Valerie Velazquez
San Antonio,TX
Summary
Licensed Vocational Nurse since 2009 and Registered Nurse since February 2017, offering over a decade of clinical experience across various specialties, including Floor Nursing, Infection Control, and Nurse Management. Expertise in case management and leadership as a Director of Case Management, fostering high-performance teams through strategic planning and relationship-building to enhance care coordination. Committed to delivering exceptional nursing care to diverse populations while advocating for patients and supporting clinical staff. Proven ability to implement effective solutions that elevate patient care standards and improve operational efficiency.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Director of Case Management
Post Acute Medical Warm Springs
09.2023 - Current
- Collaborated with multidisciplinary teams to facilitate client care and reduce case management barriers.
- Streamlined, standardized and implemented case management processes and techniques to maximize revenue cycle.
- Created care plans that addressed clinical and financial challenges, family requirements and facilitated patient quality of life.
- Collaborated with interdisciplinary teams to optimize patient outcomes and ensure seamless transitions between care settings.
- Conducted regular performance evaluations to identify strengths, areas for improvement, and opportunities for growth among team members.
- Enhanced patient care by implementing efficient case management systems and processes.
- Maintained compliance with regulatory requirements through rigorous quality assurance processes and timely reporting mechanisms.
- Developed strong relationships with community partners to facilitate comprehensive support services for patients and families.
- Coordinated with external agencies, such as insurance providers and regulatory bodies, to ensure smooth operations within the case management department.
- Influenced policy decisions at both the organizational level by advocating for improvements in case management practices based on industry trends and emerging evidence.
- Provided leadership, guidance and support to staff members.
- Increased staff productivity by providing ongoing training, support, and mentorship for case managers and related professionals.
- Spearheaded initiatives aimed at reducing readmissions, improving discharge planning, and enhancing overall continuity of care.
- Referred clients to appropriate team members, community agencies and organizations to meet treatment needs.
- Monitored program performance and outcomes for successful delivery of services.
- Developed and implemented training programs for staff.
- Utilization review to ensure patients met criteria for In Patient Rehab stay and records are sent for review by thee insurance company.
- Setup Peer to Peer and appeal as needed
REGISTERED NURSE-CASE MANAGER
St Luke’s Baptist
12.2018 - 10.2023
- Initial assessment of patient to identify discharge barriers and needs.
- Utilization Review daily on assigned patients, using Interqual and Milliman programs.
- Educate, discuss, and provide resources for next level of care needs. Rather it be Rehab, Home Health Care, Palliative or Hospice services for continuity of care.
- Continuous review of patient medical record, for discharge planning and Identify needs and recommendations.
- Daily collaboration with health care team and Interdisciplinary communications
- Lead and collaborate daily huddles with physician and providers to discuss patient’s inpatient care and discharge needs.
- Actively participate in In-services, weekly meetings, and complete assigned education modules.
- Attend huddles with the interdisciplinary Team to Identify Length of stay, barriers to discharge and discharge plan/needs.
Nurse Care Manager
Centene, Superior Health Services
03.2023 - 09.2023
- Coordinated and analyzed sustainable person-centered care plans involving internal and external providers.
- Reduced hospital readmissions by closely monitoring patients'' progress and adjusting care plans as needed.
- Educated and evaluated clinical and support staff regarding care quality management regulations and standards of care.
- Coordinated referrals to specialists, hospitalizations, ER visits, ancillary testing, and other enabling services for patients.
- Facilitated assessment of individual physiological, psychological, financial, cultural and family situation and coordinated social services to address individual and family needs.
- Assessed healthcare needs and monitored effectiveness and progress plans to achieve desired outcomes.
- Collaborated with community organizations to connect patients to additional resources for further support in achieving their health goals.
REGISTERED NURSE- CASE MANAGER
Wellmed
01.2019 - 03.2023
- Perform telephonic and in person intake assessments on patients within 24 hours of admission to evaluate & collaborate patients discharge needs. Managing and coordinating comprehensive Case Management services.
- Utilization Review daily on assigned patients to ensure they met criteria for continue stay & perform new reviews for next level of care.
- Evaluated patient progress and adjusted care plans accordingly, ensuring continuity of care across all healthcare settings.
- Provided education and support to patients and families, empowering them to make informed decisions regarding their healthcare needs.
- Collaborated with physicians and other healthcare providers to ensure appropriate resource utilization for complex cases.
- Improved patient outcomes by consistently providing comprehensive assessments and developing tailored care plans.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Streamlined care coordination processes to reduce hospital readmissions and emergency department visits.
- Enhanced interdisciplinary team communication through regular case conferences, promoting effective collaboration for optimal patient care.
REGISTERED NURSE/LICENCE VOCATIONAL NURSE
Warm Spring Rehabilitation
04.2010 - 03.2020
- Essential duties of an RN Charge Nurse
- Admissions/discharges/Care Plans
- Orientation/training
- Gathering and reporting data
- Chart check audits
- Functional Independence Measure Scores (FIMS)
- Supervise Nursing care provided by LVN, and CNA
- Attend and Involvement in In-Services and education modules.
LICENCE VOCATIONAL NURSE/UNIT MANAGER
San Pedro Manor
10.2009 - 03.2010
- Essential duties of an LVN
- Supervise Nursing care, Interview, recommend, correct job performance and provide in-service training.
- Assign, find replacements, and direct work. Attend meetings, and assist with Marketing.
- Track weight loss, falls, pressure/non-pressure wounds and Patient changes Infection Control
Education
REGISTER NURSE -
GALEN COLLEGE OF NURSING
12.2016
LICENSE VOCATIONAL NURSE - undefined
KAPLAN COLLEGE
06.2009
Skills
- Leadership in teams
- Effective utilization
- Effective team collaboration
- Analytical problem-solving
- Strategic decision-making
- Team management
- Metrics evaluation
- Regulatory adherence
- Team development
- Strong clinical judgment
- Effective time management
- Proficient in task delegation
Accomplishments
Certified Case Manager (CCM)2024
Leadership of the Quarter July 2024
Leadership Certification 2025
Certification
- ACLS-ADVANCED CARDIAC LIFE SUPPORT, American heart Association, AHA, 2019
- BLS-BASIC LIFE SUPPORT, American Heart Association, AHA, 2024
- Certified Case Manager (CCM) 2024
References
Upon request
Timeline
Director of Case Management
Post Acute Medical Warm Springs
09.2023 - Current
Nurse Care Manager
Centene, Superior Health Services
03.2023 - 09.2023
REGISTERED NURSE- CASE MANAGER
Wellmed
01.2019 - 03.2023
REGISTERED NURSE-CASE MANAGER
St Luke’s Baptist
12.2018 - 10.2023
REGISTERED NURSE/LICENCE VOCATIONAL NURSE
Warm Spring Rehabilitation
04.2010 - 03.2020
LICENCE VOCATIONAL NURSE/UNIT MANAGER
San Pedro Manor
10.2009 - 03.2010
LICENSE VOCATIONAL NURSE - undefined
KAPLAN COLLEGE
REGISTER NURSE -
GALEN COLLEGE OF NURSING
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