TRACEY SOLIS
Rio Grande City,TX
Summary
Experienced nursing professional bringing demonstrated clinical expertise, leadership skills and technical knowledge. Proficient in updating charts, monitoring medications and working with multidisciplinary teams to optimize patient care. Quality-driven and efficient with strong interpersonal abilities.Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Clinical Review Nurse
Centene
04.2023 - Current
- Performed medical necessity reviews of inpatient and outpatient services to ensure compliance with relevant regulations and standards.
- Reviewed patient records for accuracy, completeness, timeliness, and appropriateness of care prior to authorization requests.
- Conducted utilization management activities such as pre-certification and pre-authorization requests for services rendered by health care providers.
- Participated in interdisciplinary meetings to discuss complex cases or special projects requiring further investigation or review.
- Consulted with physicians regarding appropriate documentation requirements when necessary to support clinical decision making.
- Collaborated with health plan members, providers, case managers and other stakeholders involved in the delivery of patient care.
- Maintained up-to-date knowledge on changes in healthcare industry regulations.
- Ensured timely completion of all assigned tasks within required deadlines.
Service Coordinator
Centene
06.2016 - 01.2022
- Assisted in the development of training materials related to service coordination processes.
- Worked closely with other departments within the company to ensure successful completion of projects.
- Obtained paperwork from the field and distributed to appropriate departments for processing.
- Managed scheduling of appointments and service calls to meet client needs.
- Monitored service delivery and client satisfaction, implementing improvements as necessary.
- Provided support and guidance to clients, navigating them through service options.
- Implemented and monitored quality assurance measures to uphold service standards.
- Assisted in the development and implementation of service plans based on client assessments.
- Facilitated communication between clients, service providers, and internal teams.
LVN Field Nurse
With Open Arms Home Care
Mcallen , TX
05.2015 - 06.2016
- Provided primary care services to patients in their homes.
- Assessed, developed and implemented nursing care plans for patients.
- Performed physical assessments of patients and monitored vital signs.
- Administered medications, injections, treatments and wound care as prescribed by physicians.
- Conducted patient education about disease prevention and health promotion activities.
- Collaborated with physicians, interdisciplinary teams and other healthcare professionals to optimize patient outcomes.
- Maintained accurate records of patient visits and care provided in accordance with agency policies.
- Monitored changes in patient condition between visits and reported any significant findings to physician or supervisor promptly.
- Ensured compliance with all applicable laws, regulations and standards governing professional nursing practice.
- Communicated effectively with other healthcare providers to coordinate quality patient care.
Education
Bachelor of Science - Nursing
Grand Canyon University
Phoenix, AZ09-2024
ADN -
South Texas College
McAllen, Texas12.2022
LVN -
South Texas College
McAllen, Texas08.2014
High School Diploma -
Rio Grande City High School
Rio Grande City, Texas05.2006
Skills
- TruCare
- Amysis
- TruCare cloud
- Database: MS Access
- Presentation: MS PowerPoint
- Applications: Microsoft Project, MS Word & Excel
- Customer service
- Leadership
- Communication
- Team player
- Able to read, write and speak English and Spanish
- Utilization review
- Policy compliance
- Quality Improvement
- HIPAA Compliance
- Care Coordination
- HIPAA knowledge
- Evidence-Based Practice
- Case Management
- Time management abilities
- Geriatric treatment knowledge
- Preventive Healthcare
- Multitasking
- Attention to Detail
- Team Collaboration
- Written Communication
- Reliability
- Adaptability and Flexibility
- Problem-solving aptitude
- Delegation and Motivation
- Critical Thinking
- Active Listening
- Treatment Plan Modification
- Teamwork and Collaboration
- Problem-solving abilities
- Acute and rehabilitative care
Certification
- Registered Nurse, 1107593, 2022
- Licensed Vocation Nursing Certification, 323094, 2014
- Basic Life Support Certified, 2021
- Suicide Prevention Training, 2022
- Registered Nurse, 1107593, 2023
Personal Information
Title: REGISTERED NURSE
References
- Martha Villa, (210) 760-1097, LTSS Manger Case Manager
- Blanca Escobar, (956) 341-1136, LTSS Senior Case Manager
- Heather Brock, (210) 854-7874, Supervisor Utilization Management
Clinical rotation experience
- McAllen Heart Hospital, McAllen, TX, 2013
- McAllen Medical Center, McAllen, TX, 2013
- Rio Grande Regional, McAllen, TX, 2013
- Mission Hospital, Mission, TX, 2013
- Dr. Hospital at Renaissance, Edinburg, TX, 2022
- McAllen Heart Hospital, McAllen, TX, 2022
- Rio Grande Regional Hospital, McAllen, TX, 2022
- South Texas Behavioral Center, Edinburg, TX, 2022
Timeline
Clinical Review Nurse
Centene
04.2023 - Current
Service Coordinator
Centene
06.2016 - 01.2022
LVN Field Nurse
With Open Arms Home Care
05.2015 - 06.2016
Bachelor of Science - Nursing
Grand Canyon University
ADN -
South Texas College
LVN -
South Texas College
High School Diploma -
Rio Grande City High School
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