Dedicated registered nurse with over three decades of expertise in clinical nursing, case management, and leadership roles. Proven track record of providing high-quality patient care, managing complex cases, and leading healthcare teams. Skilled in developing and implementing care plans to optimize patient outcomes and ensure a positive healthcare experience. Committed to continuous learning and staying current with industry best practices to deliver top-notch care.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Manager Case Management, Care & Disease Management Ops External Channel
United Health Group/Optum Health
04.2019 - Current
Manage and be accountable for team of professional telecommute staff
Responsible for daily assignments for staff of 17-20 including auto dialer, manual outbound and work queues
Collaborate with Workforce management to influence and provide input to forecasting and planning activities, set daily direction and attend monthly 6x13 planning meetings
Address and solve system/application issues affecting operations by entering tickets through company portal and follow up to ensure resolution
Audit staff calls and cases on a monthly basis
Meet monthly/quarterly with staff to review performance and expectations; provide annual evaluations; performance manage when needed
Meet with leadership to adapt operational plans, and priorities to address business and operational goals
Product, service, or process decisions, I make impact multiple groups of employees and/or customers (internal or external)
Demonstrates knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid, commercial) or regulatory bodies (e.g., HIPAA, URAC, ISO, Milliman, NCQA)
Chaired OPTUMization Committee in 2023 to find opportunities and solution for improvement from feedback received from employees
Participation in Monthly Employee Engagement committee meetings to help increase employee experience by driving outcomes
Transitioned 16 legacy RN O&E nurses to new roles within the company, collaborating with our people business partners to ensure smooth relocation.
Participated in the onboarding of 20 new staff and transition of new O&E team
Manager Case Management, Population Health Solutions Total Population - Custom Accounts
United Health Group/Optum Health
Richardson, TX
10.2016 - 04.2019
Manage and be accountable for team of professional staff both onsite and telecommute
Set team direction, resolve problems, and provide guidance to staff
Audit staff calls and cases on a monthly basis
Meet monthly/quarterly with staff to review performance and expectations; provide annual evaluations
Meet with leadership to adapt operational plans, and priorities to address business and operational goals
Demonstrates knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid, commercial) or regulatory bodies (e.g., HIPAA, URAC, ISO, Milliman, NCQA)
Chaired CCM Council/Education Committee helping Registered Nurses in obtaining their Certified Case Manager Certification with average pass rate of 89%
Involvement with implementation and onboarding of new client accounts
Sr. Case Manager, Team Lead - Population Health Solutions Total Population - Custom Accounts
United Health Group/Optum Health
Richardson, TX
04.2010 - 10.2016
Review work of team and provide coaching recommendations for improvement
Person of contact for complex and/or critical member issues
Forecast and plan to meet goal requirements
Chaired Optum Power and Co-Chair CCM Council Committees
Sr. Case Manager responsible for multiple clients ranging from 80K to 160K members
Review and edit job aids to follow current process
Involvement with implementation and onboarding new client accounts
RN Case Manager Custom and Standard Accounts
United Health Group/Optum Health
Richardson, TX
10.2006 - 04.2010
Telephonic case and disease management
Knowledge of account specific programs, both internal and external
Working with internal and external partner referrals
Owner and completion of daily work queue and client escalated cases
Collaborating with Medical Director, Social Worker, Internal Disciplinary Care Teams
Side by side precepting new peers to help onboard and orientate to team and processes
Staff Nurse/Charge Nurse
Doctor's Hospital Dallas
Dallas, TX
09.2002 - 01.2007
Newborn Nursery and Intermediate Nursery Level II
Attended deliveries
Childbirth Educator in formal classroom
Precept and orientate new employees
NRP Certified using knowledge learned when attending deliveries
Staff Nurse/Charge Nurse
Medical City Dallas Hospital
Dallas, TX
01.1994 - 07.2003
Staff nurse PCU-Step down ICU, care of moderately acute patients with cardiac, renal, and diabetic conditions and recovery of angioplasty/heart catheter procedures
BLS and ACLS certified using knowledge learned when taking care of critically ill patients
Charge Nurse Normal Newborn & float to NICU
Admit Nurse average 350-400 newborns per month
Certified Breastfeeding Educator- helping new mothers learn to breastfeed
NRP Certified using knowledge learned when attending deliveries
Education
Associate of Applied Science - Nursing
El Centro College
Dallas, TX
12.1993
Skills
Demonstrated organizational and leadership capabilities
Proficient in MS Office applications
Employee growth and performance oversight
Job aid development
Certification
