Vannaitti Vasquez
BSN RN Service Coordination Supervisor
Corpus Christi,Texas
Summary
Committed and determined individual looking for a position to maintain working relationships to improve patient care outcomes, productivity, integrity. Willingness to take on added responsibilities to meet team and operational goals and provide quality performance. Approach obstacles and duties with a positive attitude and able to adapt easily with a calm demeanor during times of critical need to provide competent and dignified patient care satisfactorily. Strong sense of initiative and urgency in addressing unexpected patient crisis; self-directed. Proven problem solver and effective communication skills. Flexible and able to collaborate with team members to improve health outcomes.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Population Health RN Supervisor
Driscoll Health Plan
12.2021 - Current
- Maintains composure, effectiveness, and flexibility under pressure
- Directly supervise 20-22 FTEs, clinical and non-clinical staff, and assist as requested in supervising other department managers with staff
- Manage critical situations calmly and efficiently, providing guidance to department staff, including RNs, during emergent situations affecting member outcome
- Promote a culture of continuous improvement within Medically Dependent Children Program (MDCP) and Private Duty Nursing (PDN) population by regularly soliciting feedback from staff members and incorporating suggestions into practice when appropriate.
- Establish strong relationships with interdisciplinary teams to include but not limited to department managers, Medical Directors, treating physicians, Director of hospital case management for seamless coordination of patient care services and maximize positive outcomes for the member and organization
- Serve as an approachable leader who consistently addresses concerns raised by both staff and families regarding patient care issues or operational challenges within the department effectively resolving and escalating them promptly whenever possible.
- Monitor individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures and is in compliance with medical policy and medical necessity guidelines
- Assist and complete IRR audits of MDCP/PDN staff to monitor compliance with performance standards
- Maintain appropriate team/staff assignments and caseloads based on volume, acuity, and geographical location
- Participates in health plan committees as appropriate and on request; participate in health plan's performance improvement activities
- Team SME for health plan initiates and programs, roll out of new member record systems and authorization management system-SDOH, Epic, PDN, MDCP, LTSS authorizations and PA requirements
- Knowledgeable in Medicaid criteria/guidelines- UMCCM, STAR Kids Contract, UMCM, TMPPM, TAC, STAR Kids Handbook, COB,URAC
- Participate in hiring process, provide on-going coaching, develop and maintain desk reference guides on work procedures and act as resource to staff
- Collaborate with physicians and appropriate departments on complex case and coverage determination processes
- Lead and directly manage case conference discussions with medical directors and staff to determine medical necessity for Private Duty Nursing PA request
- Schedule, organize and assist in P2P process for pending MN denial determinations for MDCP recipients
- Assist, attend and perform appeals, denials and state fair hearings as needed
- Conduct and assist in team meetings and staff 1:1 for regular updates, communications and team performance updates
STAR Kids Lead Medically Complex Service Coordinator I RN
Driscoll Health Plan
4 2019 - 11.2021
- Assess, plan, implement, coordinate, monitor and evaluate options and services required to meet the member’s health and human service’s needs
- Educated clients about their rights and responsibilities under the Medicaid program, empowering them to make informed decisions about their care options.
- Navigated challenging cases with exceptional attention to detail while adhering strictly to legal requirements.
- Streamlined service delivery for improved efficiency in managing client caseloads.
- Developed comprehensive care plans, ensuring appropriate allocation of resources for clients'' needs.
- Implemented time-saving strategies that resulted in increased productivity while maintaining a high level of service quality.
- Advocated on behalf of clients to secure needed services and overcome barriers to access.
- Collaborated with healthcare providers to enhance the quality of care for Medicaid recipients.
- Maintained accurate documentation and records management, ensuring compliance with state regulations and guidelines.
- Provided ongoing case management support, addressing any concerns or changes in clients'' situations promptly.
- Established and maintained relationships with key stakeholders.
- Coordinated individual referrals to obtain community services, advocate for client needs and resolve roadblocks.
STAR Kids Health Home Service Coordinator I RN
Driscoll Health Plan
11.2017 - 03.2019
- Dual role carrying caseload up to 200 members in addition to 3 days/week embedded in DHP's largest health home
- Embedded in health home assisting practice with coordination, integration, collaboration of necessary services and supports for STAR Kids members
- Identify and assist PCP in referral to Resource Coordinator for patients within health home exhibiting qualifications for STAR Kids Medicaid vs STAR
- Participate, facilitate and collaborate in timely completion of PA activities and LTSS services.
