Summary
Overview
Work History
Education
Skills
Websites
Languages
Timeline
Generic

MELISSA LOPEZ

Cibolo

Summary

Registered Nurse with expertise in individualized patient care and effective education. Proven leadership in enhancing patient satisfaction and streamlining safety protocols. Over 9 years of experience in healthcare insurance at Centene, known for problem resolution and customer satisfaction improvement.

Overview

28
28
years of professional experience

Work History

RN Care Manager

Centene
08.2015 - Current
  • MMP RN Care Manager
  • Waiver Assessment Nurse
  • Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short- and long-term goals, treatment, and provider options.
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes.
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
  • Provide patient and provider education.
  • Facilitate member access to community-based services.
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
  • Effectively communicated with physicians regarding patient needs, performance, medications, and changes.
  • Completed initial assessments of patients and family to determine and address individual home care needs.
  • Case Management Predictive Modeling
  • PM ESRD and Non-ESRD
  • LTSS Service Care Manager (RN), LTSS Clinical Care Manager

Independence Plus PDN
08.2023 - 11.2024
  • Company Overview: Private duty nursing

RN Supervisor

ADVENT
06.1997 - 09.2023
  • Coordinated nursing activities and staffing with health-related, therapeutic and support services to streamline service delivery.
  • Created, implemented, and evaluated programs that promoted staff recruitment, retention and development.
  • Created customized care plans, working with hospital staff and families to assess and meet individual needs.

LVN Clinical Instructor

Career Point College
11.2015 - 12.2016
  • Instructor to LVN students at the clinical site. Overseeing and supervising. In addition to teaching and ensuring each student passed each clinical objective.

RN Care Manager

Hill Country Home Health
03.2011 - 03.2013
  • Managed care from admission to discharge.
  • Provided direct patient care, stabilized patients and determined next course of action.
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Supervisory visits for LVN’s

Education

Master of Science - Nursing Administration

UT Arlington
Arlington, Texas
12.2018

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Colorado Technical University
Colorado City, CO
12.2024

Bachelor of Science - Nursing

St Philips College
San Antonio, TX
12.2010

Associate of Science - undefined

St Philips College
San Antonio, TX
08.1997

LVN - undefined

St Philips College
San Antonio, TX
08.1997

Skills

  • Health risk assessment
  • Healthcare educator
  • Understanding disease mechanisms
  • Disease management

Languages

English
Full Professional
Spanish
Full Professional

Timeline

Independence Plus PDN
08.2023 - 11.2024

LVN Clinical Instructor

Career Point College
11.2015 - 12.2016

RN Care Manager

Centene
08.2015 - Current

RN Care Manager

Hill Country Home Health
03.2011 - 03.2013

RN Supervisor

ADVENT
06.1997 - 09.2023

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Colorado Technical University

Bachelor of Science - Nursing

St Philips College

Associate of Science - undefined

St Philips College

LVN - undefined

St Philips College

Master of Science - Nursing Administration

UT Arlington

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