Certified Case Manager through Commission for Case Manger Certification
Licensed RN in the state of TX and CA
Awards and Programs
Optum Superhero Award 2013 and 2024, Kina' ole Award 2024, Values Base Leadership completed April 2015, Emerging Leadership program completion Nov 2015, Inspire Mentor 2022, 2023
Timeline
Manager Case Management, Care & Disease Management Ops External Channel
United Health Group/Optum Health
04.2019 - Current
Manager Case Management, Population Health Solutions Total Population - Custom Accounts
United Health Group/Optum Health
10.2016 - 04.2019
Sr. Case Manager, Team Lead - Population Health Solutions Total Population - Custom Accounts
<ul><li>Manage three separate teams for which their scope includes middle office support for the client relations community including known population remediations, complex reporting as well as a business manager team executing on efficiencies and development opportunities (eleven individuals both domestic and overseas contingent workers). 13 years of Institutional Relationship experience, 7 of those involving people management</li><li>Currently own and assist with facilitating the client relation pieces of various Management Action Plans (MAP) and internal audits within Revenue Credit Account (RCA) and Service Level Agreement (SLA) areas</li><li>In February 2024 released the first Salesforce Intake system at TIAA after five years of development and advocacy. This build has been noted as the blue print for all future case management intake systems within Salesforce at TIAA providing efficiency and ease for the user while reducing risk for the company</li><li>Worked on advancements and efficiencies within the Service Level Agreement process including salesforce automation. Implemented continuous improvement projects which reduced specific quarterly reporting tasks from days to minutes as well as the inception of a single budget code to pull penalties from rather than dozens of different budget codes</li><li>Through partnership with operations, updated the standard operating procedures for Client Service Managers concerning non bulk Lost Earning Calculations in 2021 to be submitted primary through plan focus unless through special exception. This reduced volumes for my team around lost earning calculations by 22% compared to the year prior while providing a more seamless and straight through process for the external clients</li><li>Continue working through obstacles, avoid duplication of efforts between client relations and other support team within different departments while creating synergy towards “working as one”</li><li>Advanced public speaking skills presenting both in person and virtually to groups as small as senior leadership to hundreds of employees on various forums</li></ul> at TIAA<ul><li>Manage three separate teams for which their scope includes middle office support for the client relations community including known population remediations, complex reporting as well as a business manager team executing on efficiencies and development opportunities (eleven individuals both domestic and overseas contingent workers). 13 years of Institutional Relationship experience, 7 of those involving people management</li><li>Currently own and assist with facilitating the client relation pieces of various Management Action Plans (MAP) and internal audits within Revenue Credit Account (RCA) and Service Level Agreement (SLA) areas</li><li>In February 2024 released the first Salesforce Intake system at TIAA after five years of development and advocacy. This build has been noted as the blue print for all future case management intake systems within Salesforce at TIAA providing efficiency and ease for the user while reducing risk for the company</li><li>Worked on advancements and efficiencies within the Service Level Agreement process including salesforce automation. Implemented continuous improvement projects which reduced specific quarterly reporting tasks from days to minutes as well as the inception of a single budget code to pull penalties from rather than dozens of different budget codes</li><li>Through partnership with operations, updated the standard operating procedures for Client Service Managers concerning non bulk Lost Earning Calculations in 2021 to be submitted primary through plan focus unless through special exception. This reduced volumes for my team around lost earning calculations by 22% compared to the year prior while providing a more seamless and straight through process for the external clients</li><li>Continue working through obstacles, avoid duplication of efforts between client relations and other support team within different departments while creating synergy towards “working as one”</li><li>Advanced public speaking skills presenting both in person and virtually to groups as small as senior leadership to hundreds of employees on various forums</li></ul> at TIAA
<ul>
<li>Spearhead the management and oversight of the National Bio and Agro-Defense Facility (NBAF) project, a pivotal national asset developed in partnership with the U.S</li>
<li>Department of Agriculture (USDA) and the U.S</li>
<li>Department of Homeland Security (DHS)</li>
