FRANCES REYES
Professional Nurse
Jersey City,NJ
Summary
Dynamic Telephonic Nurse Case Manager with a proven track record of delivering appropriate and cost-effective healthcare services for medically rehabilitated individuals through the development of patient-centered case management plans. Expertise in leveraging independent nursing judgment and evidence-based clinical decision-making to optimize health outcomes across the care continuum, complemented by extensive experience in chronic disease management and collaborative care planning. Recognized for strong capabilities in quality assessment and planning, along with a demonstrated ability to lead cross-functional teams effectively. An outgoing, people-oriented approach fosters connections with diverse groups while maintaining exceptional organizational and communication skills to support upper management initiatives.
Overview
25
25
years of professional experience
2
2
Certification
1
1
EPIC Trained
Work History
UAS Assessor and Field Nurse Supervisor
Gotham Companies
The Bronx, NY
02.2023 - Current
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
- Skillfully managed challenging patient situations using de-escalation techniques, crisis intervention strategies, and therapeutic communication skills.
- Facilitated patient transitions between different levels of care, ensuring continuity of services and minimizing disruptions in treatment plans.
- Implemented evidence-based fall prevention strategies, resulting in a significant decrease in patient falls within the unit.
- Educated family members and caregivers on patient care instructions.
- Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
UAS RN (Per Diem) and Field Nurse Supervisor
Rockaway Home Care
The Bronx, NY
08.2023 - 08.2025
- Visit ML TC members receiving long term care
- Conduct face to face UAS assessments according to state and plan guidelines.
- Perform assessments in the home setting and/or video conference
- Act as intermediary between providers, LHCSA and members
- Assess eligibility of Medicaid members in need of managed long term care using a comprehensive web based system.
- Review medical records and medications to support assessment outcomes.
- Conduct needs assessment by utilizing UAS-NY/DOH tool to determine consumers’ qualifications and appropriateness for Long Term Care Services.
- Utilizing Lenavi and/or QCCS Analyzer for recommendations for finalization.
Clinic RN Certified Community Behavioral CONTRACT
Tandy M Group
The Bronx, NY
07.2023 - 11.2023
- Performed Medical Assessment on clients with comorbidities to ensure that appropriate medical support is provided
- Provided IM injections for psychiatric clients.
- Provided ongoing teaching on mental health, drug abuse, and nutrition counseling.
- Interviewed patients and collected medical histories
- Developed patient care plans based on assessments
- Provided counseling and followed up with patients via phone or in person
- Monitored patients for medication side effects and adherence
- Collaborated with psychiatrists, psychologists, social workers, and other professionals
- Helped patients with activities of daily living and improving coping skills
- Advocating for patients and connecting them to resources and support services
Telephonic Nurse Case Manager FULLTIME
Senior Whole Health
Manhattan, NY
05.2017 - 05.2021
- Telephonic Quality Calls performed daily to meet daily quota of 7-9 calls per day by assessing current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives. Total monthly calls 100-125 calls.
- Patient Service Care Plans evaluated daily for patients referred for case management to determine physical, mental, financial and psychosocial status by utilizing comprehensive, standardized criteria to identify existing and potential needs.
- Utilization Review conducted daily with collaboration with other health care professionals, regarding plan of care and variances in plan implementation and its appropriateness in order to achieve best health outcomes and cost efficiency.
- Grievance and Appeals were generated daily through participants requests and scaled its priority to 3 day responses depending on the appropriateness and patient's urgency.
- Quality Assurance maintained by screening medical information for Medicaid/Medicare compliance and STATE/FEDERAL guidelines
Nursing Supervisor/Instructor FULLTIME
Heart to Heart Home Care
Bronx, NY
01.2017 - 04.2017
- Supervised nursing staff to ensure high-quality patient care and compliance with health regulations.
- Developed training programs to enhance staff competencies and improve service delivery standards.
- Implemented quality assurance protocols to monitor patient outcomes and identify areas for improvement.
- Coordinated care plans with interdisciplinary teams to optimize patient recovery processes.
Infusion Nurse
Walgreens/Trinity Infusion
Queens, NY
12.2014 - 04.2016
- Administered intravenous therapies and medications to patients with diverse medical conditions.
- Monitored patients' vital signs and reactions during infusion treatments.
- Educated patients and families on treatment procedures and potential side effects.
- Collaborated with multidisciplinary teams to optimize patient care plans.
Patient Service Mgr. Telehealth/Wound Care RN
Montefiore Hospital Homecare
02.2013 - 12.2013
- Oversaw daily operations to ensure high-quality patient care and service delivery standards.
- Developed and implemented training programs for staff to enhance service efficiency and patient satisfaction.
- Led service team to enhance customer satisfaction and operational efficiency.
- Developed training programs to improve staff performance and service delivery.
- Led service teams to enhance customer satisfaction and operational efficiency.
Visiting Nurse FULLTIME
Visiting Nurse Service of New York
NY
02.2011 - 12.2013
- Delivered patient-centered care in home settings, ensuring safety and comfort during visits.
- Assessed patient health needs and developed individualized care plans in collaboration with interdisciplinary teams.
- Educated patients and families on disease management, medication adherence, and preventive health practices.
- Coordinated services with healthcare providers to streamline patient transitions from hospital to home care.
Education
Master of Public Administration - Nursing Administration
Baruch College, Allen G. Aaronson
MANHATTAN06.2018
Bachelor of Science - Professional Nurse
New Jersey City University
Jersey City06.2008
Associate of Applied Science - Registered Nurse
Christ Hospital Nursing School
Jersey City01.2001
Skills
- Quality Assessments
- Utilization Review Authorizations
- Competency in Case management
- Supervisory Skills
- Administrative Support
- Conceptual Skills
- Effective Communication
- Decision-making Skills
- Organization & Presentation Skills
- Staff Management
- Critical Thinking Skills
- Time Management
- Attention to details and accuracy
- Team Work
- Care Planning
- Wound Care
- Chronic Disease Management
- Case Management
- Health Care Consultation
- Medical Assessment
- Culturally Sensitive
- Spanish Fluency
- IV and Venipuncture Certified
- Patient Discharging
Certification
UAS Assessor 2017
CPR Instructor 2024
EPIC Trained
Languages
Spanish
Native or Bilingual
Impacted by Covid Epidemic
Career Interruption (2021–2022): Employment pause due to pandemic-related workplace requirements and resulting financial constraints. Fully resolved.
Timeline
UAS RN (Per Diem) and Field Nurse Supervisor
Rockaway Home Care
08.2023 - 08.2025
Clinic RN Certified Community Behavioral CONTRACT
Tandy M Group
07.2023 - 11.2023
UAS Assessor and Field Nurse Supervisor
Gotham Companies
02.2023 - Current
Telephonic Nurse Case Manager FULLTIME
Senior Whole Health
05.2017 - 05.2021
Nursing Supervisor/Instructor FULLTIME
Heart to Heart Home Care
01.2017 - 04.2017
Infusion Nurse
Walgreens/Trinity Infusion
12.2014 - 04.2016
Patient Service Mgr. Telehealth/Wound Care RN
Montefiore Hospital Homecare
02.2013 - 12.2013
Visiting Nurse FULLTIME
Visiting Nurse Service of New York
02.2011 - 12.2013
Bachelor of Science - Professional Nurse
New Jersey City University
Associate of Applied Science - Registered Nurse
Christ Hospital Nursing School
Master of Public Administration - Nursing Administration
Baruch College, Allen G. Aaronson