Open To Work
ERIKA PARADA
CARELON HEALTH
El Paso,TX
Work Preference
Desired Job Title
Manager II, Behavioral Health ServicesHCMS Manager ISenior Case Manager | High Intensity Registered NurseComfort Care CoordinatorWork Type
Full TimeLocation Preference
RemoteImportant To Me
Work-life balanceCompany CultureFlexible work hoursWork from home optionPersonal development programsPaid time offCareer advancementHealthcare benefitsSummary
Strategic healthcare executive with 15 years of experience in clinical operations, behavioral health, and population health across Commercial, Medicare, and Medicaid sectors. Led multi-state operations and developed high-performing clinical teams, improving quality outcomes and reducing care costs through effective initiatives. Fostered partnerships with leadership and interdisciplinary teams to ensure regulatory compliance while driving organizational transformation through data-driven decision-making and process improvement.
2
Languages
1
Certification
20
years of professional experience
Work History
Manager II, Behavioral Health Services
3 Years 5 Months- Lead, coached, and developed a team of 17 Behavioral Health Case managers supporting integrated behavioral health and physical health case management operations.
- Supported five states in delivering Medicare, Medicaid, commercial, and FEP services.
- Lead implementation of innovative care management initiatives and pilot programs that improve quality metrics and operational efficiency.
- Led implementation of innovative care management initiatives and pilot programs to enhance quality metrics and operational efficiency.
- Ensure compliance with NCQA, CMS, accreditation, and organizational quality standards.
- Analyzed operational KPIs to identify workflow optimization and improve member engagement.
HCMS Manager I
8 Years- Led teams of 20 field clinicians and 10 medical management specialists in supporting LTSS operations for our Medicare- Medicaid population throughout Texas
- Developed and monitored operational budgets, staffing plans, and departmental priorities to align resources with organizational goals
- Oversaw resource utilization and quality initiatives to enhance operational performance
- Collaborated across departments to enhance continuity of care and streamline operational effectiveness
Senior Case Manager | High Intensity Registered Nurse
3 Years- Managed medically complex members with catastrophic injuries and chronic illnesses, ensuring continuity of care and adherence to treatment plans.
- Coordinated interdisciplinary care among physicians, specialists, hospitals, and community resources to streamline patient services and enhance care delivery.
- Identified high-risk patients and implemented targeted interventions, leading to improved patient health outcomes.
- Conducted orientation and mentorship for newly hired case managers.
- Participated in statewide retention initiatives and case management improvement workgroups
Comfort Care Coordinator
5 Years- Coordinated palliative care services, ensuring comprehensive support for patients with advanced illness.
- Coordinated patient care plans to ensure comprehensive support for seniors' health needs.
- Implemented effective communication strategies between healthcare providers and patients to enhance service delivery.
- Streamlined appointment scheduling processes to improve patient access and reduce wait times.
Education
Bachelor of Science - Nursing
slated to graduate in 2027
Associate of Applied Science - Nursing
ADN
Skills
Behavioral Health Operations
Behavioral health management
Healthcare Operations
Value-Based Care
Medicare & Medicaid
Commercial Health Plans
Cost of Care Management
Population Health
Case management
People Leader
People Leader
Operational Efficiency
Strategic Planning
Certification
- Registered Nurse (Texas)
- Lean Six Sigma Yellow Belt
- Conflict resolution
- AI-Powered People Manager
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Manager II, Behavioral Health Services
CARELON HEALTH
03.2023 - 08.2026
HCMS Manager I
AMERIGROUP
01.2015 - 01.2023
Senior Case Manager | High Intensity Registered Nurse
AMERIGROUP
01.2012 - 01.2015
Comfort Care Coordinator
BIENVIVIR SENIOR HEALTH SERVICES
01.2007 - 01.2012
The University of Texas At Arlington
Bachelor of Science from Nursing
El Paso Community College
Associate of Applied Science from Nursing