Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Jessica AGuilar

San Antonio,TX

Summary

Licensed Vocational Nurse with 8 years working in many areas of healthcare. Maintains critical thinking skills essential to providing competent and dignified patient care. Interfaces seamlessly with doctors, specialized support services, patients and families. Clear communicator, both written and verbal. Works well independently and within a team. Seeking a new and exciting opportunity that will enable me to use my existing skills and gain new ones; while making a positive contribution to the business.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Case Manager, LVN

WellMed United Healthcare
San Antonio, USA
07.2017 - Current
  • Works with discharge planners and assists in the coordination of support services
  • Assisted patients in navigating the healthcare system by providing education on insurance coverage, financial resources, and available support services
  • Serves as an advocate for patients in dealing with healthcare providers, insurance plans, and community resources
  • Facilitated seamless transitions of care by collaborating with healthcare providers, patients, and families on discharge planning
  • Provides education and support to patients and families related to their medical condition, treatments and the importance of following continuing treatment plan

Utilization Management, LVN

WellMed United Healthcare
San Antonio, USA
07.2017 - Current
  • Uses an established set of criteria to evaluate and authorize the medical necessity of services
  • Collaborates with the Providers to recommend policies, procedures, and standards with affect the care of the member
  • Demonstrate understanding necessary to assess, review, and apply criteria; Coordinate with Medical Directors when services do not meet criteria or require additional review
  • Meet/exceed department Turn Around time, daily established productivity goals, and service levels
  • Demonstrate knowledge of process flow and UM including prior authorizations, concurrent authorizations and/or clinic appeal and grievance reviews; Proficient knowledge of policies and procedures, Medicare, HIPPA and NCQA standards

Clinical Quality LVN

WellMed United Healthcare
San Antonio, USA
07.2017 - Current
  • Analyze data, evaluate for possible data integrity and data deficits and document findings
  • Analyze and audits for trends to identify any barriers to improvements of rates and create or offer solutions to such
  • Works closely with local leadership to execute quality strategies
  • Provides reports and monitors performance at local level
  • Supports and improves communications between market and corporate departments
  • Maintain education, knowledge base of HEDIS/STARs standards and guidelines

Intake LVN

WellMed United Healthcare
San Antonio, USA
07.2017 - Current
  • Coordinates patient care as directed by Providers, Registered Nurses and policies including referrals, transition visits, medications, procedures and follow up
  • Telephonically obtains information on chief complaints and symptoms and accurately relays information to Providers
  • Participates in implanting established education plans for patients and their families with common health problems
  • Monitored Physician patient panels for missing quality measures
  • Worked with management to implement quality strategies to meet monthly and yearly measures
  • Maintains knowledge of current HEDIS/STARs standards and guidelines to stay up to date

PRN Work

care Now – uRGENT cARE
San Antonio, USA
04.2018 - 04.2019
  • Performed clinical responsibilities such as taking vital signs, collecting lab specimens, performing EKGs, and administering IM injections
  • Maintained records and logs on activities including in-house lab work, drug screens, and lab work sent out to other labs
  • Managed patient charts including collecting patient history, documenting EHR appropriately, and conducting regular chart audits
  • Applied splints, dressings and bandages
  • Maintained records and logs on activities including in-house lab work, drug screens, and lab work sent out to other labs

LVN Clinical Documentation Specialist

Gonzaba Medical Group
San Antonio, USA
01.2016 - 07.2017
  • Carefully reviewed patient chart/ records in search of DataRaps codes from Chart Audits and supporting documentation
  • Communicated with healthcare staff, including physicians, nurses and other caregivers to explain the importance of accurate and clear documentation
  • Maintained a strong knowledge of medical terminology, diseases and conditions and procedures
  • Requested further information for clarification purposes to Physicians/Providers regarding missing or unclear health record documentation
  • Strategically planned methods to achieve operational goals and targets to meet Metrics for HEDIS/STARS

LVN II

Gonzaba Medical Group
San Antonio, USA
01.2016 - 07.2017
  • Lead Nurse responsible for Oncology Specialty office
  • Provided leadership, directions and support to Medical Assistants and LVN's on the issues of outpatient care, medications and scheduling
  • Performed patient teaching, medication administration, triaged walk-in patients and triaged calls when needed
  • Administer IV Therapy (fluids, IV iron, other IV therapeutic drugs as ordered by MD
  • Assisted doctors with surgeries and non-invasive procedures such as Bone Marrow Biopsies and Therapeutic Phlebotomies

Education

Licensed Vocational Nurse -

Career Point College
San Antonio, TX
11.2015

Medical Assisting -

SW School of Business and Technical Careers
San Antonio, TX
01.2007

Skills

  • Strong customer service skill
  • Strong clinical judgment
  • Analytical thinking
  • Managing deadlines
  • Communication
  • Process Improvement
  • Disease Prevention and Management
  • Patient Care and Education
  • Solutions Oriented

Certification

  • BLS Certified
  • IV Certified
  • Stop the Bleed Course

Timeline

PRN Work

care Now – uRGENT cARE
04.2018 - 04.2019

Case Manager, LVN

WellMed United Healthcare
07.2017 - Current

Utilization Management, LVN

WellMed United Healthcare
07.2017 - Current

Clinical Quality LVN

WellMed United Healthcare
07.2017 - Current

Intake LVN

WellMed United Healthcare
07.2017 - Current

LVN Clinical Documentation Specialist

Gonzaba Medical Group
01.2016 - 07.2017

LVN II

Gonzaba Medical Group
01.2016 - 07.2017

Licensed Vocational Nurse -

Career Point College

Medical Assisting -

SW School of Business and Technical Careers

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Jessica AGuilar