Open To Work
JESSICA LOPEZ
Fidelis Care New York
Swansboro,NC
Work Preference
Job Search Status:
Open to work
Desired start date:
Open to discussion
Desired Job Title
Senior Nurse Case ManagerCase ManagerHome Health NURSE/CASE MANAGERRegistered Nurse
Work Type
Full TimePart TimeContract WorkConsultingSeasonal Work
Location Preference
RemoteHybridOn-Site
Open to relocation:
Yes
Important To Me
Career advancementWork-life balanceCompany CultureHealthcare benefits401k match
1
Certification
22
Years of experience
Registered Nurse with 22 years of diverse clinical experience and Certified Case Manager (CCM) credential. Expertise in case management, care coordination, discharge planning, and regulatory compliance. Proven ability to reduce readmissions, improve patient outcomes, and collaborate with interdisciplinary teams across the continuum of care. Experienced with Medicare, Medicaid, commercial payers and MCG criteria.
Work History
Senior Nurse Case Manager
10 Years 10 Months- Designed and executed tailored care plans to improve health outcomes for a diverse group of 75 high-risk members.
- Spearheaded team initiative to develop and distribute breast cancer support boxes for members undergoing surgery and chemotherapy, enhancing patient care. Lead to company wide adoption of program.
- Conducted assessments and evaluations to ensure adherence to treatment protocols.
- Collaborated with interdisciplinary teams to streamline patient services and resources.
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Managed complex cases involving multiple comorbidities, requiring close monitoring and coordination of various healthcare services.
- Educated patients and families on available community resources, facilitating access to necessary support services.
- Served as a key liaison between patients, families, and healthcare providers, fostering open communication and trust among all parties involved in the care process.
- Advocated for patients'' rights and preferences, working diligently to align care with individual values and goals.
- Mentored new nursing staff, facilitating a faster learning curve and increased overall team efficiency.
- Navigated regulatory requirements effectively, ensuring proper documentation and compliance with relevant laws and guidelines. Including participating in NCQA audit preparation and audits.
- Boosted patient adherence to treatment plans through regular check-ins and motivational interviewing techniques.
- Leveraged technology to improve patient record accuracy and accessibility, ensuring seamless communication across care teams. Including Microsoft suite and CCA EMR.
- Developed strong relationships with patients and their families, providing support and education on health management.
- Reduced hospital readmission rates through effective case management and patient education on self-care techniques.
Case Manager
6 Years 4 Months- Achieved enhanced client care through coordinated cost-effective service delivery for approximately 100 Members.
- Reduced skilled nursing facility placements by identifying alternative care resources.
- Successfully detected and monitored clients' evolving physical and psychosocial needs. Developed tailored care plans that authorized services aligned with client needs.
- Streamlined service delivery by integrating efforts with various providers. Expanded access to essential services by collaborating with local community agencies.
- Enhanced team communication and support for complex cases through active participation in advisory and interdisciplinary meetings. Facilitated onboarding and training of new case managers to promote best practices.
DIRECTOR
6 Years 4 Months- Directed operations of nursing staff, PT, home health aides and personal care aides, facilitating comprehensive care for approximately 75 clients in a home setting.
- Achieved comprehensive understanding of long-term home health care program needs through assessments. Leveraged insights from Medicare educational seminars to implement effective training procedures for uniform documentation of critical patient data.
- Created and delivered targeted training sessions for new registered nurses to optimize staff performance and ensure high-quality patient care. Supported case managers by coordinating durable medical equipment requests and sourcing the most economical suppliers.
- Enhanced team collaboration through regular communication, goal setting, and performance evaluations. Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
- Analyzed billing protocols to support revenue recovery initiatives and control operational costs.
- Strengthened internal controls by reviewing existing policies and procedures, ensuring compliance with regulatory requirements and developed and implemented additional policies to ensure compliance with industry regulations and standards
- Established team priorities, maintained schedules and monitored performance.
Home Health Nurse
- Conducted daily visits to 10-14 patients, prioritizing effective time management and upholding rigorous standards of care and detail-oriented assessments. Achieved optimal patient care by executing thorough assessments and adhering to established protocols and best practices. Analyzed patient factors like diet and physical activity to tailor treatment plans, resulting in improved patient condition management. Designed personalized care strategies to enhance patient outcomes based on thorough assessments and teamwork with healthcare professionals.
- Conducted assessments of patient living conditions to identify and recommend optimal support parameters.
- Enabled patients to achieve greater independence at home through effective education on nutrition, mobility aids, and medication management strategies. Simplified explanations of care plans and medication side effects for patients and caregivers to promote understanding.
- Implemented comprehensive wound management strategies to promote effective healing and decrease infection rates in patients with intricate wound conditions.
- Pursued ongoing professional development to enhance clinical skills and support high-quality patient care standards.
- Supported recovery efforts for individuals facing acute incidents and chronic health issues. Delivered expert emergency interventions for critically ill patients
Coordinator of Care
9 Months- Managed care for patients in home setting.
- Developed individualized care plans based on comprehensive patient assessments.
- Coordinated multidisciplinary team meetings to enhance patient outcomes.
