Lazaro Alvarez
Jackson North Medical Center Hospital
Miramar,FL
2
Languages
1
Certification
21
years of professional experience
To continue my career with a company that will utilize my management and supervision skills to benefit mutual growth and success.
Lead case management professional with strong track record in guiding teams and achieving results. Skilled in client assessment, resource coordination, and conflict resolution. Known for adaptability, reliability, and fostering collaborative environments to meet evolving needs. Passionate about delivering impactful outcomes and driving continuous improvement.
Results-driven professional prepared for leadership in case management, with extensive experience in coordinating client services and supporting team operations. Known for strong collaborative abilities and consistently achieving positive outcomes. Highly adaptable, with a focus on client-centered solutions and effective communication.
Work History
Lead Case Manager
8 Years 7 Months- Discharge planning coordination assigned to the 7th floor Medical Surgical unit.
- Promoted to Case Manager Supervisor and Assistant for Utilization Resources Senior Manager Director.
- Led daily morning huddle with General CEO at Jackson Memorial Corporation to align on departmental goals.
- Conducted daily clinical rounds with hospitalist and clinical teams to identify and address discharge process barriers.
- Daily administrative meetings with CMD, CFO and Director of Hospitalist Dr Rodriguez.
- Daily dispatch with CNO, CMO DR Pyke and Bed Control Department Director for the discussion of the Discharge-Admission process.
- Facilitated bi-weekly meetings with UR Lead Case Manager to review denial cases and strategize resolution.
- Bi-weekly meeting with the nurse directors, case manager and social worker for the discussion of the daily discharge planning process.
- Meetings with Risk Management Director for the discussion of complex cases.
- Worked at Jackson Memorial Health to provide patient care and support.
Case Manager Director
2 Years 1 Month- Supervise and Direct Case Management Department and employees Improved organizational efficiency by implementing census management strategies. Review clinical records of admission referral Facility liaison.
- Confidently managed the overall operation of Case Management services and Utilization Review services, including financial management, quality assurance, patient satisfaction, and safety.
- Organized department operations to ensure compliance with legal, organizational, and medical guidelines for effective case management services.
- Streamlined, standardized, and implemented case management processes and techniques to maximize revenue cycle.
- Structured standardized case management processes to comply with regulatory agency statutes and standards.
- Created care plans that addressed clinical and financial challenges, family requirements and facilitated patient quality of life.
- Collaborated with multidisciplinary teams to facilitate client care and reduce case management barriers.
- Developed and administered budgets, authorized expenditures, and monitored financial indicators to improve profitability.
- Leveraged case management tools and conflict management techniques to help interdisciplinary teams achieve optimal outcomes.
- Devised and implemented cost-control plans to enhance department operations.
- Reviewed and developed intake and discharge planning strategies to encourage client engagement and retention.
- Served as corporate resource for compliance and audits to facilitate legal processes and appeals.
- Developed and implemented training programs for staff.
- Conducted admission review and oversight of Inpatient stay cases.
- Conducted daily strategy meetings with CEO and CFO to align departmental goals. with CEO and CFO for discussion of budget and development of strategies to reach corporate goals.
Case Manager
1 Year 4 Months- Conducted clinical reviews utilizing clinical knowledge and IQ criteria guidelines to facilitate Medicare/HMOs insurance approvals.
- Managed discharge planning process with emphasis on evaluating readmission cases to optimize patient transitions.
- Oversaw clinical evaluations for all admissions as Case Manager in emergency room; coordinated discharge planning efforts to ensure effective patient care.
- Tenet Healthcare
Lead Case Manager
1 Year 3 Months- Supervised discharge planning process, ensuring smooth transitions for patients.
- Conducted clinical reviews and facilitated discussions with Case Manager Director, CMO, and CFO to optimize care plans.
- Discharge planning process supervision.
- Supervised observation admissions processes for all insurance types. for all insurances using InterQual Criteria, Midas, and Meditech.
Medical Director of Post Acute Care
9 Months- Supervised performance of hospitalist and SNFs physicians in patient care across South East Florida region, enhancing quality of care.
- Heading meetings with insurance Medical Directors such as Humana, Care Plus, Coventry, Health Sun, Simply, and Sunshine.
- In charge for the Training of the Physicians on InterQual criteria and admission status process.
- Established and maintained relationships with primary care physicians and the subspecialty physicians in the community.
- In charge of the Training of the Physicians on InterQual criteria and admission status process.
- Weekly meetings with Health Sun Medical Director Dr Barrial.
- Heading meetings with insurances Medical Directors such as Humana, Care Plus, Coventry, Health Sun, Simply, and Sunshine.
- Led daily activities of hospital and SNFs teams, fostering improved patient care and satisfaction.
Lead Case Manager
5 Years 8 Months- In charge of Observation Admissions for all insurances using InterQual, Midas, and Meditech, Epic Healthcare system.
- Completed daily clinical reviews and collaborated with Case Manager Director, CMO, and CFO to ensure adherence to care standards.
- Daily completion of clinical reviews and discussion with Case Manager Director, CMO, CFO.
- Managed oversight of Observation Admissions for all insurances using InterQual, Midas, and Meditech, Epic Healthcare system.
- Supervised team in delivering customized solutions to address patient needs and fulfill employer contract requirements.
- Trained staff on how to improve case management skills resulting in increased ability to serve members with diverse needs and educational levels.
