Thelma Villa
Cypress,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Transition of Care Supervisor
Devoted
Remote
04.2022 - Current
- Manage a team of nurses that provide transition of care support to member returning home after an inpatient stay
- Hired, created and provided education training to the new and current team members for new and ongoing changes in current practices
- Maintained, created and facilitated all Standard Operating Practices that aline with HEDIS/Stars measure to ensure quality care
- Supported, managed and intervene on emergent issues, critical interventions and crisis issues to support the team and patients to recieve optimal care.
- Consulted with staff on resolution of complex service issues.
- Recruited, interviewed and hired volunteers and staff.
- Partner with clinicians, operational staff and interprofessional teams to coordinate care for patients.
Triage Nurse Specialist
Houston Methodist Physicians Group
Houston, TX
01.2020 - 04.2022
- Assess patients with emergent symptoms to guide them to appropriate medical care
- Apply evidence-based practices to assess and promote patient care advice
- Coordinate care with physicians’ services to access care promptly
- Advocate for patient to recieve the care to address their emergent symptoms.
- Evaluated medical histories and case records to develop summaries and chronologies of care.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Care Coordinator Manager
United Healthcare
Las Cruces, NM
07.2012 - 10.2019
- Managed a team of 13 telecommuting professionals to educate, coordinate transition, facilitate community care, and access resources for patients, families, and clinical providers
- Developed learning activities, job aids, and policies and procedures to appraise clinical staff of company practices, documentation standards, and evidence-based patient care
- Applied Centers of Medicaid and Medicare Standards (CMS) to evidence-based practice standards to provide the best care for patients
- Applied knowledge of CMS regulations and requirements of third-party payers to problem-solve ongoing provider/patient escalated issues to resolve concerns
- Educated patients with chronic medical conditions, coordinated discharge, and nurture a smooth transition of care to help patients remain independent in the community
- Facilitated and led interdisciplinary care conferences with community providers to provide optimal patient care
- Provided telephonic support to patients to manage medical conditions, contact medical/DME/Home Health providers to resolve issues, and assess members for continued care services.
- Monitored staff performance and addressed issues.
- Trained employees on additional job positions to maintain coverage of roles.
- Led team meetings and one-on-one coaching sessions to continuously improve performance.
- Created training modules and documentation to train staff.
Charge Nurse/Utilization Review Case Manager/Discharge Coordinator
Texas Department of Health, El Paso Psychiatric Center
El Paso, TX
03.2005 - 07.2012
- Managed and mentored a team of nurses to provide psychiatric/medical care and coordination for adults, adolescents, and children
- Medical/psychiatric knowledge applied with patients in medication management, patient education, and crisis management scenarios
- Relayed clinical information to external reviewers and 3rd party payers to access reimbursement of clinical services
- Implemented and maintained regulatory standards for the hospital by incorporating CMS,
- OSHA, and state guidelines to continue operations and payer practices
- Coordinated discharge care with inpatient and outpatient providers to maintain continuity of care for patients
- Accessed, networked, and organized community services with providers and continuity of care services to link patients to appropriate care upon hospital discharge to ensure successful community transitions.
- Reviewed social service and case management plans to guide implementation.
- Discussed client advocacy and referral services, supporting families with education and resources.
Education
Master of Science - Nursing Administration
Capella University
Bachelor of Science - Nursing
The University of Texas
Bachelor of Liberal Arts - Psychology
The University of Texas
Skills
- Knowledgeable in crisis interventions and management
- Excellent writing and communication skills
- Success building interprofessional relationships
- Management/Utilization Review Management
- Fluently Bilingual in Spanish
- Evaluation and Assessment
- Behavioral Specialist
- Conducting Interviews
- Microsoft Office
- Reliable & Trustworthy
- Planning & Organizing
- Team Building
- Conflict Resolution
- Critical Thinking
- Team Management
- Problem Resolution
- Training & Development
- Fluent in Spanish
- Supervision & Leadership
- Active Listening
- Friendly, Positive Attitude
- Computer Skills
References
References: Available upon request
Languages
Spanish
Full Professional
Certification
- Basic Life Support (BSL) Training - 2022
- Registered Nurse License - 2022
Timeline
Transition of Care Supervisor
Devoted
04.2022 - Current
Triage Nurse Specialist
Houston Methodist Physicians Group
01.2020 - 04.2022
Care Coordinator Manager
United Healthcare
07.2012 - 10.2019
Charge Nurse/Utilization Review Case Manager/Discharge Coordinator
Texas Department of Health, El Paso Psychiatric Center
03.2005 - 07.2012
Master of Science - Nursing Administration
Capella University
Bachelor of Science - Nursing
The University of Texas
Bachelor of Liberal Arts - Psychology
The University of Texas
Similar Profiles
Victor JaraVictor Jara
Customer Support Specialist at DevotedCustomer Support Specialist at Devoted
Victor JaraVictor Jara
Customer Support Specialist at DevotedCustomer Support Specialist at Devoted
Ian ShaoIan Shao
Cook at DevotedCook at Devoted
Kenna HargroveKenna Hargrove
Member Outreach Specialist at DevotedMember Outreach Specialist at Devoted
Mark ConlonMark Conlon
Corporate Counsel at Hewlett Packard EnterpriseCorporate Counsel at Hewlett Packard Enterprise