Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Elizabeth Tinguely

Las Cruces,NM

Summary

Motivated and detail-oriented professional with over 13 years of experience managing Medicaid-related programs within School-Based Services, both at the Local Education Agency (LEA) level and as a Program Manager for the New Mexico Medical Assistance Division’s Exempt Services & Programs Bureau, School Health Office. Demonstrated success in contract oversight, policy development, interagency collaboration, regulatory compliance, and staff supervision. Known for cultivating strong partnerships with local, state, and federal stakeholders to promote equitable access and sustainable program outcomes. Dedicated to advancing Medicaid School-Based Services through data-driven decision-making, meaningful stakeholder engagement, and strategic, system-level thinking.

Overview

40
40
years of professional experience

Work History

MSBS Program Manager

NM HCA
06.2024 - Current
  • Conduct program integrity audits to ensure compliance with state and federal Medicaid regulations.
  • Conducted quarterly 4B/4C audits to monitor documentation accuracy and claiming compliance
  • Provide program direction and technical guidance to LEAs, SFEAs, and RECs participating in the Medicaid School-Based Services (MSBS) program.
  • Coordinated onboarding and training for new Medicaid Coordinators across LEAs and RECs
  • Lead cross-sector efforts to ensure program alignment with state and federal regulations, including IDEA and EPSDT requirements.
  • Develop training resources, compliance guides, and reference materials to support participating districts and agency partners.
  • Collaborative problem-solving, policy input, and data reporting.
  • Conducted training sessions for school personnel on health policy implementation and best practices in student care.
  • Evaluated program effectiveness through stakeholder feedback, adapting strategies to meet evolving community needs.
  • Established strong relationships with key stakeholders, ensuring support for program initiatives.
  • Identified program obstacles and communicated possible impacts to team.
  • Devised creative solutions to critical customer and user needs related to Provider Enrollment and KYP Workspace

LCPS Medicaid Coordinator

Las Cruces Public Schools
05.2016 - 06.2024
  • Ensure compliance with both State and Federal Medicaid rules and regulations.
  • Ensure compliance with both State and Federal Special Education rules and regulations regarding Individual Educational Plans (IEP).
  • Adhere to all requirements as outlined in the Governmental Services Agreement (GSA) between the Human Services Department and LCPS.
  • Maintain and submit all required documents for Medicaid Fee for Services (FFS) Billing and Administrative Time Studies within compliance requirements of the State Medicaid Office and any contracted entity administer the program for the State of NM.
  • Maintain 3rd party biller Service Capture program by ensuring IEP, Student demographics and Medicaid information is accurate and up to date.
  • Maintain all records and documents as designated by the MSBS program and district for the State cyclic audit process, annual Cost Settlement and Federal PERM Desk audits.
  • Monitor disbursement of funds in accordance with requirements of Governmental Services Agreement (GSA) as entered between the NM HSD and LCPS.
  • Maintain and ensure continuity of care between Student PCP and medically related services provided in the school setting in accordance with the Student’s IEP
  • Monitored Medicaid claims submissions, resolving discrepancies to ensure timely reimbursement for services rendered.
  • Coordinated Medicaid enrollment processes for students, ensuring accurate documentation and compliance with regulations.
  • Developed training materials for staff on Medicaid policies, enhancing understanding and implementation of services.
  • Advocated for policy changes within the district to optimize Medicaid resources and improve student outcomes.
  • Exceeded departmental goals for timely case processing, contributing to the overall success of the Medicaid program.
  • Conducted thorough case reviews to identify areas for improvement, enhancing overall program effectiveness.
  • Implemented new filing systems that streamlined recordkeeping processes, improving efficiency and organization within the department.
  • Maintained up-to-date knowledge of state and federal regulations, ensuring compliance in all Medicaid coordination efforts.
  • Provided leadership, guidance and support to staff members.
  • Monitored program performance and outcomes for successful delivery of services.
  • Developed and implemented training programs for staff.
  • Established and maintained relationships with key stakeholders.
  • Researched best practices and developed strategies to improve program outcomes.
  • Analyzed trends and data to inform decision-making and program development.

Medicaid Coordinator

Gadsden Independent School District
06.2012 - 11.2015
  • Ensure compliance with both State of NM HSD/MAD/Office of School Health and Centers of Medicare and Medicaid (Federal) rules and regulations.
  • Ensure compliance with both State and Federal Special Education rules and regulations regarding Individual Educational Plans (IEP).
  • Adhered to all requirements as outlined in the Governmental Services Agreement (GSA) between the Human Services Department and LCPS.
  • Maintain and submit all required documents for Medicaid Fee for Services (FFS) Billing and Administrative Time Studies within compliance requirements of the State Medicaid Office and any contracted entity administer the program for the State of NM.
  • Maintain 3rd party biller Service Capture program by ensuring IEP, Student demographics and Medicaid information is accurate and up to date.
  • Maintain all records and documents as designated by the MSBS program and district for the State cyclic audit process, annual Cost Settlement and Federal PERM Desk audits.
  • Monitor disbursement of funds in accordance with requirements of Governmental Services Agreement (GSA) as entered between the NM HSD and LCPS.

