Erika Cuellar
Brookdale Senior Living
Houston,TX
1
Certification
20
years of professional experience
Work History
Health and Wellness Coordinator
3 Years 2 Months- Collaborated with healthcare professionals to coordinate personalized care plans for residents.
- Trained staff on wellness initiatives to enhance resident engagement and participation.
- Advocated for resident wellness by promoting mental, emotional, and physical health initiatives throughout the community.
- Served as a liaison between employees and management, addressing concerns related to workplace policies and practices.
- Built productive relationships with vendors and on-site providers
- .· Maintain medical records and required documentation under state regulatory guidelines for appropriate licensing and standard operating procedures and policies
- · Assess residents for changes in the level of care, and medical appointments and coordinate required transportation
- · Coordinate medications for residents, order refills, and fax new orders
- · Perform cart audits to be sure medication carts are kept in compliance
- · Work closely with residents and families to develop & implement appropriate Plans of Care
- · Monitor staffing schedules and assist to secure replacements for absences
- · Supervise and assign work for caregivers
- · Maintain strong communication with family members of residents
- · Monitoring response times to resident calls
- · Assist Health & Wellness Director when absent from the community
Utilization Review Nurse
2 Years 9 Months- Initiated timely communication with insurance companies for authorization of hospitalizations and advanced imaging, ensuring maximum allowable reimbursement is achieved.
- Identify inappropriate utilization of services/settings through the application of established clinical criteria using Interqual, CMS, Commercial guidelines for medical necessity.
- Maintained daily communication with medical director, reporting inpatient acuity levels per Interqual criteria and conducting reviews and assessments of criteria.
P4Q Nurse
6 Years 11 Months- Review and abstract EMR to optimize HEDIS scores
- Reviewed and abstracted EMR to enhance HEDIS score accuracy
- Communicate status of measures / scores to appropriate team members and physicians
- Coordinate and manage relationships with multiple providers
- Coordinated and managed relationships with multiple providers to streamline patient care
- Educated patients and coordinated care to improve member health outcomes
Surgical Specialties Nurse - Urology
4 Years 2 Months- Coordinated care for patients with urinary tract conditions in clinic
- Assessed symptoms and communicated findings to physician
- Evaluate symptoms and report to physician
- Delivered patient education on urinary health management
Disease Registry Nurse (Pilot Program)
8 Months- Identify Gaps in Care and Preventative Measures
- Identified gaps in care and preventative measures to enhance patient outcomes
- Reviewed and abstracted EMR and paper records to improve data accuracy and support quality initiatives
- Outreach to members to coordinate appointments with physician or specialists
- Coordinated outreach to members for appointment scheduling with physicians or specialists to ensure timely care access
- Embedded program
Correctional Nurse
1 Year 7 Months- Administer care and treatment to the inmate population
- Administered medications to ensure timely and accurate treatment of inmate health needs
- Wound care and specialty care
- Coordinated outside medical services to facilitate comprehensive treatment for inmates
- Led intake services team to streamline patient assessments and improve care coordination
- Respond to medical emergencies
Telemetry Nurse
2 Years 3 Months- Assessed acute changes in patients to ensure timely interventions in a fast-paced environment.
- Monitored and analyzed heart rhythms, interpreted ECGs, noted arrhythmias, and intervened during emergencies to maintain patient safety.
- Facilitated patient admissions and discharges to streamline workflow and enhance patient care.
- Transfusions
Education
Vocational Nursing - Vocational Nursing
Skills
Utilization management
Case management
Quality assurance
HEDIS
EMR systems
Care coordination
InterQual criteria
Medical necessity review
Prior authorization
Patient education
Utilization review criteria
Concurrent review
Appeals support
Transitions of care
Interdisciplinary team coordination
Certification
- PN
- Expires: June 2022
Timeline
Health and Wellness Coordinator
Brookdale Senior Living
06.2023 - CurrentRead More
Utilization Review Nurse
Kelsey-Seybold Clinic
08.2020 - 05.2023Read More
P4Q Nurse
Cigna HealthSpring
06.2013 - 05.2020Read More
Disease Registry Nurse (Pilot Program)
Cigna Medical Group
09.2012 - 05.2013Read More
Surgical Specialties Nurse - Urology
Cigna Medical Group
06.2009 - 08.2013Read More
Correctional Nurse
Central Arizona Detention Center
11.2007 - 06.2009Read More
Telemetry Nurse
Citizens Medical Center
08.2006 - 11.2008Read More
Victoria College
Vocational Nursing from Vocational Nursing
Read More