Imelda Ramirez
El Paso,TX
Summary
Registered Nurse with 25+ years of experience across hospital, clinic, and senior health settings. Proven leader in utilization management, patient care, and interdisciplinary collaboration. Skilled in coding, compliance, and process improvement, with a track record of enhancing care quality, reducing costs, and mentoring healthcare teams.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Senior Clinical Coding Nurse Consultant
WellMed
04.2023 - Current
- Enhanced coding accuracy by educating on ICD-10-CM and HCC guidelines.
- Streamlined documentation processes through effective training and quality feedback sessions.
- Acted as primary contact for clinicians regarding coding inquiries and support.
- Identified educational needs by tracking failed validations and communication gaps.
- Prioritized clinician training based on metrics and trending analysis.
- Leveraged reporting tools like Tableau and EMR systems for effective data analysis.
Utilization Manager
Bienvivir All-Inclusive Senior Health
07.2009 - 04.2023
- Direct daily operations of the Utilization Management Department, including staffing, budgeting, and workflow optimization.
- Supervise coding department and utilization nurse, ensuring compliance with CMS, HIPAA, and quality standards.
- Implement physician practice profile analysis, improving cost efficiency and patient outcomes.
- Develop and enforce new policies, reduce readmission rates and enhancing care delivery.
Participant Manager
Bienvivir All-Inclusive Senior Health
06.2007 - 07.2009
- Enhanced patient adherence to medication by meticulously managing individualized care plans.
- Ensured compliance with physician instructions, fostering better health outcomes for patients.
- Conducted educational sessions for patients and families, clarifying complex treatment plans effectively.
- Improved patient understanding and compliance through tailored education on medication regimens and therapies.
- Developed strong relationships with patients, providing continuous support throughout their treatment journeys.
Charge Nurse – Oncology Unit
Sierra Medical Center
01.2005 - 12.2007
- Supervised nursing staff and coordinated patient assignments.
- Delivered direct care for oncology patients receiving chemotherapy, blood products, and immunotherapy.
- Improved patient safety and satisfaction through effective communication and care coordination.
Travel Nurse (Contract)
William Beaumont Army Medical Center
03.2007 - 06.2007
- Provided transitional care for patients between ICU and telemetry units.
- Maintained accurate documentation and collaborated with interdisciplinary teams.
Travel Nurse
Ready Link
01.2003 - 12.2005
- Delivered bedside care to diverse patient populations (medical, surgical, pediatrics, geriatrics, orthopedics).
- Conducted assessments, administered medications, and reviewed diagnostic tests.
Staff Nurse – Oncology Unit
Sierra Medical Center
El Paso, Texas
01.2000 - 12.2003
- Provided direct patient care, including chemotherapy and immunotherapy administration.
- Educated patients and families on disease prevention and health maintenance.
Education
Associate of Science - Nursing
El Paso Community College
El Paso, TX05.2000
Skills
- IV infusion
- Oncology care
- Patient education
- Medication administration
- Documentation review
- Leadership & Management: Utilization management
- Staff supervision
- Policy development
- Process improvement
- Case management
- Technical Proficiency: ICD-9/10 coding
- CPT/HCPCS
- EMR systems
- Tableau
- Microsoft Office Suite, ePRG, Zephyr
- Interpersonal Strengths: Bilingual (English/Spanish)
- Communication
- Critical thinking
- Time management
- Team collaboration
Certification
- RN License (Nurse Licensure Compact)
- Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC)
- Certified Medical Coder (CMC)
Languages
Bilingual: English & Spanish
Timeline
Senior Clinical Coding Nurse Consultant
WellMed
04.2023 - Current
Utilization Manager
Bienvivir All-Inclusive Senior Health
07.2009 - 04.2023
Participant Manager
Bienvivir All-Inclusive Senior Health
06.2007 - 07.2009
Travel Nurse (Contract)
William Beaumont Army Medical Center
03.2007 - 06.2007
Charge Nurse – Oncology Unit
Sierra Medical Center
01.2005 - 12.2007
Travel Nurse
Ready Link
01.2003 - 12.2005
Staff Nurse – Oncology Unit
Sierra Medical Center
01.2000 - 12.2003
Associate of Science - Nursing
El Paso Community College