- Audited staff performance and medical records, coaching staff to enhance care standards and improve compliance.
Case Manager
3 Years 1 Month- Conducted clinical reviews using clinical knowledge and IQ criteria to facilitate Medicare/HMO insurance approvals.
- Facilitated discharge planning process for patients, ensuring smooth transitions to post-hospital care.
- Managed patient cases in the ER and facilitated discharge planning.
Case Manager
1 Year 1 Month- Documented clinical information for admitted patients to ensure accurate patient records.
- Apply clinical knowledge when preparing reviews for the Insurances approval on admissions cases.
- Working on the denial process on cases with clinical discussion with the Medical Director.
- Facilitated clinical discussions with Medical Director to address denial processes on cases.
- Coordinated discharge planning for patients to ensure smooth transitions from hospital to home or other care facilities.
- Daily documentation on clinical information for admitted patients.
Medical Assistant
11 Months- Oversaw responsibilities for Medical records review and completion.
- Prepared allergy tests and audiometry tests; assisted in minor surgical procedures to support patient care.
- Managed patient intake, vital signs, and medical histories to support efficient clinical workflows.
- Coordinated exam room preparation, instrument sterilization, and supply organization for provider readiness.
- Documented patient information accurately in electronic health records and maintained chart integrity.
Referral Department Director
1 Year 1 Month- Director of the Referral Department in charge for building and maintaining strong network affiliations with hospitals, physicians, social workers, and case managers
- Coordinated patient referrals by visiting hospitals, ALFs, nursing homes, and rehab centers.
- Compiled and presented monthly referral status reports to CEO and CFO.
- Monthly meetings with Insurance Medical directors: Humana, Care Plus, United Healthcare
- Maintained a high level of confidentiality according to the HIPAA regulations.
- Monitored patient satisfaction through surveys and post discharge from hospital follow up for the patient’s care.
Education
High School Diploma
Medical Superintendent
Training in Anesthesia Emergency care.
MBA - International Business
Graduated with Honors and selected as member of the International Honor Society in Business Delta Mu Delta
Pediatric Specialist
Family Medicine Specialist
Medical Doctor
Skills
Successfully working for 17 years in the medical field as a Clinical Case Manager.
Complete knowledge skills of the Medicare Guidelines-CMS.
Complete knowledge for the inpatient process management
discharge planning and the Utilization Review Process.
Extensive experience working with medical records and well versed in the medical documentation for Doctors
Nurses
and the Social Workers.
Skills in MIDAS
MEDITECH
EPIC
ALLSCRIPTS
CERNER systems and MICROSOFT: EXCEL
WORD.
Case documentation
Client advocacy
Ethical practice
Progress monitoring
Compliance monitoring
Case assessment
Marketing and promotion
Positive attitude
Problem-solving
Time management
Multitasking and organization
Accomplishments
- Medical Director at Corporate Office IPC Healthcare for Acute Care and Post-Acute Care, BPCI bundle Corporate Management, Corporate Management with Director of Insurances (Humana, Care Plus, United HealthCare, Health Sun, Simply HealthCare).
- MBA International Business Degree graduated with Honors at Keiser University, Fort Lauderdale, Florida, USA.
- Selected by Keiser University as a Member of the International Honor Society in Business Delta Mu Delta in recognition of high scholastic attainment.
- Lead Case Manager at Aventura Hospital.
- Referral Department Director at Doctors Medical Center S.A.
- Lead Case Manager at Jackson North Medical Center Hospital.
- Director of Case Manager at Larkin Palm Spring Hospital, Hialeah Campus.
Certification
- [Area of certification] Training - [Timeframe]
- Licensed [Job Title] - [Timeframe]
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Case Manager Director
Larkin Palm Spring Community Hospital
03.2022 - 04.2024Read More
Lead Case Manager
Jackson North Medical Center Hospital
03.2018 - CurrentRead More
Case Manager
Florida Medical Center
03.2017 - 07.2018Read More
Lead Case Manager
Aventura Hospital and Medical Center
12.2015 - 03.2017Read More
Medical Director of Post Acute Care
IPC Healthcare S.A Hospitalist Team
03.2015 - 12.2015Read More
Lead Case Manager
Aventura Hospital and Medical Center
08.2009 - 04.2015Read More
Case Manager
Continucare Corporation
07.2007 - 08.2008Read More
Case Manager
University of Miami Hospital
06.2006 - 07.2009Read More
Medical Assistant
South Florida Ent Office of Dr. Goldberg
06.2006 - 05.2007Read More
Referral Department Director
Doctor’s Medical Center
05.2005 - 06.2006Read More
UNIVIVERSITY-MEDICAL SCHOOL ISCM HABANA: MIGUEL ENRIQUEZ FACULTY
Medical Doctor
Read More
UNIVIVERSITY-MEDICAL SCHOOL ISCM HABANA: MIGUEL ENRIQUEZ FACULTY
Family Medicine Specialist
Read More
UNIVIVERSITY-MEDICAL SCHOOL ISCM HABANA: MIGUEL ENRIQUEZ FACULTY
Pediatric Specialist
Read More
KEISER UNIVERSITY
MBA from International Business
Read More
UNIVERSITY OF TRANSKAI
Medical Superintendent
Read More
VOCATIONAL HIGH SCHOOL V.I LENIN
High School Diploma
Read More