Kariz Zozaya, RN
San Antonio,TX
Summary
Dedicated and compassionate Registered Nurse (RN) with progressive career history in direct patient care, triage and care coordination in fast-paced environments. Proven to remain calm under pressure and skillfully handle difficult patients and high-stress situations. Consistently developing strong relationships with patients and families through empathetic communication, respectful attitude and excellent customer service.
Overview
13
13
years of professional experience
1
1
Certificate
1
1
Language
Work History
Concierge Aesthetic Registered Nurse
June Skin
03.2025 - Current
- Maintained current knowledge of industry trends and advancements through continued professional development.
- Educated clients on skincare regimens and recommended appropriate products for at-home use.
- Assisted in the development of marketing strategies to increase client base and promote clinic services.
- Improved overall skin health for clients by performing customized chemical peels based on individual needs.
- Administered neurotoxins, for optimal cosmetic results.
- Provided exceptional customer service by addressing any concerns or questions from patients promptly and professionally.
- Developed long-lasting relationships with clients, leading to increased repeat business and positive word-of-mouth referrals.
- Conducted thorough pre-and post-treatment evaluations, ensuring patients were well-informed about procedures and expectations.
- Enhanced patient satisfaction by providing personalized aesthetic consultations and treatment plans.
- Promoted patient safety by adhering to proper sterilization protocols and infection control standards.
Medical Review Nurse
Avosys
06.2024 - 03.2025
- Improved overall efficiency by streamlining the review process, creating clear documentation, and developing strong communication channels.
- Supported legal and compliance teams in investigations related to medical fraud, waste, and abuse through meticulous case analysis.
- Provided detailed documentation on audit findings, facilitating swift corrective action when necessary.
- Maintained confidentiality, handling sensitive information discreetly throughout all stages of the audit process.
- Increased accuracy in billing processes by verifying correct coding practices within reviewed medical records.
- Developed strong relationships with clients, building trust and ensuring a high level of satisfaction during the audit process.
- Interpreted state and federal laws, accepted auditing principles and procedures and program standards to audited materials and data to detect non-compliance and facilitate recommendations.
Bilingual Senior Clinical Quality Registered Nurse
Wellmed Medical Management (Optum)
05.2022 - 11.2023
- Developed market business plans to motivate providers and large or complex group leadership to engage in improving Stars measures up to 4 STARS or higher
- Provided analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups
- Primary subject matter expert for all STARS related activities within assigned markets, working within a matrix of relationships which includes Quality corporate operations and Regional/Market operations
- Lead or participated and present in weekly, monthly, Bi-monthly, Quarterly, and Annual business review meetings related to STAR activities which summarize provider and large group performance and market performance as requested by or required by Quality or Regional Leadership
- Analyzed and evaluated provider and large group structure and characteristics, provider group/provider office operations and personnel to identify most effective approaches and strategies
- Assisted in developing of training and analytical materials for Stars and HEDIS.
- Conducted thorough patient assessments by phone 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.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
COVID Nurse Investigator/Case Manager
Arkansas Department of Health (Via GDIT)
11.2020 - 03.2022
- Clinically investigated and interviewed individuals with confirmed and probable diagnosis of COVID-19
- Provided first point of contact for COVID-19 positive individuals
- Input interview data into electronic data collection program RedCap and Maven
- Performed initial health risk assessment of COVID-19 cases according to protocols or guidance as indicated
- Worked with team members to ensure timely contact with positive cases to ensure proper isolation and quarantine precautions are explained and met by case.
- Performed accurate documentation of patient assessments, interventions, and outcomes in compliance with regulatory standards.
- Remained calm during high-stress, critical situations, demonstrating sustained focus and problem-solving in real-time.
- Educated patients on disease management, self-care techniques, and wellness strategies to improve long-term health outcomes.
- Collaborated with interdisciplinary teams for optimized patient treatment plans and outcomes.
- Maintained up-to-date knowledge on emerging trends in nursing practice to enhance effectiveness in delivering quality care.
- Documented nursing services provided and uploaded to comprehensive tracking systems for health records and billing.
- Provided emotional support to patients'' family members during critical incidents, strengthening overall trust in healthcare team.
- Came up with treatment plans and communicated with patients about options, medications and self-management.
- Educated family members and caregivers on patient care instructions.
- Evaluated patient histories, complaints, and current symptoms.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
Concurrent Review Nurse/Utilization Management Nurse
Superior Health Plan (Via Centene Corporation)
12.2017 - 03.2020
- Performed review of emergent/urgent and continued stay requests for appropriate care setting
- Followed dynamic policies and guidelines to perform reviews with use of Interqual and HEDIS
- Approved services or forwards requests to appropriate Physician or Medical Director with recommendations for other determinations
- Worked with interdisciplinary team to ensure cost-effective and quality care throughout patient’s stay in care setting.
