Skilled nursing professional with strong background in patient care coordination and healthcare management. Demonstrates expertise in clinical assessment, discharge planning, and patient advocacy.
Overview
34
34
years of professional experience
1
1
Certification
Work History
RN Case Manager Senior Analyst
Aetna Care Allies & Cigna
Houston, TX
10.2019 - 11.2023
Maintain detailed understanding of HEDIS / STAR performance measures
Develop and maintain a process to ensure patients meet all quality metrics
Coordinate utilization management and discharge planning
Care plan development and implementation for the delivery of cost-effective, quality –based health care services for diabetes case load
Provided Diabetes Classes in Spanish & English at network Endocrinology Clinics in the greater Houston area
High Risk Case Manager
TriHealth Inc.- Good Samaritan Hospital
Cincinnati, OH
09.2013 - 05.2019
Spearheaded an OB high-risk case management initiative to enhance care access for over 12,000 families in underserved communities
Developed, implemented, and evaluated patient care plans to ensure comprehensive service delivery for optimal health outcomes
Facilitated patient care coordination to enhance health outcome strategies
Conducted bilingual diabetes education sessions to empower individuals manage and prevent disease progression through lifestyle changes
Contributed to data gathering efforts for statistical reporting aimed at enhancing outcomes for at-risk patients
Care Coordinator
TriHealth Inc.- Bethesda North Hospital
Cincinnati, OH
03.2004 - 09.2013
Optimized care cost management through strategic service coordination and multidisciplinary collaboration
Prepared weekly care plan reviews with medical team to monitor patient progress and adjusted care strategies based on evolving needs
Engaged with community resources to strengthen patient support networks and streamline referral pathways
Analyzed existing workflows and instituted process enhancements to optimize care coordination and reduced delays in services
Resolved customer inquiries through effective communication and problem-solving techniques
Emergency Room Nurse
The Christ Hospital
Cincinnati, OH
11.1999 - 03.2004
Collaborated with multidisciplinary teams to develop comprehensive treatment plans
Provided critical patient assessments in high-pressure emergency situations
Hospital Corpsman
US Department Of Defense, Navy
San Diego, CA
07.1989 - 07.1994
Administered medical care for range of conditions and basic health concerns including immunization, medications and blood draws.
Provided emergency medical care, including conducting physical exams and interviews to gain medical history and relevant health data.
Provided leadership, delegation and exceptional medical service in high-pressure situations.
Administered emergency medical treatment and first aid to injured personnel in various operational environments.
Assisted in the management of patient care activities, ensuring compliance with safety protocols and standards.
Assisted in medical examinations, treatments and procedures for diverse conditions and patient populations.
Education
Master of Science in Organizational Leadership - Business Administration & Management
Mount St. Joseph University
Cincinnati, OH
12-2016
Bachelor of Science - Nursing
Mount St. Joseph University
Cincinnati, OH
05-2010
Associate of Science - Nursing
Los Angeles Valley College
Van Nuys, CA
05-1996
Skills
Patient education
Process optimization expertise
Excellent interpersonal communication with diverse population
Self-motivated individual
Experienced with diverse software tools
Structured and results-driven
Adaptable to tight deadlines
Proficient in English and Spanish
Certification
Certified Case Manager
Trained Bilingual Interpreter
Timeline
RN Case Manager Senior Analyst
Aetna Care Allies & Cigna
10.2019 - 11.2023
High Risk Case Manager
TriHealth Inc.- Good Samaritan Hospital
09.2013 - 05.2019
Care Coordinator
TriHealth Inc.- Bethesda North Hospital
03.2004 - 09.2013
Emergency Room Nurse
The Christ Hospital
11.1999 - 03.2004
Hospital Corpsman
US Department Of Defense, Navy
07.1989 - 07.1994
Master of Science in Organizational Leadership - Business Administration & Management
RN Case Manager/Case Manager/Registered NurseCase Manager/Registered Nurse Case Manager/Clinical Team Manager at Elara CaringRN Case Manager/Case Manager/Registered NurseCase Manager/Registered Nurse Case Manager/Clinical Team Manager at Elara Caring
Hospice Clinical Liaison/GIP RN/Hospice RN Case Manager at Constellation Health ServicesHospice Clinical Liaison/GIP RN/Hospice RN Case Manager at Constellation Health Services