Paulite Blaza

• Company Overview: (NDA PROHIBITS RELEASE OF INFORMATION)
• Compassionate, caring, respectful, & appropriate direct patient care as ordered by medical provider(s) & per care-plan, with regular communication between client, permitted family, & IDT to promote healing & recovery, & prevent risk of injury, infection, & readmission
• Medication Management- daily administration & weekly reconciliation with PCP & Pharmacist
• Monitor/Assist per care-plan: ADLs, PT/OT, Meal-plan & prep, & feedings (PRN)
• Assist with transportation, appointment scheduling, & leisurely outdoor physical activities

• Company Overview: Maitland, FL
• Process approx 50-75 PA requests daily utilizing MCG/Medicare/Medi-Cal Guidelines as well as Health Plan, Commercial Plan, & Milliman Criteria
• Track assigned cases for timely reviews/updates & decisions as reflected in case documentation with requests & reviews of medical records to identify appropriate acute care days & determine recommendation to medical director for appropriate decision
• Liaison between providers, members, & IDTs, while serving as a resource for Utilization Management & medical providers
• Identify trends that impact utilization at hospitals during the review process & find resolutions
• Telecommute/Remote from home position

• Company Overview: Los Angeles, CA
• Process PDRs for appeals & retro-reviews by thorough review of clinical documentation to confirm medical necessity for IP/OP services (from adm to dc) based on LOC criteria
• Telephonic/electronic precertification, Concurrent UR, DC planning, & CM for obs, acute care, SNF, AR/SAR, & LTACH stays, & initial AH ER/ED admissions
• Determine medical necessity for appropriate IP/OP services per medical guidelines, benefit determination, & compliance with state-mandated regulations per Milliman/MCG LOC criteria
• Assign appropriate CPT, ICD-10, & MS-DRG codes for accurate billing
• Collaborate with IDTs to coordinate & provide appropriate LOC to meet health needs, ensure proper utilization of health services, & promote cost-effective care
• Telecommute/Remote from home position

• Company Overview: Rancho Cucamonga, CA
• Manage intake, referrals, & staffing of required disciplines
• 2018 promoted to LVN Case Mgr
• Submit & process authorization requests for required home health & ancillary services upon discharge & transition
• Determine medical necessity per criteria guidelines according to respective governing agencies to provide services & concurrent review of present illness & past medical history
• Prepare & conduct compliance audits as delegated by respective governing agencies to ensure all associated parties meet & maintain guidelines & criteria for designated service periods

• Company Overview: Baldwin Park, CA
• Office administration, human resources, & payroll in a union/non-union environment according to company policies, client contract, & CBA
• Daily, monthly, & quarterly auditing & reporting
• Manage compliance, quality improvement, recruitment, new hire processing, & orientations
• Maintain all personnel files & payroll records
• Daily time-keeping management, weekly & bi-weekly payroll processing
• Admin Assistant to the General Manager

• Company Overview: Los Angeles, CA
• Office administration, human resources, & payroll in a union/non-union environment according to company policies, client contract, & CBA
• Daily, monthly, & quarterly auditing & reporting
• Manage compliance, quality improvement, recruitment, new hire processing, & orientations
• Maintain all personnel files & payroll records
• Daily time-keeping management, weekly & bi-weekly payroll processing
• Admin Assistant to the General Manager

Vocational Diploma & Certification in IV/BW

(IV/BW - Intravenous Therapy & Blood Withdrawal)

Certificate of Course Completion

Successfully earned GED

Certificate of Course Completion with Phlebotomy Certification

Certificate of Course Completion