<li>Collaborate with USDA and DHS stakeholders to ensure a seamless transition of operations and mission capabilities from the aging Plum Island Animal Disease Center (PIADC) to NBAF, ensuring uninterrupted research, diagnostics, and training essential to national security</li>
<li>Lead the operational endurance phase, validating work processes and laboratory setups to guarantee compliance with the highest safety and biocontainment standards, particularly in biosafety level-4 (BSL-4) environments</li>
<li>Act as the hiring manager, conducting interviews and selecting high-quality employees to ensure the success of both DCA and NBAF</li>
<li>Serve as a subject matter expert pert for the payroll system Paychex, overseeing and approving payroll for 63 officers biweekly while managing paid time off and leave requests to maintain the security posture for the facility</li>
<li>Monitor project milestones, providing critical updates to senior management and stakeholders while ensuring alignment with USDA's mission objectives and federal guidelines</li>
<li>Direct the development and execution of strategic initiatives to facilitate efficient collaboration with federal partners, ensuring all laboratory operations adhere to regulatory requirements set forth by the Federal Select Agent Program (FSAP)</li>
<li>Foster a culture of excellence and professionalism within the team, emphasizing rigorous training, safety compliance, and operational integrity as key components of NBAF's mission to safeguard public health and the nation's food supply</li>
<li>Monitored budgeting activities by tracking expenditures and providing regular updates to management.</li>
<li>Analyzed existing processes within a department or organization in order to identify areas for improvement or increased efficiency.</li>
<li>Implemented quality control measures throughout each stage of a project's lifecycle.</li>
<li>Worked closely with senior managers to ensure that all projects were completed according to schedule.</li>
<li>Conducted research on potential vendors, suppliers, contractors and subcontractors for projects.</li>
<li>Provided administrative support to the Project Manager in order to facilitate successful project outcomes.</li>
<li>Prepared monthly progress reports summarizing key accomplishments achieved since the last report.</li>
<li>Trained junior staff on best practices for managing multiple projects simultaneously.</li>
</ul> at Defense Contracting Activity, LLC<ul>
<li>Spearhead the management and oversight of the National Bio and Agro-Defense Facility (NBAF) project, a pivotal national asset developed in partnership with the U.S</li>
<li>Department of Agriculture (USDA) and the U.S</li>
<li>Department of Homeland Security (DHS)</li>
<li>Collaborate with USDA and DHS stakeholders to ensure a seamless transition of operations and mission capabilities from the aging Plum Island Animal Disease Center (PIADC) to NBAF, ensuring uninterrupted research, diagnostics, and training essential to national security</li>
<li>Lead the operational endurance phase, validating work processes and laboratory setups to guarantee compliance with the highest safety and biocontainment standards, particularly in biosafety level-4 (BSL-4) environments</li>
<li>Act as the hiring manager, conducting interviews and selecting high-quality employees to ensure the success of both DCA and NBAF</li>
<li>Serve as a subject matter expert pert for the payroll system Paychex, overseeing and approving payroll for 63 officers biweekly while managing paid time off and leave requests to maintain the security posture for the facility</li>
<li>Monitor project milestones, providing critical updates to senior management and stakeholders while ensuring alignment with USDA's mission objectives and federal guidelines</li>
<li>Direct the development and execution of strategic initiatives to facilitate efficient collaboration with federal partners, ensuring all laboratory operations adhere to regulatory requirements set forth by the Federal Select Agent Program (FSAP)</li>
<li>Foster a culture of excellence and professionalism within the team, emphasizing rigorous training, safety compliance, and operational integrity as key components of NBAF's mission to safeguard public health and the nation's food supply</li>
<li>Monitored budgeting activities by tracking expenditures and providing regular updates to management.</li>
<li>Analyzed existing processes within a department or organization in order to identify areas for improvement or increased efficiency.</li>
<li>Implemented quality control measures throughout each stage of a project's lifecycle.</li>
<li>Worked closely with senior managers to ensure that all projects were completed according to schedule.</li>
<li>Conducted research on potential vendors, suppliers, contractors and subcontractors for projects.</li>
<li>Provided administrative support to the Project Manager in order to facilitate successful project outcomes.</li>
<li>Prepared monthly progress reports summarizing key accomplishments achieved since the last report.</li>
<li>Trained junior staff on best practices for managing multiple projects simultaneously.</li>
</ul> at Defense Contracting Activity, LLC
Manager of Care Coordination/Disease Management BH at Texas Children’s Health PlanManager of Care Coordination/Disease Management BH at Texas Children’s Health Plan