Nancy Villamizar
Case Management
Kaysville,Utah
Summary
Compassionate, dependable, self-directed, loyal, experienced Case Management Director for the past six years and RN for nineteen years in a variety of Hospital settings, who is people-oriented and skilled in team development. Passionate about the health and well-being of every patient and team member, specializing in safe care transitions and utilization review. In-depth knowledge of Case Management, including Self-denials and Care coordination to positively impact revenue cycle. Proficient in Midas and Interqual with skills in data management, documentation, and reporting metrics.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Director of Case
HCA Lakeview Hospital, 128 Bed Community Hospital
Bountiful, UT
09.2018 - Current
- Ensures proper utilization of the hospital resources.
- Oversight for all aspects of daily hospital case management operations and accountable for achieving established outcomes through actively engaging interdisciplinary teams and external stakeholders.
- Developed and implemented successful transition of patient care for safe discharges, and participates in readmission reduction efforts.
- Cultivated teamwork and respect by developing outstanding relationships with payers, physicians, and members of the team through solid leadership skills, team, and trust building.
- Screened for needs of patients by conducting reviews and monitoring observation hours to achieve the Hospital standard
- Works with the hospital CFO and Division CM Leader to establish goals that align with the company vision.
- Assess and works on improvement of the department by evaluating process, and monitoring performance through data analytic tools.
- Developed and lead an efficient process for NCD/LCD/LCA hospital adherence for proper reimbursement.
Manager
HCA Brigham City Community Hospital
Brigham City, UT
01.2016 - 09.2018
- Management
- Responsible for the day-to-day management of the Case Management Department, supervising three RN-Case Management professionals, personally developed coordinated procedures for in-patient and out-patient care
- Implemented a new admission process to improve accuracy for patient admissions
- Proficient in Leadership Rounding process of collaborating to improve patient satisfaction and higher quality of care based on patient input
- Developed Denial Process Improvements as well as identifying gaps in the process to maximize Hospital gross revenue
- Key participant in reduction of denial rate within a two-year period to record low amounts
- Co-Chair of UR Committee which includes the development of agenda, data collection, and self-denial process
Utilization Review Case Manager
HCA Lakeview Hospital, 128 Bed Community Hospital
Bountiful, UT
05.2013 - 01.2016
- Asked to change roles to develop and implement a successful transition for the Behavioral UR to Case Management, by developing efficiencies in the submission of the medical records process, therefore providing a reduction of costs, improving time efficiency, verification of records, and decreased denials
- Developed procedures for information collection in working with Physicians that improved documentation of proven medical necessity.
Registered Nurse
HCA Lakeview Hospital, 128 Bed Community Hospital
Bountiful, UT
09.2004 - 05.2013
- Responsible for the cohesive relationship between healthcare professionals, patients, and family members
- Medication administration, patient health history assessments, patient care, counseling patients and family on treatment options,
- Experience and proven agility in diverse healthcare settings (Transitional care unit, Home Health Care, Ortho/Spine, Medical/Surgical, Mental Health, and Progressive Care Unit)
Certified Nurse Assistant
Rocky Mountain Home Health, Home Care, Hospice
Bountiful, UT
01.2001 - 01.2003
- Responsible for helping patients with assistance in health & personal hygiene.
Education
Associate of Applied Science - Registered Nurse
Salt Lake Community College
Salt Lake City, UT05.2003
Bachelor of Science - Nursing
University Of Utah
Salt Lake City, UT05.2008
Master of Arts - Health Care Administration
University of Arizona – Global Campus University of Utah
09.2022
Skills
- Meditech, Midas - NaviHealth, InterQual
- Fluent in English & Spanish
- CMS Requirements
- Patient Coordination
- Quality management
- Utilization Review
- Denials Management
- Team Development
- LOS management
- Communication
- Lead of multi-disciplinary rounds
- Re-admission Reduction
- Management of observation hours
- Quality Improvement
Certification
Registered Nurse, License # 354673-3102 exp. January 31, 2023
ACMA Certification #66702 exp. November 08, 2025
Basic Life Support exp. March 2023
Mountain Leadership University Cohort 19-02 June 28, 2019
Institute for Healthcare Improvement Certifications in:
Leading Quality Improvement Pursuing Professional Accountability and a Just Culture Teamwork & Communication Introduction to Health Care Leadership.
gardening, kayaking, hiking
I enjoy living life to its fullness by being outdoors with my family during a hike, kayaking or simply growing vegetables and beautiful flowers in my backyard.
Timeline
Director of Case
HCA Lakeview Hospital, 128 Bed Community Hospital
09.2018 - Current
Manager
HCA Brigham City Community Hospital
01.2016 - 09.2018
Utilization Review Case Manager
HCA Lakeview Hospital, 128 Bed Community Hospital
05.2013 - 01.2016
Registered Nurse
HCA Lakeview Hospital, 128 Bed Community Hospital
09.2004 - 05.2013
Certified Nurse Assistant
Rocky Mountain Home Health, Home Care, Hospice
01.2001 - 01.2003
Associate of Applied Science - Registered Nurse
Salt Lake Community College
Bachelor of Science - Nursing
University Of Utah
Master of Arts - Health Care Administration
University of Arizona – Global Campus University of Utah
Registered Nurse, License # 354673-3102 exp. January 31, 2023
ACMA Certification #66702 exp. November 08, 2025
Basic Life Support exp. March 2023
Mountain Leadership University Cohort 19-02 June 28, 2019
Institute for Healthcare Improvement Certifications in:
Leading Quality Improvement Pursuing Professional Accountability and a Just Culture Teamwork & Communication Introduction to Health Care Leadership.
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