Licensed Vocational Nurse with more than 4 decades of experience working with Managed Care, Stars Rating.HEDIS reporting, Quality Assurance, Medicare and Medicaid, Case Management
Overview
14
14
years of professional experience
1
1
Certification
Work History
Clinical Quality LVN
WellMed Medical Management
San Antonio
02.2020 - 01.2026
Review medical records for HEDIS Compliance; close GAPS in care using Data RAP, True Care, ECW, and IKA Data basis
Field Nurse
Crest Home Health
Boerne
07.2022 - 03.2025
Completing home health visits for assessments, wound care
United Health Care Community and State
Corpus Christi
06.2016 - 10.2019
Supervise 17 Navigators and 4 Navigator Aide across the state of Texas.
A team responsible for Addressing barriers, closing GAPS in care to improve Star ratings and improve members over all Health Status.
Develop new program policies and processes.
Supervisor, National Stars Member Navigator Program
United Healthcare – Community and State
Corpus Christi
12.2011 - 06.2015
Coordination / relocating members from the nursing home setting into the community.
Collaborated with state entities, providers, Home Health services and medical equipment to
Money Follows the Person Service Coordinator
Education
Crawford County Vocational school of Practical Nursing -
Crawford County Vocational school of Practical Nursing
Skills
Microsoft Office
Excel
Medical record review
Critical thinking
Analyzing medical records
Certification
Licensed Vocational Nurse, Texas, 05/28
Professional Values Offered
Compassion towards members and co-workers
Collaborate well with multiple entities, other departments
Timeline
Field Nurse
Crest Home Health
07.2022 - 03.2025
Clinical Quality LVN
WellMed Medical Management
02.2020 - 01.2026
United Health Care Community and State
06.2016 - 10.2019
United Healthcare – Community and State
12.2011 - 06.2015
Crawford County Vocational school of Practical Nursing -
Crawford County Vocational school of Practical Nursing
Clinical Quality Program/Project Manager at Parkland Health And Hospital SystemsClinical Quality Program/Project Manager at Parkland Health And Hospital Systems