- Act as a liaison between Health Home PCP clinic and DHP for collaboration and program initiatives for improvement of access to care and member outcomes
STAR Kids General Service Coordinator I RN
Driscoll Health Plan
06.2016 - 10.2017
- Knowledgeable and assess, plan, implement, coordinate, monitor and evaluate options and services required to meet the member’s health and human service’s needs
- Focus on person-centered care planning and assess all members’ services and support needs
- Educate and help provide health-related information to the member and their support team
- Assure timely community-based LTSS to prevent, delay, or reduce the progression of chronic conditions and the need for institutionalization and to maintain the member safely in the community.
- Provide holistic evaluation of members’ dynamics, needs and preferences and connect them to covered and non-covered services to meet those identified needs.
- Facilitate clinically appropriate and fiscally responsible patient care through communication with the physicians involved in the member’s care, family, caregiver, and all other members of the health care team.
- Collaborate in a team effort to create and revise workflows, policies and SOPs.
- Facilitate and coordinate whole person care within a multi-practice health home to provide efficient and comprehensive health care
Registered Nurse – Pediatric PDN
Epic Health Services
04.2014 - 10.2016
- Provide direct 1:! private duty nursing care in private home setting of highly acuity patients dependent on tracheostomy, ventilator and gastrostomy tube
- Administer medications, treatments, feeds, dressings and other nursing services, according to physician's instructions, plan of care, and condition of patient.
- Observe, evaluate and record symptoms.
- Apply independent emergency measures to counteract adverse developments and notify supervisor/physician of patient's condition.
Registered Nurse – Pediatric PDN
National Nursing And Rehab
08.2014 - 06.2016
- Provided direct 1:1 nursing care to high acuity patient dependent on tracheostomy, ventilator and gastrostomy
- Render pediatric private duty nursing care in CCISD school setting; high school and elementary as well as AE classrooms
- Accompany patient on CCISD school transportation to and from school and provided direct nursing care
- Consistently applied and utilize the nursing process, critical thinking skills, scientific judgement, technical skills and leadership to independently deliver safe nursing care to pediatric patients
- Demonstrate team work, adaptability, and promote a positive image of nursing with students, teachers, principals, coaches and ARD team members
Registered Nurse – Pediatric PDN
Angels Of Care Pediatrics
06.2013 - 04.2014
- Provide nursing services, treatments and diagnostic procedures requiring specialized skills and assuming full responsibility for each pediatric patient
- Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
- Improved patient outcomes by implementing evidence-based nursing interventions and individualized care plans.
- Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
- Implement and document the plan of care to ensure quality and continuity of care for pediatric patient
- Coordinate services for patients as needed to other agencies and health care providers
- Provide effective communication to family, team members, and other health care professionals
- Accompany patient to physician appointments
Education
Bachelors of Science in Nursing -
Texas Woman’s University
Skills
AHA/BLS
RUG certification
Self-reflection
Interdisciplinary Collaboration
Compassionate Care
Staff Development
Information Systems Development
Operational Records Maintenance
Employee Supervision
Epic Systems
Employee Training
Critical Thinking
Decision-Making
Process Implementation
Budget Planning
Utilization Management
Multitasking
Patient education and counseling
Effective Communication
Adaptability and Flexibility
Regulatory Requirements
Problem-solving aptitude
Task Prioritization
Attention to Detail
Certification
835664, 10/2024
Timeline
Population Health RN Supervisor
Driscoll Health Plan
12.2021 - Current
STAR Kids Health Home Service Coordinator I RN
Driscoll Health Plan
11.2017 - 03.2019
STAR Kids General Service Coordinator I RN
Driscoll Health Plan
06.2016 - 10.2017
Registered Nurse – Pediatric PDN
National Nursing And Rehab
08.2014 - 06.2016
Registered Nurse – Pediatric PDN
Epic Health Services
04.2014 - 10.2016
Registered Nurse – Pediatric PDN
Angels Of Care Pediatrics
06.2013 - 04.2014
STAR Kids Lead Medically Complex Service Coordinator I RN
Driscoll Health Plan
4 2019 - 11.2021
Bachelors of Science in Nursing -
Texas Woman’s University