- Conducted regular home visits to assess patient needs and ensure care compliance.
- Utilized evidence-based practice guidelines when administering medications or performing treatments/procedures ensuring optimal safety and efficacy.
- Reduced hospital readmissions by providing thorough patient education and comprehensive discharge planning.
- Collaborated with interdisciplinary team members for comprehensive patient assessments, resulting in tailored care strategies.
- Ensured regulatory compliance by adhering to federal, state, and agency guidelines in all aspects of home health nursing practice.
- Maintained high-quality care standards by participating in ongoing professional development activities.
- Conducted comprehensive assessments of patients'' physical, emotional, social, and environmental needs to develop individualized care plans.
- Facilitated smooth transitions between healthcare settings by coordinating services and maintaining open communication with patients, families, and providers.
- Determined and addresses individual home care needs by completing detailed assessments and reviewing documentation.
- Educated patients and families on disease processes, medications and treatments.
- Documented patient vitals, behaviors, and conditions to communicate concerns to supervising nurse.
- Administered medications and treatments as prescribed by physicians.
DIALYSIS NURSE
9 Months- Provide Nursing Care at Dialysis Center. Responsibilities included but were not limited to: access and de-access patients for treatment; monitor patients during treatments; instruct in care of access device as well as other dialysis needs.
Home Health NURSE/CASE MANAGER
2 Years 8 Months- Provide Full Range of Nursing care for Home Health Care Agency. Responsibilities included but were not limited to: Collection of patient data, both objective and subjective and ensure proper documentation. Perform wound care (Dressings and Wound Vac) and prevention. Review and report lab results in a timely fashion. Management of Tube Feeding and G-Tube Changes, Venipuncture, Mediprots and Peripheral Intravascular Central Catheter. Supervision and orientation of LPN’s and Home Health Aides. Education of LPN’s, Home Health Aides, Therapists, clients, and family regarding various disease processes. Obtain Insurance Verification and continued authorization.
- Administered medications and treatments per physician orders, ensuring patient safety and compliance with protocols.
- Monitored vital signs and patient conditions, documenting changes accurately for medical team review.
- Collaborated with multidisciplinary teams to develop and implement individualized care plans for patients.
- Assisted in training new nursing staff on best practices and operational procedures to promote quality care.
- Implemented infection control measures, significantly reducing risk factors within home healthcare settings.
- Established trust with patients and their families, fostering a supportive environment conducive to healing.
- Demonstrated adaptability in diverse settings including urban homes, assisted living facilities, hospice centers, or rural locations to deliver consistent quality nursing services.
- Served as a mentor and preceptor for new visiting nurse hires, facilitating a smooth transition into their roles and fostering professional growth within the team.
- Developed strong relationships with community partners such as physicians'' offices and local pharmacies for enhanced collaboration in serving mutual clients more efficiently.
- Assisted patients in navigating the healthcare system by providing resources, referrals, and advocacy when needed for comprehensive support throughout their medical journey.
- Contributed to efficient care coordination by participating in regular case conferences and updating colleagues on patient progress.
- Improved patient outcomes by consistently providing high-quality, compassionate care and thorough assessments.
- Promoted continuity of care by maintaining detailed documentation and timely communication with healthcare providers.
- Reduced hospital readmissions by closely monitoring patients and promptly addressing any changes in condition.
- Implemented patient-specific interventions to decrease risk of disease exacerbation.
- Educated patients and families regarding disease processes, interventions and lifestyle changes.
- Enhanced patient satisfaction through effective communication, education, and active listening to address concerns.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Developed resource materials for clients, improving access to community support services.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Participated in community events to promote services and engage with public.
- Educated patients on self-care techniques such as proper nutrition, mobility assistance devices usage, and medication management for increased independence at home.
Education
Bachelor of Science - Nursing
Skills
Relationship building
Strategic planning
Verbal and written communication
Critical Thinking and Decision-making
Chronic disease management
HIPAA compliance
Care coordination
Case management
Compassionate and caring
Interdisciplinary collaboration
EMR / EHR
Email and telephone etiquette
Accomplishments
- Coordinated complex discharge plans for high-risk patient populations, facilitating safe transitions and reducing readmission rates.
- Managed a caseload of medically complex patients while collaborating with physicians, payers, and community agencies to optimize outcomes.
- Led interdisciplinary care conferences to address barriers to discharge, length-of-stay management, and resource utilization.
- Reviewed medical records for medical necessity, prior authorizations, appeals, and denial prevention initiatives.
Certification
- Certified Case Manager
Timeline
Senior Nurse Case Manager
Fidelis Care New York
09.2015 - CurrentRead More
DIRECTOR
LTHHCP
05.2009 - 09.2015Read More
Case Manager
Elant Choice
05.2009 - 09.2015Read More
Home Health NURSE/CASE MANAGER
Willcare
08.2006 - 04.2009Read More
Coordinator of Care
VNSNY
11.2005 - 08.2006Read More
DIALYSIS NURSE
Duchess Dialysis
11.2005 - 08.2006Read More
Home Health Nurse
VNSNY
2008 - 2017Read More
Dominican College
Bachelor of Science from Nursing
Read More