- Optimized resource utilization by assessing appropriateness of medical treatments and making recommendations for alternative courses of action when necessary.
- Streamlined the utilization review process for more efficient case management and improved resource allocation.
- Achieved timely authorizations for services by maintaining strong relationships with insurance company representatives and advocating for patients'' needs.
- Enhanced interdisciplinary collaboration by participating in daily rounds, discussing patient cases, and providing clinical input.
- Implemented quality improvement initiatives within concurrent review process, leading to more accurate and efficient decisionmaking.
- Conducted comprehensive chart reviews to assess medical necessity, ensuring optimal reimbursement levels for services rendered.
- Managed complex cases effectively, coordinating with multidisciplinary teams to ensure seamless delivery of care across continuum.
- Improved patient outcomes by conducting thorough concurrent reviews and recommending appropriate care plans.
- Determined and authorized services for patients in accordance with guidelines and regulations.
- Reviewed and documented relevant information into data system applications.
- Conducted routine and ad-hoc evaluations and re-evaluations of services.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Supported cost containment efforts by identifying overutilization trends and recommending strategies for improvement.
- Served as a trusted liaison between patients, healthcare providers, and insurance carriers to facilitate efficient care delivery processes.
- Coordinated seamless transitions of care across multiple settings including acute care hospitals, rehabilitation facilities, and home care services.
- Streamlined utilization review processes by collaborating with interdisciplinary teams to develop individualized care plans.
- Promoted positive work environment by mentoring new nurses and serving as resource for clinical questions and concerns.
- Maintained up-to-date knowledge of payer-specific guidelines to ensure accurate authorizations for medically necessary services.
- Applied critical thinking skills to assess complex medical cases and determine appropriate levels of care in accordance with industry benchmarks.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed admission reviews based for medical necessity
- Supervised and maintained all utilization review documentation through TruCare
- Facilitated workgroup meetings with medical personnel to find effective solutions to issues.
- Devise or identify solutions for irregular requests and issues.
NICU Staff Nurse
Methodist Children’s Hospital
04.2015 - 10.2016
- Monitored and provided care for infant’s basic needs
- Coordinated infant’s medical treatment with multidisciplinary team in critical care setting
- Offers comfort and support to premature and ill newborns
- Provides education and guidance to parents and family members of infant
- Maintains certifications required as staff nurse to perform care.
- Improved patient outcomes by developing and implementing individualized care plans for NICU patients.
- Demonstrated excellent time management skills in a high-stress environment, prioritizing tasks to provide optimal care for numerous patients simultaneously.
- Facilitated smooth transitions from critical care to step-down units by coordinating discharge planning with interdisciplinary team members.
- Served as an advocate for neonates and their families when collaborating with interdisciplinary team members, ensuring best interests were considered throughout treatment planning.
- Increased clinical competency by attending educational workshops, staying current on evidence-based practices in neonatal care.
- Minimized complications through diligent monitoring of vital signs, recognizing changes in neonate''s condition, and adjusting interventions accordingly.
- Managed parent-infant bonding opportunities such as kangaroo care sessions while maintaining medical stability for improved developmental outcomes.
- Promoted a safe environment through adherence to infection control policies, reducing risk of cross-contamination among patients.
- Enhanced family satisfaction with thorough communication regarding patient progress and support resources.
- Performed comprehensive assessments to identify subtle changes in neonates'' conditions that may indicate potential issues or complications.
- Provided compassionate emotional support to families during difficult times, improving overall relationships between staff and parents.
- Collaborated effectively with interdisciplinary healthcare teams to optimize neonatal care and recovery.
- Supported breastfeeding mothers through education and guidance on lactation techniques, increasing successful breastfeeding rates among NICU patients.
- Reduced infection rates by maintaining aseptic techniques during procedures, wound care, and central line management.
- Responded quickly and effectively to emergency situations in the NICU setting, stabilizing patients as needed prior to physician intervention.
- Assisted physicians during rounds, ensuring clear communication about patient status and necessary interventions.
- Maintained accurate documentation of patient assessments, interventions, and outcomes for effective continuity of care.
- Administered medications safely according to prescribed protocols to maintain patient health and stability.
- Assessed, evaluated, and cared for neonate and pediatric patients.
- Conducted patient assessments, recorded vitals, and analyzed records and charts to define care requirements.
- Administered medications and treatments as ordered by physician.
- Coordinated with healthcare staff from various disciplines to devise, carry out, and manage personalized care plans to benefit patient health and recovery.
- Assessed and documented changes in patient's condition and prepared patient for transfer to higher level of care.
