Mayra Torres
Glendale,CA
Summary
Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Case Manager
Molina Healthcare/ Brand New Day
03.2024 - 09.2024
- 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.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Thorough Knowledge of MOC guidelines
- Assessing case for HEDIS gaps and proceeding accordingly
- Knowledge of CMS guidelines and protocols
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Achieved positive client outcomes by developing and implementing comprehensive case management plans.
- Improved client satisfaction by efficiently addressing concerns or grievances in a timely manner.
- Assisted clients in setting achievable goals while providing ongoing encouragement and support throughout the process of reaching those objectives.
- Fostered open lines of communication with clients'' families and support networks, involving them in the case management process as appropriate.
- Conducted thorough assessments to identify client needs, laying groundwork for effective case management.
- Completed thorough, accurate and timely documentation in accordance with company model of care guidelines
Care Manager
Bright Healthcare/ Brand New Day
11.2022 - 03.2024
- Responsible for up to 200-250 medium/ high risk cases
- Assessing and risk stratifying member cases to provide appropriate outreaches and care coordination
- Assessing members HEDIS gaps and implementing plan with member for compliance
- Provided crisis intervention services when necessary by assessing risk levels promptly addressing safety concerns collaboratively with the treatment team.
- Developed strong rapport with patients and families through empathetic listening and compassionate communication techniques.
- Accurate and timely completion and outreaches of Transition of Care and ER cases following MOC guidelines
- Timely completion of HRA assessments, supporting documentation and plan of care
- Assisting member with outpatient needs including scheduling follow up appointments wit providers, scheduling transportation, scheduling third party referrals and community referrals
- Providing education on plan benefits and information on vendor benefits
- Communicated with healthcare providers to facilitate continuity of care.
- Providing Transition of Care assistance, assessing risk factor and assisting member to prevent reoccurring admissions.
- Established and maintained relationships with clients, families and community partners to coordinate services to meet client's needs.
- Promoted patient self-management by providing education on chronic condition management and healthy lifestyle choices.
- Participated in team meetings and trainings to stay updated on best practices and new developments in care management.
- Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
- Conducted thorough assessments to identify patients'' needs, strengths, and barriers to achieving optimal health outcomes.
- Served as a liaison between patients, families, physicians, insurance providers, and other healthcare professionals for seamless care coordination efforts.
- Responded to emergency situations and provided support to promote client safety and wellbeing.
- Maintained network of community resources to provide most comprehensive support services possible to clients.
- Maintained up-to-date knowledge of community resources by networking with local organizations and attending professional development opportunities.
- Enhanced patient care by developing and implementing individualized care plans.
- Improved patient satisfaction through effective communication and collaboration with interdisciplinary healthcare teams.
Licensed Vocational Nurse
Studio City Rehabilitation Center
01.2019 - 03.2024
- 2019-2024 Working in Sub-Acute specialty unit
- Responsible for care of 10-12 residents requiring higher acuity of care with special attention to tracheostomy, ventilator and GT care
- Administering all medications as ordered by physician under the supervision of Registered nurse
- Assisting with tracheostomy's care and tube changes, assisting respiratory therapist with ventilator care and management
- Providing and anticipating care for complex resident cases, especially nonverbal residents
- Monitoring for changes in resident baseline and reporting to Registered nurse and MD
- Working knowledge in completing SBARs and COCs
- Working knowledge with Point Click Care E Mar system.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Cared for wounds, provided treatments, and assisted with procedures.
- Promoted patient safety through vigilant monitoring of vital signs and reporting any abnormalities to the appropriate healthcare provider promptly.
- Facilitated effective communication between patients, families, and healthcare providers to ensure continuity of care during transitions between facilities or levels of care.
Licensed Vocational Nurse
Studio City Rehabilitation Center
01.2017 - 01.2019
- Working as MDS nurse
- Responsible for collecting and interpreting patient data from charts, and previous history then preparing detailed reports
- Coordinating with IDT teams to provided patient tailored plan of care during stay
- Ensuring compliance with state and federal guidelines
- Responding to care related complaints from family and residents
- Developing a detailed patient focused care plan for resident
- Attending quarterly meetings with long term residents, family, social worker and rehab teem to provide updates review medication and solidify best plan of care.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Facilitated effective communication between patients, families, and healthcare providers to ensure continuity of care during transitions between facilities or levels of care
Licensed Vocational Nurse
Studio City Rehabilitation Center
05.2014 - 01.2017
- Worked in a variety of areas in Long term and short term stay department including Wound Care Nurse and Charge nurse
- Was in charge on 42 resident secured unit mainly focused on Dementia and Gero Psych residents
- Administering medication and treatment to 42 residents
- Specialized in care of memory loss, dementia residents ensuring resident dignity and maintaining quality of life
- Advocating for residents who no longer could verbalize needs
- Relaying abnormal lab results for MD
- Taking and transcribing telephone and verbal orders from MD and NP
- Responsible for overseeing 5 CNA's.
- Prevented medication errors by meticulously reviewing physician orders and administering medications as prescribed.
LVN Charge Nurse
Mountain View Convalescent Hospital
01.2012 - 01.2014
- Charge nurse in Long term care facility caring for 33-34 residents
- Wound care relief nurse on the weekends
- As wound care nurse my responsibilities included providing wound care to multiple residents as MD ordered
- Assessing and Monitoring resident for new skin breakdown, identifying residents who are higher risk for skin breakdown and implementing non pharmacological interventions to prevent skin breakdown
- Coordinating with wound care specialist to develop individualized treatments
- Assisting in collecting wound measurement for wound reports
- As charge nurse responsible for administering all medications as md ordered
- Assist with carrying out MD orders under the supervision of a registered nurse
- Respectful bedside manor providing calm and cheerful dialog.
Education
Vocational Nurse -
American Career College-Los Angeles
Los Angeles, CA03.2011
Skills
- MDS 20
- Case Management
- Dementia Care
- Medication Administration
- Alzheimer's Care
- Vital Signs
- Tube Feeding
- Laboratory Experience
- Transcription
- Patient Care
- EMR Systems
- Wound Care
- Case Documentation
- Organization and Multitasking
- Conflict Resolution
- Email and Telephone Etiquette
- Care Coordination
- Community Resources
- Documentation proficiency
- Referral Coordination
- Annual Case Reviews
- Patient Management
- Excel
- Genesys phone system
- Working knowledge of Panorama and Point Click Care
Certification
- BLS for Healthcare Providers
- Preventing sexual Harassment in california
Languages
Spanish
Native or Bilingual
Timeline
Case Manager
Molina Healthcare/ Brand New Day
03.2024 - 09.2024
Care Manager
Bright Healthcare/ Brand New Day
11.2022 - 03.2024
Licensed Vocational Nurse
Studio City Rehabilitation Center
01.2019 - 03.2024
Licensed Vocational Nurse
Studio City Rehabilitation Center
01.2017 - 01.2019
Licensed Vocational Nurse
Studio City Rehabilitation Center
05.2014 - 01.2017
LVN Charge Nurse
Mountain View Convalescent Hospital
01.2012 - 01.2014
Vocational Nurse -
American Career College-Los Angeles
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