Melissa Perez
Alton,TX
Summary
Compassionate Nurse Case Manager offering 28 years of experience working with patients and families to facilitate smooth transitions following discharge from medical facilities. Committed to working collaboratively with health plan, leadership, and department coordinators to achieve highest quality of patient satisfaction. Well-versed in developing individualized care plans and advocating patient welfare.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Nurse Case Manager
Optum Health United Health Care
10.2021 - Current
- Evaluated medical necessity, appropriateness, and efficiency of requested treatments or procedures
- Utilized industry-specific guidelines and criteria to determine the level of care required for patients
- Reviewed and analyzed patient data including diagnoses, treatment plans, medications, and test results
- Communicated findings and recommendations to physicians, nurses, case managers, and other relevant stakeholders
- Participated in interdisciplinary team meetings to discuss complex cases and develop care plans
- Conducted comprehensive reviews of medical records to ensure appropriate utilization of healthcare services
- Maintained accurate documentation of all review activities in accordance with regulatory requirements
- Collaborated with interdisciplinary healthcare team to ensure continuity of care and optimal patient outcomes
- Maintained accurate documentation of patient assessments, interventions, and outcomes in electronic medical records system
- Facilitated smooth transitions between different levels of care (e.g., hospital to home) by coordinating resources
- Collaborated with healthcare team to develop discharge plans that met patient needs and ensured continuity of care
LVN Nurse
CONVIVA CARE CENTER
01.2019 - 10.2021
- Administered medications and treatments to patients, ensuring accurate dosages and proper documentation
- Monitored vital signs, assessed patient conditions, and reported any changes or concerns to the healthcare team
- Assisted with the development of care plans for patients based on their individual needs and medical history
- Performed wound care, including cleaning, dressing changes, and monitoring healing progress
- Collaborated with physicians and other healthcare professionals to provide comprehensive patient care
- Educated patients and their families about medication instructions, disease management, and self-care techniques
- Managed inventory of medical supplies and equipment to ensure availability for patient care needs
- Implemented infection control measures to prevent the spread of diseases within the healthcare setting
- Participated in interdisciplinary team meetings to discuss patient progress and develop appropriate treatment plans
- Collaborated with nursing staff to maintain a clean and safe environment for patients at all times
- Supported physicians during examinations by preparing exam rooms, taking vital signs, obtaining specimens
Pre-Op/PACU Nurse
United Surgical Partners
06.2017 - 01.2019
- Provided pre-operative care to patients, ensuring their safety and comfort before surgery
- Assessed patients' medical history, allergies, and current medications to identify potential risks or complications
- Administered pre-operative medications as prescribed by physicians
- Monitored vital signs, including blood pressure, heart rate, and oxygen saturation levels
- Prepared patients for surgery by assisting with gowning, positioning, and other necessary preparations
- Ensured proper functioning of equipment in the operating room and performed routine checks on monitors and anesthesia machines
- Documented all patient assessments, interventions, and outcomes accurately in electronic medical records (EMR)
- Responded promptly to any changes in patients' conditions or emergencies during pre-operative phase
- Provided post-anesthesia care to patients recovering from surgery, monitoring vital signs and assessing pain levels
- Monitored patients for any signs of complications or adverse reactions to anesthesia, taking immediate action when necessary
- Educated patients and their families about post-operative recovery expectations, providing instructions for self-care at home
Service coordinator
Cigna HealthSpring Medicare Advantage
12.2011 - 03.2017
- Conduct assessments on members to determine eligibility for managed care programs based on healthcare needs.
- Create a care plan, organize services, and monitor progress toward healthcare goals of members.
- Perform daily audits of assessments completed by contract staff.
- Coordinated care for a caseload of over 200 patients, ensuring timely and appropriate healthcare services
- Collaborated with interdisciplinary team members to develop comprehensive care plans tailored to each patient's needs and goals
- Maintained accurate documentation of patient assessments, interventions, and outcomes in electronic medical records (EMR) system
LVN Home Health Nurse
New Life Home Care
08.2007 - 06.2010
- Provided skilled nursing care to homebound patients, including wound care, medication management, and symptom assessment
- Administered medications and treatments as prescribed by physicians, following all safety protocols
- Monitored vital signs, recorded patient data, and maintained accurate medical records
- Educated patients and their families on disease management, medication administration, and self-care techniques
- Collaborated with a multidisciplinary team of healthcare professionals to provide comprehensive care
- Implemented infection control measures to prevent the spread of illness and ensure patient safety
- Coordinated with healthcare agencies and community resources to enhance patient care and support
- Assisted in the training and orientation of new nursing staff, ensuring compliance with protocols and standards
- Provided wound care, including dressing changes, wound assessment, and infection control
- Administered injections and intravenous therapy as prescribed, with strict attention to safety and cleanliness
- Monitored and managed chronic conditions such as diabetes, hypertension, and respiratory disorders
- Performed regular audits of manufacturing processes to ensure compliance with established quality standards
Education
Licensed Vocational Nurse -
UTB /TSC
Weslaco, TX08.1997
Skills
- Achieving HIPAA compliance
- OSHA (regulatory compliance area)
- Post-acute care experience
- Communication skills
- Managed Care
- Triage
- Documentation Review
- Patient monitoring
- HEDIS
- Medical-surgical
- Patient Care
- Regulatory compliance
- Case Management (10 years)
- Interdisciplinary collaboration
- Disease management
- Electronic recordkeeping
Certification
- CPR Certification
- LVN May 2026
- Compact State Nurse License
- LPN
Languages
Spanish - Fluent
English - Fluent
Timeline
Nurse Case Manager
Optum Health United Health Care
10.2021 - Current
LVN Nurse
CONVIVA CARE CENTER
01.2019 - 10.2021
Pre-Op/PACU Nurse
United Surgical Partners
06.2017 - 01.2019
Service coordinator
Cigna HealthSpring Medicare Advantage
12.2011 - 03.2017
LVN Home Health Nurse
New Life Home Care
08.2007 - 06.2010
Licensed Vocational Nurse -
UTB /TSC