Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Klein Martinez

Harlingen,Texas

Summary

Skilled Licensed Vocational Nurse with good knowledge and understanding of factors of nursing. Committed to assisted positive outcomes in patients. Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking opportunities to expand skills while facilitating company growth.

Overview

15
15
years of professional experience

Work History

Service Coordinator

Centene, Superior Health Services
McAllen, TX
08.2023 - Current
  • Conduct in-home face to face member assessments and telephonic outreach
  • Document assessments and contacts, develop and approve service plans, and ensure authorizations are completed
  • Conduct follow-up contacts or in-person visits to determine if services meet member’s needs
  • Assess member’s medical, safety and support service needs and coordinate the delivery of services
  • Provide education related to member’s health condition and care
  • Assist with modification and management of care plans under the direction of Registered Nurse in conjunction with member, medical consenter or caregiver, Department of Family and Protective Services caseworker and family, if applicable, as well as the managing physician
  • Maintain case record documents and enter information in an automated system, establishing a record for each member receiving services
  • Coordinate member care through collaboration with community outreach and member advocates, assigned service coordinators, and/or case managers
  • Educate providers and community resources on program components and available support services
  • Educate members to foster compliance with program and positively impact outcomes
  • Performs other duties as assigned
  • Complies with all policies and standards

Business Project Analyst

Cigna
08.2022 - 08.2023
  • Managed projects and served as primary liaison between client and multiple internal groups to clarify goals and meet standards and deadlines.
  • Coordinated with team members to ensure timely completion of tasks.
  • Maintained documentation of all project activities and progress reports.
  • Supported senior leadership in developing business cases for proposed projects or initiatives.

Case Manager Analyst, CHAT Program

Careallies
, Pennsylvania
05.2019 - 08.2022
  • Deliver professional activities in the case management job family
  • Coordinates enrollee care needs across the continuum for assigned members who are medically stable, but require primary psychosocial support and acute intermittent medical support
  • Interviews members and relatives to obtain social history relevant to medical problems and care planning
  • Assist members with environmental difficulties that interfere with obtaining maximum benefits from medical care
  • Serve as liaison between primary care team, members, relatives and appropriate outside agencies
  • Apply standard techniques and procedures to routine instructions that require professional knowledge in specialist areas
  • Provide standard professional advice and creates initial reports/ analyses for review
  • Provide guidance, coaching and direction to more junior members of the team in case management Able to work independently and effectively communicate to internal and external customers by telephone, email or face to face with customers
  • Use clinical knowledge to assess diagnosis and treatment plans and goals, and identifies gaps in care or risks for readmission or complications
  • Work with a multicultural population and is constantly aware of the cultural differences among that population
  • Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare
  • Visit providers to manage and coordinate care for customers by reviewing medical and claim information, ensure compliance with approved services and fees and discuss cases with hospital staff and physicians
  • Work with Cigna physicians to evaluate complex cases and receive appropriate clinical expertise on diagnosis and treatment plan
  • Demonstrates sensitivity to culturally diverse situations, clients and customers
  • Assessed customer medications and assisted customer with patient assistance program.

LVN - Correct Care Solutions
Nashville, TN
10.2017 - 04.2018
  • Assist in the assessment of physical, psychological and social aspects of patients in the health care units and housing units
  • Implements of individualized treatment programs as directed by health care practitioner
  • counts controlled substances, syringes, needles, and sharps at the beginning of each shift
  • Respond to a code or health emergency within the standards of guidelines.

LVN - United Health Care WellMed
Harlingen, Texas
06.2017 - 08.2017
  • Assist in patient preparation for medical examinations
  • Take all vitals and record all vitals in electronic chart
  • Provide medication education and education with adherence to medications
  • Document complaints in patient room according to policy and procedure
  • Telephonically obtain any complaints and symptom and accurately relays symptom to medical provider
  • Organize exam room ,stock and clean exam room after every use
  • Medication refills following approved protocols
  • Ensures medication management following policies and procedures ,appropriately documents and immunizations on patient charts
  • Following IV protocols and procedures , start peripheral lines, monitor and adjust flow rates, prime IV lines, change dressing on IV sites if needed, and discontinue if needed
  • Coordinate patient care as directed by providers, RNs and policies, including referrals, transition visit, medications, procedures and follow ups.

Service Coordinator

Healthcare Support Staffing
Tampa, FL
02.2017 - 06.2017
  • Received and reviewed waiver assessments
  • Transcribed assessments as needed to continue waiver process of application
  • Educated member on waiver program and process
  • Called member to advise of application process
  • member to local community agencies in their area according to their needs.

Team Nurse

CIGNA/ HealthSpring
Harlingen, Texas
10.2011 - 01.2017
  • Assisting physicians with evaluation and management of all members
  • Ensured implementation of physicians orders and order follow up, medication refills, patient education
  • Evaluate HEDIS and Star measures and report measures to patients PCPs
  • Et up for procedures exams, and take vital signs
  • Provided detailed education of diseases and chronic illnesses to all members
  • Documented all nursing assessments, treatments, medications, and discharge instructions and follow up care.

Field Nurse

National Nursing & Rehab Harlingen
Harlingen, TX
04.2009 - 10.2011
  • Provide nursing care to residents as ordered by the physicians
  • Prepare and review medical records and nurses notes
  • Assessed residents to evaluate their physical and emotional status
  • Wound care provided as ordered by physicians
  • Documentation on all visits and treatment plans.

Education

Licensed Vocational Nursing in LVN -

Valley Grande Institute
01.2007

Skills

  • Quick learner
  • Patient focused
  • Efficient and reliable
  • Compassionate
  • Adaptable
  • Committed
  • Patient assessment
  • Treatment plans knowledge
  • Community outreach
  • Customer support and assistance

Languages

English
Native/ Bilingual
Spanish
Native/ Bilingual

Timeline

Service Coordinator

Centene, Superior Health Services
08.2023 - Current

Business Project Analyst

Cigna
08.2022 - 08.2023

Case Manager Analyst, CHAT Program

Careallies
05.2019 - 08.2022

LVN - Correct Care Solutions
10.2017 - 04.2018

LVN - United Health Care WellMed
06.2017 - 08.2017

Service Coordinator

Healthcare Support Staffing
02.2017 - 06.2017

Team Nurse

CIGNA/ HealthSpring
10.2011 - 01.2017

Field Nurse

National Nursing & Rehab Harlingen
04.2009 - 10.2011

Licensed Vocational Nursing in LVN -

Valley Grande Institute

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Klein Martinez