- Guided patients, caregivers, and family members on plans of treatment and helpful resources available locally to support care.
- Delivered outstanding patient care in Neonatal critical care units.
Cardiovascular Unit Staff Nurse
Northeast Baptist Hospital
09.2012 - 04.2015
- Helps diagnose and treat conditions that affect pulmonary and or circulatory systems
- Coordinated with multidisciplinary team to provide cost-effective, quality medical treatment and care for patient’s post Coronary Artery Bypass Graft surgery, pre and post pacemaker insertion as well as maintenance, pre and post cardiac catheterization lab procedures, pre and post carotid artery endarterectomy and many other procedures pertaining to circulatory system
- Provides education and emphasis on preventive care
- Assists with diagnostic and specialized tests.
- Assisted physicians during procedures by providing skilled hands-on support, ensuring safe practices and optimal outcomes for patients.
- Enhanced patient care by efficiently administering medications, treatments, and IV therapy according to physician orders.
- Collaborated with interdisciplinary healthcare teams to develop coordinated care plans, promoting optimal patient outcomes.
- Provided comprehensive nursing care for patients with various medical conditions, ensuring timely interventions and appropriate treatment.
- Conducted comprehensive assessments on assigned patients upon admission that includes physical, emotional, social factors contributing towards their overall wellbeing.
- Promoted patient comfort by addressing concerns promptly, adjusting treatment plans accordingly, and providing emotional support during difficult moments.
- Administered medications to patients under physician orders in accordance with nursing knowledge and competency.
- Implemented evidence-based nursing interventions to optimize patient outcomes while using critical thinking skills for effective problemsolving.
- Developed strong rapport with patients and family members through empathetic listening skills and clear communication that enabled trust-building in the healthcare team.
- Streamlined communication between physicians, ancillary staff members, patients'' families for better understanding of clinical situations leading to informed decision-making processes.
- Ensured proper documentation of all patient information, maintaining confidentiality and accuracy in electronic health records.
- Maintained regulatory compliance by adhering to infection control protocols, safety guidelines, and other relevant policies within the unit.
- Functioned as patient advocate between patient, family, healthcare providers and administration to help patient make informed health decisions and navigate complex medical system.
- Advocated for patients'' rights effectively while respecting their cultural beliefs or preferences when delivering culturally competent care solutions.
- Reduced hospital readmissions by providing thorough discharge education and follow-up care instructions for patients and families.
- Initiated diagnostic, preventive and rehabilitative nursing procedures to support patient care and safety.
- Participated in unit-specific quality improvement efforts to enhance patient satisfaction with quality of care and service through research and evidence-based practices.
- Increased efficiency of unit operations through effective delegation, time management, and prioritization of tasks among nursing staff.
- Prevented complications by closely monitoring vital signs, recognizing early warning signs of potential issues, and taking immediate action as needed.
- Performed complete patient assessments and communicated findings and results to providers to establish plan of care.
- Documented and maintained accurate nursing records to facilitate provision of care and nursing management of patient.
- Performed various nursing interventions such as wound dressing, vital sign monitoring, and specimen collection.
- Monitored patients' conditions and reported changes in physical presentation, appearance, and behavior to discuss treatment with physicians.
- Administered medications via oral, IV, and intramuscular injections and monitored responses.
- Assessed physical, psychological, physiologic, and cognitive status of patients.
- Collaborated with physicians, pharmacists and therapists to deliver quality, evidence-based care.
- Directed patient care by initiating and following through with plan of care, continuing care, and discharge instructions.
- Educated patients, families and caregivers on diagnosis and prognosis, treatment options, disease process, and management and lifestyle options.
- Implemented medication and IV administration, catheter insertion, and airway management.
- Updated patient charts with data such as medications to keep records current and support accurate treatments.
- Developed and implemented individualized patient care plans for optimal outcomes.
- Documented treatments delivered, medications and IVs administered, discharge instructions, and follow-up care.
- Educated family members and caregivers on patient care instructions.
- Evaluated patient histories, complaints, and current symptoms.
- Communicated with healthcare team members to plan, implement and enhance treatment strategies.
- Monitored patient reactions after administering medications and IV therapies.
- Managed patients recovering from medical or surgical procedures.
- Explained course of care and medication side effects to patients and caregivers in easy-to-understand terms.
- Provided skilled, timely and level-headed emergency response to critically-ill patients.
- Offered exceptional care and support to individuals recovering from acute incidents and dealing with chronic conditions.
- Used first-hand knowledge and clinical expertise to advocate for patients under care and enacted prescribed treatment strategies.
