Michelle Lopez BSN,RN
San Antonio,TX
Summary
Accomplished RN professional skilled in managing diverse healthcare teams and optimizing care delivery processes. Focused on addressing social determinants of health and advancing value-based care through effective service coordination. Demonstrated ability to create tailored care plans that meet individual patient needs and improve health outcomes.
Overview
24
24
years of professional experience
3
3
Certifications
Work History
RN LTSS Field Service Coordinator
Elevance
10.2021 - 09.2024
- Managed caseload of 90-120 complex Medicaid STAR+PLUS members requiring LTSS and community-based services.
- Conducted comprehensive health risk assessments and developed individualized service plans within regulatory timelines.
- Coordinated home health, DME, personal attendant services, behavioral health, and specialty care providers.
- Reduced preventable hospital readmissions through proactive transition-of-care outreach and medication reconciliation.
- Addressed social determinants of health including housing instability, transportation barriers, food insecurity, and caregiver support.
- Collaborated with interdisciplinary teams to ensure cost-effective, quality-driven outcomes.
- Maintained accurate documentation in electronic case management systems while meeting productivity metrics.
- Provided chronic disease education and self-management coaching to improve member engagement and adherence.
RN Practice Manager Pediatric Sub Specialties
UT Health At San Antonio
12.2019 - 11.2021
- Oversaw multidisciplinary pediatric specialty clinics (Cardiology, Pulmonology, Neurology, GI, Hem/Onc).
- Supervised 12+ clinical and administrative staff and collaborated with 16+ providers.
- Managed budgeting, productivity, and operational metrics.
- Resolved patient and team concerns while maintaining compliance and quality standards.
- Supported care coordination for medically complex pediatric patients.
RN Nurse Manager
Clarity Child Guidance Center
06.2016 - 09.2019
- Trained and mentored new nursing staff on best practices and center policies effectively.
- Collaborated with physicians, nurses, therapists, social workers and other healthcare professionals to develop individualized treatment plans for each patient.
- Directed nursing staff in crisis center, inpatient and partial hospitalization behavioral health programs (ages 3–17).
- Provided trauma-informed care to children in CPS custody.
- Developed treatment plans and coordinated multidisciplinary behavioral health services.
- Managed crisis intervention and therapeutic milieu.
RN Adult Psychiatry, Chemical Dependency, ICU
Methodist Specialty and Transplant Hospital
11.2017 - 06.2019
- Delivered acute psychiatric and medical care for adult patients with dual diagnoses.
- Collaborated on discharge planning and care transitions to outpatient and community resources.
- Administered medications and monitored treatment responses to prevent relapse and readmission.
RN Business Manager
Lopez Family Practice
03.2001 - 02.2016
- Managed primary care operations including staffing, billing (ICD-9/ICD-10), insurance verification, and compliance.
- Processed and reconciled insurance claims, reducing denials through improved documentation processes.
- Coordinated care across outpatient, hospital, and long-term care settings.
- Led recruitment, onboarding, and performance management initiatives.
Education
Bachelor of Science - Nursing
The University of Texas At El Paso
El Paso, TXBachelor of Arts - Sociology
The University of Texas At San Antonio
San Antonio, TXAssociate of Applied Science - Nursing
Illinois Central College
East Peoria, ILSkills
Case Management Medicaid STARPLUS Waiver Medicare Advantage
Community-Based Care Discharge Planning
Chronic Disease Management (CHF, Diabetes, CKD)
Behavioral Health Trauma-Informed Care Crisis Intervention
Utilization Management LTSS & HCBS Coordination
Care Plan Development Social Determinants of Health
Regulatory Compliance Quality Improvement
Microsoft Office Suite Electronic Health Records (EPIC, HIP, Meditech, Avatar, eClinical Works)
SAMA/CPI (previous)
Certification
RN Texas compact license
Timeline
RN LTSS Field Service Coordinator
Elevance
10.2021 - 09.2024
RN Practice Manager Pediatric Sub Specialties
UT Health At San Antonio
12.2019 - 11.2021
RN Adult Psychiatry, Chemical Dependency, ICU
Methodist Specialty and Transplant Hospital
11.2017 - 06.2019
RN Nurse Manager
Clarity Child Guidance Center
06.2016 - 09.2019
RN Business Manager
Lopez Family Practice
03.2001 - 02.2016
Bachelor of Science - Nursing
The University of Texas At El Paso
Bachelor of Arts - Sociology
The University of Texas At San Antonio
Associate of Applied Science - Nursing
Illinois Central College