patients during challenging times, fostering sense of trust and rapport that contributed to better overall wellbeing.
- Evaluated patient histories, complaints, and current symptoms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
- Maintained strong attention to detail while reviewing numerous documents daily, ensuring consistent quality and accuracy.
- Maintained strict confidentiality with sensitive client information, adhering to industry standards and company policies.
- Reduced turnaround time for reviews by effectively prioritizing tasks and managing deadlines.
- Identified areas for potential improvements within reviewed materials, providing actionable recommendations to clients.
Concurrent Review RN
Cognizant Technology
10.2019 - 06.2020
- Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
- Managed complex cases of critically ill patients, ensuring optimal treatment plans were executed effectively.
- Streamlined documentation processes to ensure accurate record-keeping and compliance with regulatory standards.
- Evaluated patient histories, complaints, and current symptoms.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
Director of Nursing
Clearwater Center
01.2019 - 06.2019
- Participated in management team meetings to discuss resident status, census changes, and resident complaints or concerns.
- Oversaw and approved recruitment, hiring and orientation of new nursing staff.
- Ensured regulatory compliance by staying current on industry standards and updating policies accordingly.
- Monitored and evaluated nursing staff performance, providing feedback and guidance to support standards of care.
- Performed rounds to observe care and interview staff, residents, and families.
- Streamlined nursing operations by optimizing staffing schedules, resource allocation, and workflow processes.
- Developed positive employee relations, incentives, and recognition programs to promote teamwork and mutual respect.
Buckeye Health Plan Concurrent/Utilization Review Registered Nurse
Centene Corporation
05.2018 - 12.2018
- Company Overview: (Same position as HealthCare Support
- Offered and accepted full time status
- Transitioned from contract to full time employee with Centene)
- (Same position as HealthCare Support
- Offered and accepted full time status
- Transitioned from contract to full time employee with Centene)
Buckeye Health Plan Concurrent/Utilization Review Registered Nurse
HealthCare Support
11.2017 - 05.2018
- Company Overview: (Contract to hire)
- (Contract to hire)
Education
Associate of Applied Science -
Owens Community College
Perrysburg, OHSkills
- InterQual and Milliman guidelines
- Successful Remote experience
- Retrospective and Concurrent Reviews
- Hedis Measures
- NCQA
Personal Information
Title: Registered Nurse
Professional Highlights
- Clinical nursing experience in Medical Surgical, Level 1 trauma ICU, Step-Down, LTC, and Rehab units
- Leadership experience in both Acute and long-term care settings
- Chart audits in accordance to Medicaid/Medicare state guidelines
- Utilization/Concurrent Review Experience (InterQual) (MCG) (CareWebQi)
- Retrospective clinical reviews
- Heidis Measures
- Formal quarterly ICT meetings
- CCM and DM
- Discharge Planning
- Process Improvement focus groups
- Successful Remote employment 4 years
- Microsoft knowledge
Timeline
RN Case Manager
Ultimate Health Plan
10.2021 - 12.2024
Lead RN Reviewer
Cohere Health Care
06.2020 - 10.2021
Concurrent Review RN
Cognizant Technology
10.2019 - 06.2020
Director of Nursing
Clearwater Center
01.2019 - 06.2019
Buckeye Health Plan Concurrent/Utilization Review Registered Nurse
Centene Corporation
05.2018 - 12.2018
Buckeye Health Plan Concurrent/Utilization Review Registered Nurse
HealthCare Support
11.2017 - 05.2018
Associate of Applied Science -
Owens Community College