- Quickly responded to situations impacting safety and security to unit, actualizing crisis prevention interventions to control and de-escalate situations.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Observed and documented patient factors such as diets, physical activity levels, and behaviors to understand conditions and effectively modify treatment plans.
- Promoted patient and family comfort during challenging recoveries to enhance healing and eliminate non-compliance problems.
- Conducted ongoing monitoring and evaluations of behaviors and conditions, and updated clinical supervisors with current information.
- Recorded details regarding therapies to keep patient charts updated.
- Equipped patients with tools and knowledge needed for speedy and sustained recovery.
- Provided exceptional care to high-acute patients needing complex care such as ventilator management, extensive wound care and rehabilitation.
- Conveyed treatment options, diagnosis information and home care techniques to patients and caregivers to continue care consistency.
- Performed frequent checks on life support equipment and made necessary adjustments to preserve optimal patient conditions.
Education
Associate Degree Nursing -
University of Texas at Brownsville
Brownsville, TX05.2012
Associates of the Arts -
University of Texas at Brownsville
Brownsville, TX12.2009
Skills
- Proven expertise in supporting nursing process and working with multidisciplinary team to provide inpatient and discharge planning care
- Solid knowledge in art and science of Nursing
- Excellent communication skills, bilingual, fluent in both English and Spanish
- Solutions-oriented multitasking professional
- Able to follow policies in healthcare and insurance as well as following HIPPA guidelines to protect patient information
- Medical Recordkeeping
- Lab result interpretation
- Vaccine administration
- Wound Care
- Medical assessment
- Chronic Disease Management
- Critical Care
- Care Planning
- Case Management
- Chart updating
- Health screening
- Patient Management
- Diabetes management
- Physical assessments
- Health and wellness expertise
- At-risk patient care
- Acute care expertise
- Chest pain management
- Patient care planning
- Breastfeeding education
- Insulin medication assistance
- Intake and discharge
- Medical Records Management
- Patient Assessment
- Indirect Patient Care
- Medication and IV administration
- Medical evaluation
- Patient Evaluation
- Family Education
- Patient Discharge
- Collecting vitals
- Coordinating referrals
- Medication Distribution
- Performing EKGs
- Strong Clinical Judgment
- Direct Patient Care
- Patient education and counseling
- Neonatal nursing
- Tracheostomy Care
- EMR Systems
- Infant vitals monitoring
- Intravenous therapy
- Patient Counseling
- Managing deadlines
- Compassion and Empathy
- Administering immunizations
- IV setup
Certification
Registered Nurse License by the Texas Board of Nursing (Compact)
Languages
Spanish
Native or Bilingual
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Quote
Success is not final; failure is not fatal: It is the courage to continue that counts.
Winston S. Churchill
Timeline
Concierge Aesthetic Registered Nurse
June Skin
03.2025 - Current
Medical Review Nurse
Avosys
06.2024 - 03.2025
Bilingual Senior Clinical Quality Registered Nurse
Wellmed Medical Management (Optum)
05.2022 - 11.2023
COVID Nurse Investigator/Case Manager
Arkansas Department of Health (Via GDIT)
11.2020 - 03.2022
Concurrent Review Nurse/Utilization Management Nurse
Superior Health Plan (Via Centene Corporation)
12.2017 - 03.2020
NICU Staff Nurse
Methodist Children’s Hospital
04.2015 - 10.2016
Cardiovascular Unit Staff Nurse
Northeast Baptist Hospital
09.2012 - 04.2015
Associate Degree Nursing -
University of Texas at Brownsville
Associates of the Arts -
University of Texas at Brownsville
Technical Summary
Desktops, laptops, Windows 2000, XP,10, Mac iOS, MS Office Suites 2007, 2010, 2013, EMR such as Meditech, InterQual, HEDIS
Technical Summary
Desktops, laptops, Windows 2000, XP,10, Mac iOS, MS Office Suites 2007, 2010, 2013, EMR such as Meditech, InterQual, HEDIS
Similar Profiles
Rachel LodsRachel Lods
Teacher at Institute of Reading Development, 40 hours/week , June 2022-August 2022, June 2023- CurrentTeacher at Institute of Reading Development, 40 hours/week , June 2022-August 2022, June 2023- Current
MICHAEL RYAN MAGCALEMICHAEL RYAN MAGCALE
Intern at JAM Technology Solutions Inc. | March 2025 – June 2025Intern at JAM Technology Solutions Inc. | March 2025 – June 2025
JAYNI ALEXYJAYNI ALEXY
Caregiver at June StaffordCaregiver at June Stafford
Collin DoanCollin Doan
Sales Associate at Sams Club DistributionSales Associate at Sams Club Distribution
Karen VasquezKaren Vasquez
Registrar at Urban Champions AcademyRegistrar at Urban Champions Academy