Summary
Work History
Education
Skills
Timeline
OfficeManager

Tiffany Samuels

Houston,Texas

Summary

Experienced professional dedicated to bridging the gap between hospitals, clinics, and the research community to ensure quality assurance and patient-centered care. Proven track record of successfully implementing strategies that enhance collaboration, streamline processes, and optimize patient outcomes. Committed to staying abreast of industry trends and advancements to continuously contribute to the advancement of healthcare practices.

Work History

Case Manager

Texas Children's Hospital/Star Kids Health Plan for families
01.2020 - Current
  • Leading the managed care of complex medical patients via touch point calls, face to face, inpatient, telehealth and home visits
  • Processed orders/authorizations for clients in need of a home attendant
  • Provided resources to members for durable medical equipment, therapy services, and waiver interest list as needed
  • Presented complex medical and behavioral cases to the Medical Director and Interdisciplinary Care Team for improved clinical outcomes

Case Manager III

Children's Medical Center/Star Kids Health Plan for families
01.2016 - 01.2020
  • Educated families on service coordination, instructions post hospital discharge visits, processed authorizations and budget planning for home services, represented the department for interdisciplinary team meetings to discuss high Emergency Department (ED) utilizers/high claims, conducted assessments and remote contractual calls
  • Managed care for the medically complex patient

Care Manager

Children's Medical Center
01.2014 - 01.2015
  • Facilitated meetings to educate teams on patient’s with specific disease processes and patient barriers – target groups included high ED utilizers with seizures, poor asthma control, and viral complications
  • Calls Post hospitalization within defined MCO guidelines, audited charts of peers for quality assurance
  • Traveled to satellite clinics as needed for face to face visits with staff/patients

Nurse Supervisor-Case Manager

Epic Health Services
01.2014 - 01.2015
  • Supervised field nursing staff, taught tracheostomy check off skills, audited charts for quality assurance, interviewed job applicants, case management of patients with gastrostomy, tracheostomy, and in need of mechanical ventilation, and ensured adequate home transition24 hours post hospitalization
  • Conducted Nursing/PDN authorizations for homebound patients

Private Duty Nurse

Children's Home HealthCare
01.2012 - 01.2015
  • Direct care given to patients diagnosed with failure to thrive requiring constant nursing care and/or requiring tracheostomy/ventilator care

School Nurse

Mesquite Independent School District
01.2010 - 01.2012
  • Lead campus nurse for the routine and emergency care of students and adults, electronic reporting of immunization, and care provided to teaching/administrative staff as needed
  • Student Population of over800 - Pre-K to5th grade

Breast Medical / Gynecologic Oncology / and Infectious Disease Research Nurse

UT MD Anderson
01.2006 - 01.2010
  • Nurse Lead for Phase II and III Pharmaceutical and Investigational Clinical Trials - conducted site initiations, trained physicians/clinical staff, screened patients for study eligibility, conducted chart reviews in EPIC and other systems for internal/external audits, reviewed toxicities via external data and reported to Internal IRB
  • Conducted clinic visits with patients to discuss plans of care and any side effects of medication

Clinical Ob-gyn/PICU Research Nurse

Baylor Texas Children's Hospital
01.2004 - 01.2006
  • Nurse Lead for Phase II and III Pharmaceutical and Investigational Research Studies; directed concurrent and retrospective ventilator/sedation trials to establish best practice guidelines for physicians; screened PICU/ inpatients for study eligibility, traveled to research start-up meetings as needed, and closed out clinical trials

Education

Bachelor of Science Health and Associate Degree - Registered Nursing

Skills

  • Case management
  • Care coordination
  • Discharge planning
  • Utilization criteria
  • Chronic disease management
  • Regulatory compliance
  • Quality assurance controls
  • Critical thinking
  • Time management
  • EMR / EHR
  • MS office

Timeline

Case Manager

Texas Children's Hospital/Star Kids Health Plan for families
01.2020 - Current

Case Manager III

Children's Medical Center/Star Kids Health Plan for families
01.2016 - 01.2020

Care Manager

Children's Medical Center
01.2014 - 01.2015

Nurse Supervisor-Case Manager

Epic Health Services
01.2014 - 01.2015

Private Duty Nurse

Children's Home HealthCare
01.2012 - 01.2015

School Nurse

Mesquite Independent School District
01.2010 - 01.2012

Breast Medical / Gynecologic Oncology / and Infectious Disease Research Nurse

UT MD Anderson
01.2006 - 01.2010

Clinical Ob-gyn/PICU Research Nurse

Baylor Texas Children's Hospital
01.2004 - 01.2006

Bachelor of Science Health and Associate Degree - Registered Nursing

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Tiffany Samuels