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
Los Angeles, CA
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
Los Angeles, CA
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
Studio City, CA
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
Studio City, CA
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
Studio City, CA
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
Sylmar, CA
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