Professional School Nurse

Gadsden Independent School District
09.2001 - 05.2012
  • Utilized the Resource and Patient Management System (RPMS) and Electronic Health Records (EHR) for accurate documentation and reporting.
  • Provided direct care including triage, assessment, and first aid for illness and injury.
  • Delegation and Training of Health Assistants to ensure compliance and positive student outcome
  • Contacted parents, primary care providers, or specialists when a student’s condition required further evaluation or intervention.
  • Collaborated with families, school staff, and healthcare professionals to advocate for student health needs and share relevant medical information.
  • Organized and conducted immunization clinics and performed vision and hearing screenings.
  • Offered emotional support and counseling to students, promoting mental and emotional well-being.
  • Reported suspected cases of abuse, neglect, or endangerment to the appropriate authorities.
  • Monitored and enforced infection control protocols to maintain a safe and healthy school environment.
  • Evaluated students with health concerns, developing individualized care plans or making appropriate referrals.
  • Managed medical supplies inventory; ordered and stocked equipment as needed.
  • Delivered one-on-one and group health education to students on medical and wellness topics.
  • Applied clinical judgment and evidence-based practices in school nursing interventions.
  • Responded to medical emergencies with calm, effective interventions and life-saving measures.
  • Assessed student conditions, documented findings, and communicated updates to primary care providers.
  • Coordinated with medical providers, families, and school personnel to develop, implement, and monitor Individualized Healthcare Plans (IHPs).
  • Maintained confidentiality and FERPA compliance in all documentation and communication.
  • Advocated for students’ needs within interdisciplinary teams and ensured proper implementation of IEPs, 504 Plans, and IHPs.
  • Led continuous improvement initiatives to enhance the quality of student healthcare services within the school setting.
  • Reviewed and modified care plans based on student response and changing medical status.

Charge Nurse - OR/PACU/Pre-Op Nurse

Memorial Medical Center
01.1986 - 09.2001
  • Care Manager for Free Standing Surgery, Endoscopy, Radiology and Laboratory Unit
  • Supervised seventy staff members. RNs, OR techs, Endo techs and Laboratory and Radiology personnel. Completed employee annual evaluations.
  • Served as a liaison between nursing staff, physicians, and management, fostering open communication channels among all parties involved in patient care.
  • Managed supply of medical equipment and consumables, ensuring availability and reducing instances of stock-outs.
  • Championed a positive work culture by recognizing exemplary performance from team members and addressing conflicts promptly when they arose.
  • Streamlined nursing workflows for increased efficiency and improved patient outcomes.
  • Supervised and managed daily scheduling, tasking, and administration.
  • Managed staffing schedules, ensuring adequate coverage while minimizing overtime expenses.
  • Contributed significantly towards Joint Commission accreditation compliance through regular audits, staff education and process improvement recommendations.
  • Participated in quality improvement initiatives, contributing to the development of best practices within the department.
  • Facilitated ongoing education for nursing staff through in-service training sessions and workshops on relevant topics.
  • Optimized resource allocation, ensuring all patients received timely and adequate care without overburdening staff.
  • Improved team morale and reduced turnover by implementing regular feedback sessions and career development opportunities.
  • Fostered culture of continuous improvement, leading to adoption of innovative nursing practices.
  • Facilitated cross-departmental communication, enhancing efficiency of patient care coordination.
  • Enhanced patient care quality by leading team of nurses to adopt evidence-based practices.
  • Conducted regular audits of nursing practices, identifying areas for improvement and implementing corrective actions.
  • Implemented stress-reduction techniques among staff, leading to improved job satisfaction and reduced absenteeism.
  • Led teams in driving successful patient outcomes by prioritizing standard of care and best practices.
  • Delivered high level of quality care to diverse populations while overseeing patient admission and triaging based on acuity and appropriate department admission.
  • Participated in evidence-based practice project implementation, nursing competency development and nursing simulation activities.
  • Investigated and resolved issues affecting hospital operations and patient care.
  • Streamlined pre-operative processes, improving efficiency in patient flow management.
  • Supervised nursing staff to ensure adherence to patient care standards and protocols.
  • Implemented quality improvement initiatives, enhancing patient safety and care outcomes.
  • Mentored new nurses, fostering professional development and adherence to best practices.
  • Developed staffing schedules, ensuring adequate coverage for optimal patient care delivery.
  • Optimized patient satisfaction through timely response to concerns and effective communication among staff members.
  • Promoted a safe working environment by adhering to infection control policies and regularly reviewing safety protocols.
  • Maintained accurate documentation of patient information, enabling informed decision-making among the healthcare team members.

Education

Bachelor of Science - Nursing

NMSU
Las Cruces, NM
05.1986

Skills

  • Medicaid Policy & Compliance
  • Cross-Agency Collaboration
  • Budget & Contract Oversight
  • Staff Development & Supervision
  • Program Development & Evaluation
  • Stakeholder Communication & Training
  • CMS & State Plan Coordination
  • Work effectively under stress and deadlines

Accomplishments

  • National Alliance for Medicaid in Education Leadership Team
  • Honorary School Nurse, 2005 outstanding performance and team contributions.
  • MMC Nursing Services Employee of the Year 2000

Timeline

MSBS Program Manager

NM HCA
06.2024 - Current

LCPS Medicaid Coordinator

Las Cruces Public Schools
05.2016 - 06.2024

Medicaid Coordinator

Gadsden Independent School District
06.2012 - 11.2015

Professional School Nurse

Gadsden Independent School District
09.2001 - 05.2012

Charge Nurse - OR/PACU/Pre-Op Nurse

Memorial Medical Center
01.1986 - 09.2001

Bachelor of Science - Nursing

NMSU

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