PAULA BONFILS
Baton Rouge,Louisiana
Summary
Registered Nurse (RN) with a solid track record in patient-centered care, case management, clinical leadership, and strategic planning. Throughout my career, I have focused on enhancing patient outcomes through collaboration with interdisciplinary teams, proactive communication, and the use of best practices across various healthcare settings. My commitment is to achieve the best possible results for patients.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Manager, Care Integration Team
Humana/CenterWell Senior Primary Care
10.2022 - Current
- Oversee day-to-day operations, quality chart audit reviews, recruiting/hiring, team management, and overall performance for the Care Integration Team consisting of nurses, community health workers, and social workers aiming to provide quality virtual collaborative care to seniors throughout LA/MS
- Also, partner with mental health and pharmacy
- Collaborates with market leaders and key stakeholders to design market-specific strategies, data analytics, and action plans to reduce acute and post-acute care utilization
- Solicits/shares feedback with market leaders on team-based focus with attention given to success and opportunities to improve one-care team culture and collaboration on high-risk patient management at the market level
- Initiates and maintains relationships with community partners, including key community organizations (home health, hospitals, outpatient mental health, food banks)
- Accountability to key population health metrics, including quality, utilization, and financial measures
Weekend RN Liaison
Baton Rouge Rehabilitation Hospital
10.2022 - 09.2023
- Addressed patient referrals from various hospitals
- Served as primary liaison to designated healthcare facilities, maintaining communication and performing on-site pre-admission assessments and screenings
- Documented assessments in the e-Rehab program
- Assist patient/family with transition to a rehabilitation facility
- Facilitated weekend admissions
- Report out Sunday of weekend assessments and admissions
Supervisor of Case Management
Centene/Louisiana HealthCare Connections
12.2021 - 10.2022
- Supervised day-to-day operations of an integrated care case management team consist of registered nurses, Behavioral Health Care Coordinators and Social workers
- Audited clinical documentation for quality and compliance
- Monitored and managed important KPIs focusing of program performance
- Analyzed reports and data regarding productivity, caseload, and other metrics and communicated trends to the corporate leadership team
Clinic Administrator
Primary Care Plus/ United Healthcare
08.2019 - 12.2021
- Responsible for administrative oversight and coordination of all daily clinic operations
- Responsible for collecting, analyzing, and interpreting weekly clinic operational reports
- Identifying specific trends with data-driven solutions
- Contributed to new protocols regarding Covid-19 return to clinic guidelines
- Responsible for HEDIS metrics management with strong knowledge of/KPIs and Value Base Care Model
RN Case Manager
Our Lady of the Lake Regional Medical Center
02.2015 - 08.2019
- Monitored reports for hospital discharges, initiating patient outreach by assisting the patient with transitioning from hospital to home
- Assessed and resolved any barriers identified post-discharge
- Consistently maintained low monthly readmission rates
- Collaborated with clinical staff in the development and execution of the plan of care and achievement of goals
- Monitored and closed care gaps for managed health companies her HEDIS/CMS standards
Education
Master of Healthcare Administration -
Louisiana State University
Shreveport, Louisiana12.2024
RN-BSN -
University of Louisiana at Lafayette
Lafayette, Louisiana05.2019
Associate of Science - Nursing
Our Lady of the Lake College
Baton Rouge, Louisiana05.2002
Skills
- Microsoft Windows
- Microsoft Office 2013
- Excel
- Internet Explorer
- Epic
- Outlook
Certification
- Basic Life Support, 09/25
- Certified Case Manager, 05/27
- Louisiana State Board of Nursing RN Compact License, #105431, 12/26
Credentials
- MHA
- BSN
- CCM
Organizations
- Humana Nursing Advisory Council
- Humana Change Committee
Timeline
Manager, Care Integration Team
Humana/CenterWell Senior Primary Care
10.2022 - Current
Weekend RN Liaison
Baton Rouge Rehabilitation Hospital
10.2022 - 09.2023
Supervisor of Case Management
Centene/Louisiana HealthCare Connections
12.2021 - 10.2022
Clinic Administrator
Primary Care Plus/ United Healthcare
08.2019 - 12.2021
RN Case Manager
Our Lady of the Lake Regional Medical Center
02.2015 - 08.2019
RN-BSN -
University of Louisiana at Lafayette
Associate of Science - Nursing
Our Lady of the Lake College
Master of Healthcare Administration -
Louisiana State University
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