Clariz Horcher
UCLA Ronald Regan Medical Center
Winnetka,USA
21
years of professional experience
Dedicated Nurse Case Manager with extensive experience in RN case management, specializing in coordinating comprehensive patient care plans and fostering collaboration among healthcare teams to achieve optimal patient outcomes. Expertise in patient advocacy and resource management, supported by a robust 20-year background across diverse settings, including Neonatal Intensive Care Units, Intensive Care Units, Dialysis, Skilled Nursing Facilities, Utilization Review, and Case Management. Committed to delivering high-quality care and improving healthcare delivery through effective communication and strategic problem-solving. Proven ability to navigate complex healthcare environments while prioritizing and meeting patient needs.
Work History
RN Case Manager
5 Years 7 Months- Utilizes MCG and Interqual Guideline and Epic/Care Connect System
- Inpatient Utilization Review Case Manager
- ER Utilization Review Case Manager
- Procedures Utilization Review Case Manager
- Coordinated patient care plans with interdisciplinary teams to ensure comprehensive treatment approaches.
- Monitored patient progress and adjusted care strategies based on evolving needs and clinical outcomes.
- Utilized electronic health records systems for documentation, ensuring accuracy and compliance with regulatory standards.
- Collaborated with physicians and other healthcare providers to ensure appropriate resource utilization for complex cases.
RN Case Manager
7 Years- Utilizes Interqual Guideline and Epic/Care Connect System
- Pediatric Case Manager for the GI and Nephrology teams
- Medicine Floater Case Manager, able to float to the Medical ICU, CCU, Heme/Onc Department, Telemetry, and Medical Surgical Floors.
- ER Case Manager NOC Shift managing the entire house at night
- Full-Time
- Assessed patient progress through regular evaluations, adjusting care strategies as necessary for effectiveness.
- Educated patients and families on health management, enhancing understanding of treatment options and self-care practices.
- Implemented quality improvement initiatives, resulting in enhanced service delivery and patient satisfaction scores.
- Mentored junior staff on case management best practices, fostering professional development and team cohesion.
- Advocated for patient needs within the healthcare system, ensuring access to necessary services and support resources.
- 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.
- Implemented evidence-based practices to improve overall clinical performance and patient outcomes.
- Optimized resource utilization by identifying opportunities for cost containment while maintaining quality of care.
RN Case Manager
1 Year 7 Months- Utilizes MCG/Milliman Care Guideline and Cerner System.
- Per Diem
- Coordinated patient care plans to ensure comprehensive support across multidisciplinary teams.
- Managed support services and fostered communication among social workers, therapists, hospital staff, and patients.
- Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
- Conducted thorough assessments of patients'' needs, enabling more accurate diagnoses and targeted interventions.
- Streamlined discharge planning processes, ensuring a smoother transition for patients back to their homes or other facilities.
- Mentored new nursing staff, facilitating a faster learning curve and increased overall team efficiency.
- Ensured compliance with healthcare regulations and standards, conducting regular reviews of patient care activities.
- Facilitated multidisciplinary team meetings to discuss patient care, fostering collaborative approach to healthcare.
- Monitored patient progress closely, adjusting care plans as necessary to meet evolving health requirements.
RN Case Manager
5 Months- Utilizes Interqual Guideline and Protough System.
- Handles all types of patients in a Long-Term Acute Care Hospital facility.
- Full-Time
- Monitored patient progress and adjusted interventions based on clinical assessments and outcomes.
- Educated patients and families on disease management strategies and available resources.
- Collaborated with healthcare providers to streamline communication and enhance care delivery efficiency.
- Led interdisciplinary meetings focused on improving service delivery and addressing systemic challenges.
- Analyzed complex cases to develop tailored care strategies addressing individual patient needs.
- Negotiated with healthcare providers to ensure services were provided at best possible cost without compromising on quality.
RN Nursing Supervisor
6 Months- Managed a 100-bed capacity Skilled Nursing facility- Greenfield Care Center of South Gate
- Full-Time
- Administered medications and treatments per physician orders to ensure patient safety and comfort.
- Collaborated with multidisciplinary teams to develop and implement individualized care plans for patients.
- Led training sessions for nursing staff on best practices in patient care and safety protocols.
- Streamlined documentation processes, enhancing accuracy of patient records and compliance with regulations.
- Mentored junior nurses, fostering professional development through guidance and knowledge sharing.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Advocated for patient rights and needs within healthcare settings, improving overall patient satisfaction scores.
Inpatient Care Manager for Acute Hospital, SNF, AIR, LTACH- Insurance Side
4 Years 7 Months- Utilizes MCG/Milliman Care Guideline and Epic/Care Connect System
- Awards: Emerald Award for Exceptional performance that exceeded client expectations, exemplified the core values of the organization, and contributed significant business results for the months of February and May 2017
- Full-Time
Utilization Review/Utilization Management/Worker’s compensation
2 Years 8 Months- Utilizes MTUS, ODG, ACOEM, MCG/Milliman Care Guidelines
- Full-Time
Dialysis Nurse
6 Months- Dialysis Nurse, both Peritoneal and Hemodialysis
- Full-Time
- Administered dialysis treatments, ensuring patient comfort and safety throughout procedures.
- Monitored vital signs and laboratory results to assess treatment effectiveness and patient health status.
- Educated patients on treatment processes, dietary restrictions, and self-care techniques for optimal health management.
- Collaborated with interdisciplinary teams to develop individualized care plans tailored to patient needs.
- Conducted regular audits of dialysis procedures to ensure compliance with regulatory standards and best practices.
- Assisted in reducing hospital readmissions for dialysis patients through thorough patient education and follow-up care.
Neonatal Intensive Care Unit and Intensive Care Unit Floater
3 Years 1 Month- Performed bedside Registered Nurse and Charge Nurse Responsibilities.
- Full-Time
- Worked effectively in fast-paced environments.
- Used critical thinking to break down problems, evaluate solutions, and make decisions.
Education
Bachelor of Science - Nursing
Skills
Chronic disease management
Discharge planning
HIPAA compliance
Multidisciplinary approach
Utilization review
Care coordination
Clinical assessment
Critical thinking
Affiliations
- RN License State of California, Expiry Oct 2027
- RN License State of Oregon, Expired, not currently using the license
Timeline
RN Case Manager
Cedars Sinai Medical Center
11.2020 - CurrentRead More
RN Case Manager
UCLA Ronald Regan Medical Center
06.2019 - CurrentRead More
RN Case Manager
Martin Luther King Jr. Community Hospital
03.2019 - 10.2020Read More
RN Case Manager
Kindred Hospital La Mirada
10.2018 - 03.2019Read More
RN Nursing Supervisor
Evacare Management Consultancy Inc.
04.2018 - 10.2018Read More
Inpatient Care Manager for Acute Hospital, SNF, AIR, LTACH- Insurance Side
United Healthcare/OPTUM
04.2013 - 11.2017Read More
Utilization Review/Utilization Management/Worker’s compensation
Cognizant Technology Solutions
03.2010 - 11.2012Read More
Dialysis Nurse
Fresenius Medical Incorporated
06.2009 - 12.2009Read More
Neonatal Intensive Care Unit and Intensive Care Unit Floater
Cardinal Santos Medical Center
09.2005 - 10.2008Read More
Centro Escolar University
Bachelor of Science from Nursing
Read More