CAITLYN SCHOZER
San Antonio,TX
Summary
Detail-oriented Registered Nurse experienced in managed care, Medicare/Medicaid, clinical assessment, and case management. Expertise in reviewing clinical information, identifying care gaps, coordinating services, and collaborating with interdisciplinary teams. Pursuing opportunities in Utilization Management, Clinical Review, or Medical Review.
Overview
11
11
years of professional experience
Work History
RN Case Manager
Centene Corporation
San Antonio, TX
05.2025 - Current
- Develop, implement, and monitor individualized care plans to support quality outcomes and cost-effective care
- Conducted telephonic case management assessments for members with complex medical and behavioral health needs to identify appropriate interventions
- Coordinate care among providers, hospitals, specialists, community resources, and interdisciplinary teams
- Collaborate with utilization management and care coordination teams to support appropriate level of care decisions
- Educated members on disease management, treatment plans, medications, and available health resources to enhance understanding and adherence
- Review clinical information to identify gaps in care and barriers to treatment adherence
- Monitored member progress, evaluated outcomes, and adjusted care plans.
- Document member interactions, care plans, and interventions in accordance with regulatory and company guidelines
- Supported transition of care activities following hospitalizations or emergency visits to ensure continuity and quality of care
RN Case Manager, LTSS
Molina Healthcare Of Texas
San Antonio, TX
08.2024 - 05.2025
- Coordinated with healthcare providers, social workers, and community resources to facilitate seamless care transitions and comprehensive support for members in home, nursing facilities, or hospice care.
- Perform comprehensive patient assessments, documenting medical histories, functional abilities, and psychosocial needs to create personalized care plans.
- Managed caseload of Medicaid and Medicare recipients enrolled in Molina's LTSS programs, ensuring timely and appropriate care tailored to members' specific needs.
- Educated patients and families on navigating the healthcare system, understanding insurance benefits, and maximizing available services under Molina's LTSS programs.
RN Case Manager
Hummingbird Hospice
San Antonio, TX
05.2023 - 08.2024
- Collaborated with interdisciplinary team to develop and implement patient care plans, ensuring delivery of evidence-based, cost-effective care in alignment with facility policies.
- Evaluated patient and family responses to care and referred to additional services through the case management approach.
- Facilitated patient-family conferences by mediating conflicts, clarifying misunderstandings, and providing information about available care resources and options.
- Supervise and evaluate the work of nursing and personal care staff assigned to the caseload.
RN Charge Nurse
Cantex Continuing Care Network
San Antonio, TX
11.2016 - 03.2024
- Created, assessed, and implemented the interdisciplinary plan of care to provide patients with the highest quality of care.
- Administered medications to patients, orally or by injection, including intravenous medications and treatments per physician orders.
- Intervened and stabilized patients during emergencies with immediate first aid or CPR.
- Intervened to stabilize patients during emergencies by providing immediate first aid or CPR.
- Managed patient flow for the unit by overseeing admissions, processing discharge paperwork, and supervising personal care staff to enhance operational efficiency.
LVN Charge Nurse
The Haven and The Laurels
San Antonio, TX
01.2016 - 11.2016
- Supervised and evaluated nursing and personal care staff, ensuring compliance with care standards and fostering professional development.
- Coordinated daily workflow, optimizing staffing, assignments, and patient care to enhance service delivery.
- Collaborated with healthcare team to enhance patient care quality and streamline communication across disciplines.
- Monitored vital signs administered prescribed medications.
LVN
Daybreak Venture, LLC
San Antonio, TX
09.2015 - 12.2015
- Recorded and monitored patient vital signs, assessed conditions within scope of practice, and reported changes to supervising registered nurse or physician, ensuring accurate documentation of all patient care services in electronic charting systems.
- Operated and maintained medical equipment for patient care, including glucose meters, oxygen concentrators, wound vacs, catheters, tracheostomy tubes, peg tubes, and IV pumps, contributing to effective treatment delivery.
- Administered prescribed medications and monitored patient responses, while performing wound care and dressing changes to promote recovery and maintain patient comfort.
Education
Associates of Applied Science - Nursing
Baptist Health System School of Health Professions
San Antonio, TXNursing Prerequisites for AAS -
Alamo Community Colleges
San Antonio, TXCertificate In Licensed Vocational Nursing -
Galen College of Nursing
San Antonio, TXSkills
- Complex care management
- Electronic health records
- Clinical review & Level of care review
- Interdisciplinary collaboration
- Medicare, Medicaid, LTSS, DNSP
- Telephonic assessments
- Care plan development
- Disease management
LANGUAGE
English, Native
Timeline
RN Case Manager
Centene Corporation
05.2025 - Current
RN Case Manager, LTSS
Molina Healthcare Of Texas
08.2024 - 05.2025
RN Case Manager
Hummingbird Hospice
05.2023 - 08.2024
RN Charge Nurse
Cantex Continuing Care Network
11.2016 - 03.2024
LVN Charge Nurse
The Haven and The Laurels
01.2016 - 11.2016
LVN
Daybreak Venture, LLC
09.2015 - 12.2015
Associates of Applied Science - Nursing
Baptist Health System School of Health Professions
Nursing Prerequisites for AAS -
Alamo Community Colleges
Certificate In Licensed Vocational Nursing -
Galen College of Nursing