NANCY A. WINELAND
El Paso,TX
Summary
Registered Nurse with over 30 years of experience in Pediatric and Neonatal Intensive Care (PICU/NICU), hospice, trauma, and neonatal medicine, with more than 7 years of case management experience. Highly skilled in utilization management, care coordination, discharge planning, and quality improvement. Demonstrated leadership in evaluating medical necessity, optimizing resource utilization, and improving patient outcomes through evidence-based practice.
Professional with strong background in case management, prepared to make significant impact. Proven ability to collaborate with teams and adapt to changing needs. Skilled in client assessment, resource coordination, and crisis intervention. Reliable and results-focused, with commitment to achieving positive outcomes.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Case Manager
Wellmed Medical Group
04.2016 - Current
- Coordinate care with insurers, physicians, and healthcare providers to ensure cost-effective, high-quality care.
- Conduct utilization review using InterQual criteria to determine medical necessity and level of care.
- Manage comprehensive discharge planning and post-acute services including home health, hospice, and inpatient rehabilitation.
- Monitor acute and chronic conditions and submit progress reports to care teams and payers.
- Streamline Operations and prioritize tasks, allowing senior staff to increase revenue by 25%
Charge Nurse / Case Manager
Optum
03.2004 - 04.2016
- Delivered critical care to neonatal through adolescent patients with complex medical and surgical needs.
- Oversaw daily clinical operations and supervised nursing staff.
- Managed pre-operative through post-operative care and patient discharge planning.
- Educated patients and families on treatment plans, disease management, and recovery.
Charge Nurse / Hospice Case Manager
Del Sol
03.1995 - 03.2004
- Provided comprehensive hospice and pediatric nursing care, including assessment, medication administration, and documentation.
- Developed and implemented individualized care plans and coordinated interdisciplinary teams.
- Served as liaison between patients, families, physicians, and hospice staff.
- Educated families on symptom management, discharge care, and end-of-life planning.
Education
Bachelor of Science - Nursing
University of Texas At El Paso
El Paso12.1994
Skills
- MCG Reviews
- Utilization & Quality Improvement
- Auditing & Compliance
- Treatment Planning
- Medical Coding
- Inpatient & Outpatient Admissions
- Skilled Nursing Facility Coordination
- Home Health & Hospice
- Provider Collaboration
- Diagnostic Interpretation
Certification
Certified Case Manager (CCM), January 2022
Languages
Spanish
Full Professional
Timeline
Case Manager
Wellmed Medical Group
04.2016 - Current
Charge Nurse / Case Manager
Optum
03.2004 - 04.2016
Charge Nurse / Hospice Case Manager
Del Sol
03.1995 - 03.2004
Bachelor of Science - Nursing
University of Texas At El Paso