RODNEL HERNANDEZ SANCHEZ
Miami Gardens,FL
Summary
Talented Case Manager adept at handling high caseloads without sacrificing quality of care. Operates in high-pressure environments while recommending best resources and courses of action to benefit patient needs and return each to optimal quality of life. Practiced at enhancing community support with forward-thinking strategies and skilled leadership over teams and resources. Well-organized, industrious and dedicated to boosting support to meet expanding requirements. Bilingual fluency in Spanish and English.
Overview
11
11
years of professional experience
Work History
Clinical Case Manager/Utilization Review Specialist
Larkin Community Hospital
09.2021 - Current
- Enhanced care coordination for patients with complex medical needs through effective communication and collaboration with multidisciplinary teams.
- Reduced hospital readmission rates by conducting thorough patient assessments and providing appropriate resources and support for post-discharge care.
- Empowered patients to take an active role in their own care by providing education on available resources, rights, and responsibilities within the healthcare system.
- Ensured compliance with regulations and accreditation standards by maintaining accurate documentation of all utilization review activities.
- Performed prior authorization review of services requiring notification.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Targeted Case Manager
Altius Management Services LLC
08.2020 - 09.2021
- Identified care needs of individual patients and coordinated responses based on physician advice, insurance limitations and procedural costs.
- Consulted with clinicians to devise and manage ongoing care plans for at-risk patients.
- Managed support services and fostered communication among social workers, therapists, hospital staff and patients.
- Helped patients receive appropriate, high-quality care with reasonable results.
- Managed caseload of more than 20 adults to provide comprehensive, community-based care
- Developed custom strength-based services plan for each participant to meet individual therapy needs and personal strengths.
- Monitored current therapy strategies and improvised needed changes and corrections based on results.
Finance Manager and Sales Representative
Toyota and Autonation
03.2014 - 02.2020
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Used coordination and planning skills to achieve results according to schedule.
- Oversaw daily operations to ensure high levels of productivity.
- Maintained energy and enthusiasm in fast-paced environment.
- Resolved conflicts and negotiated mutually beneficial agreements between parties.
- Cultivated strong relationships with clients, resulting in numerous referrals and repeat customers.
- Demonstrated exceptional product knowledge, allowing for personalized recommendations based on customer preferences and requirements.
- Enhanced client satisfaction by addressing concerns promptly and providing exceptional service.
Education
Behavioral Health Case Manager - Behavioral Case Management
Florida Certification Board
Tallahassee, FL11.2020
Master of Arts - Languages, Translation.
University Of Matanzas, Camilo Cienfuegos.
Matanzas, Cuba.2005
Skills
- Skilled community-based case manager
- Case Report Development
- Large caseload management
- Teamwork/ Collaboration
- Leadership
- Fluent in English and Spanish
- Quick learner
- Positive and friendly
- Excellent work ethic
- Customer relations
Timeline
Clinical Case Manager/Utilization Review Specialist
Larkin Community Hospital
09.2021 - Current
Targeted Case Manager
Altius Management Services LLC
08.2020 - 09.2021
Finance Manager and Sales Representative
Toyota and Autonation
03.2014 - 02.2020
Behavioral Health Case Manager - Behavioral Case Management
Florida Certification Board
Master of Arts - Languages, Translation.
University Of Matanzas, Camilo Cienfuegos.
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