Dana Calvillo
San Antonio,TX
Summary
Compassionate Case Manager Supervisor with comprehensive background in overseeing team of case managers and coordinating client services. Efficient in completing assigned tasks, strong leadership, communication skills, and ability to work under pressure characterize professional capabilities. Demonstrated success in improving team productivity and streamlining processes for enhanced efficiency while maintaining high standards of service delivery. Willingness to help co-workers, active listener and committed to team goals.
Overview
18
18
years of professional experience
Work History
RN Director of Case Management
PAM Health Warm Springs Rehabilitation Hospital
San Antonio, Texas
05.2023 - Current
- Supervise case management staff to ensure compliance with organizational policies.
- Participate in interdisciplinary team meetings with other health professionals to coordinate services for complex cases.
- Assist and train new case managers to enhance service delivery to patients and families.
- Coordinate care plans with multidisciplinary teams for comprehensive client support.
- Monitor case progress, and adjust strategies based on client needs and feedback.
- Advocated for clients' needs by collaborating with external service providers and stakeholders.
- Develop strategies to improve workflow efficiency in order to meet performance objectives.
- Monitor caseloads for timely completion of tasks and client outcomes.
- Resolve conflicts between clients, families, care providers, and other stakeholders involved in the case management process.
- Ensured compliance with relevant laws, regulations and organizational standards related to case management services.
- Assist Case Managers with problem-solving in difficult cases and developing individualized service plans.
- Maintain confidential records regarding clients' medical history, treatment plans, and progress toward goals.
- Implemented policies and procedures for case management staff.
- Provide resources and referrals to clients, as needed.
- Respond promptly to inquiries from internal and external customers regarding case management services.
- Collaborate with other departments within the organization to ensure that all client needs are met.
- Conduct monthly meetings with case managers to review cases, discuss any issues or concerns, and educate on our congestive heart failure, brain injury, and stroke program community resources.
- Serve as a liaison between the organization and external agencies, providing support services for clients.
- Developed trusting relationships with social services, health care providers and governmental agencies.
- Assist patients with eligibility for available benefits and community resources (transportation, secondary insurance, Medicaid, SSDI, CRS, Connect-Ability).
- Assist with new patient case management evaluations within 24 to 48 hours of admission, and assist with discharge at least 48 to 72 hours prior to a patient's discharge with home health, outpatient, or skilled nursing facility.
- Perform a review of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for the appropriate level of care.
- Assess and identify discharge needs, and coordinate an appropriate discharge plan.
- Works collaboratively with the interdisciplinary team to facilitate the achievement of desired financial and quality outcomes.
- Maintain and enhance payor relationships as part of utilization review.
- Assist and maintain less than 10% (goal) to a skilled nursing facility, as appropriate for patient safety upon discharge.
Case Manager
PAM Health Warm Springs Rehabilitation Hospital
San Antonio, Texas
03.2019 - 05.2023
- Managed client intake and assessment processes to determine needs and services.
- Coordinated care plans with multidisciplinary teams for comprehensive client support.
- Responsible for the interdisciplinary coordination of care for a designated patient population.
- Perform a review of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for the appropriate level of care.
- Assess and identify discharge needs, and coordinate an appropriate discharge plan.
- Work collaboratively with the interdisciplinary team to facilitate the achievement of desired financial and quality outcomes.
- Maintain and enhance payor relationships.
- Conduct regular follow-ups to monitor client progress and adjust services as needed.
- Advocate for client rights and access to necessary resources and services.
- Document case notes and maintained accurate records in case management software.
- Facilitated communication between clients, families, and service providers effectively.
- Monitored client progress through regular follow-up contacts.
Patient Assessment Coordinator
PAM Health Warm Springs Rehabilitation Hospital
San Antonio, Texas
10.2017 - 03.2019
- Coordinates the process of providing accurate and timely data to the appropriate entities involved in the Prospective Payment System and quality reporting program for Medicare patients.
- This position oversees all aspects of data collection on the IRF/PAI, ensures the presence of supporting documentation, and provides staff education to ensure compliance with CMS guidelines.
- Assume the task of reviewing each IRF/PAI form completely, accurately, and in a timely manner.
- Monitor the accuracy in the scoring of the functional status and reflection of the patient’s care needs, and input appropriate information for the IRF/PAI into the eRehabData system.
- Responsible for coordinating the collection of patient information from the patient medical record, and the completion of assigned sections of the IRF/PAI form.
- Additional responsibilities include: setting proscribed IRF/PAI completion dates for the multi-disciplinary team; developing and interpreting policies and procedures; acting as the primary resource for immediate problem-solving regarding Medicare’s IRF prospective payment system (FIM scoring, impairment group coding, tiering distribution); coverage and classification criteria; and quality reporting program requirements.
Medical Leave
Medical Leave of Absence
San Antonio, Texas
10.2015 - 10.2017
- Dialysis and Renal Transplant Recovery
Patient Assessment Coordinator (IRF-PAI)
PAM Health Warm Springs Rehabilitation Hospital
San Antonio, Texas
03.2008 - 10.2015
- This position works under the direction of the Director of Business Development.
- Cultivates referral relationships, manages assigned territory, and completes patient assessments.
- Makes sales contacts as well as analysis of referral and admission data from assigned territory.
- Works collaboratively with business development team members including the Admissions Manager and admission staff, as well as nursing and other internal and external staff to facilitate the referral conversion.
- Provides feedback and recommendations for program development and quality improvement initiatives related to customer service, the referral and admission process and patient and referral source satisfaction.
- Develops and maintains excellent relationships to all stakeholders including prospective patient, family members, physicians, ICU and floor nurses, discharge planners, case managers and payer representatives.
Education
Associate of Science - RN-Nursing
Galen College of Nursing
San Antonio, TX09-2010
LVN - Nursing
Baptist School of Health Profession
San Antonio, TX12-1996
Skills
- Case management
- Care coordination
- Patient advocacy
- Regulatory compliance
- Interdisciplinary collaboration
- Client assessment
- Immunization skills
- Insulin medication assistance
- Team coordination
- Precepting
- Patient satisfaction and process improvement
- Patient evaluation
- Relationship building
- Empathetic listening
- Staff training
- Conflict resolution
- Effective communication
- Appointment scheduling
- Direct and indirect patient care
- Intake and discharge
- Coordinating referrals
- Patient discharging
- Policy compliance
- Case manager assessments
- Compassion and empathy
REFERENCES
- James Rennert RN, (210) 842-4538
- Sonya Morales DPT, (830) 352-1499
- Amanda Gonzalez RN, (956) 240-2840
- Hiroshi Ajas LMSW, (210) 846-3349
- Christa Abila OTR, (210) 410-1144
Timeline
RN Director of Case Management
PAM Health Warm Springs Rehabilitation Hospital
05.2023 - Current
Case Manager
PAM Health Warm Springs Rehabilitation Hospital
03.2019 - 05.2023
Patient Assessment Coordinator
PAM Health Warm Springs Rehabilitation Hospital
10.2017 - 03.2019
Medical Leave
Medical Leave of Absence
10.2015 - 10.2017
Patient Assessment Coordinator (IRF-PAI)
PAM Health Warm Springs Rehabilitation Hospital
03.2008 - 10.2015
Associate of Science - RN-Nursing
Galen College of Nursing
LVN - Nursing
Baptist School of Health Profession