Ending Homelessness
Vicki Ballard
BSN RN
Portland,TX
Summary
Highly dedicated and resourceful registered nurse with 43 years of experience in acute care, inpatient psychiatry, home health care, cardiology, and utilization review. Recognized for outstanding reputation and extensive network of contacts in Texas healthcare facilities. Skilled in managing complex patients and maintaining a strong focus on member advocacy.
Overview
2025
2025
years of professional experience
1
1
Certification
Work History
Utilization Management Nurse 2 (Post-Acute)
Humana, Inc.
Corpus Christi, TX
10.2018 - 04.2024
- Assessed medical necessity to determine appropriate post-acute care levels
- Coordinated post-hospital care plans
Manager TOC Team
01.2014 - 09.2018
- Developed TOC Nurse role with comprehensive processes
- Trained incoming front line leadership team
- Onboarding new team members during mass recruitment periods
- Established direct communication channels with G&A
- Streamlined communication across departments
- Selected to participate in the Culture Integration initiative in 2016 amid possible purchase by Aetna
Clinical Advisor-RN
11.1995 - 01.2014
- Secured consistent medical services for patients in diverse healthcare settings
- Guided newly hired nurses through onboarding procedures
- Managed workload efficiently in dynamic settings
- Engages effectively with diverse groups using extensive clinical knowledge
- Identified high-risk members for appropriate referral
- Coordinates efforts to resolve complex issues, ensuring a member-centric approach
- Expertise in CCA, CAS, CCP2, and CGX software
Clinical Team Leader
Care One
Corpus Christi, TX
10.1994 - 04.1995
- Management of field/office staff & agency
- Management of Medicare, Humana Medicare, Commercial & PPO members & private pay clients receiving home health care
- Responsible for obtaining authorization from payor source
- Active participant in internal & external (Humana) case conferences
Clinical Coordinator
04.1994 - 10.1994
- Ensured medical necessity of services by initiating and completing assessment process within required time frames of referral, time/cost-effective home care
- Assessed need for continued services on current patients and provided other options for care when indicated
Nurse Manager
Health Source America
Corpus Christi, TX
05.1994 - 08.1994
- In-hospital evaluations for home health
- Obtain authorization of visits from private insurance
- Maintain communication to physicians and private insurance case managers
- Maintain staff/patient schedule
Field RN
11.1993 - 05.1994
- Admissions, IV therapy, wound care, & peritoneal dialysis
- Assignment included ventilator dependent home patient.
Patient Care Coordinator
Humana, Inc.
Corpus Christi, TX
11.1991 - 11.1993
- Outpatient referrals (including specialist referrals, DME including prosthetics and specialty items, diagnostic testing studies, procedures) from PCP offices for Medicare & Commercial HMO members
- Onsite & telephonic reviews for acute inpatient admissions, determined medical necessity for inpatient admissions, ensured time/cost-effective appropriate care, assessed & coordinated discharge needs of members in acute hospitals, SNF, inpatient rehab facilities, precertification, referrals, psychosocial evaluations, member education regarding Humana Plan, arrange alternative levels of care including home health care, outpatient rehab, snf, acute rehab, custodial care, and hospice
PSYCHIATRIC "POOL" RN Staff RN
Southside Community Hospital
Corpus Christi
04.1991 - 11.1991
Vacation Relief Industrial Nurse
Manpower Temporary Services
Ingleside, TX
04.1991 - 11.1991
ICU "Pool" RN
Humana Hospital (DRMC)
Corpus Christi, TX
04.1990 - 11.1991
Staff/Charge Nurse-RN Acute Coronary Care Unit II
Spohn Shoreline Hospital
Corpus Christi, TX
02.1989 - 03.1990
Office Nurse for Dr. William David Jack, II
Cardiology Associates
Corpus Christi, TX
10.1985 - 02.1989
Staff/Charge RN Acute Coronary Care Unit I
Spohn Shoreline Hospital
Corpus Christi, TX
07.1983 - 10.1985
Staff/Charge RN 9B
04.1982 - 05.1983
Charge RN 9&10 Tower
St. Luke's Hospital
Houston, TX
05.1981 - 04.1982
Nurse Assistant
UTMB Child Health Center
Galveston, TX
03.1980 - 05.1981
Stretch assignments
- Point of contact for Front Line Leader
- Vacation coverage for delegated provider manager for any issues
- Assigned to a work group with the task of improving the daily census for UM nurses
Education
Bachelor of Science - Nursing
University of Texas School of Nursing at Galveston
Skills
- Humana Managed Care Expertise
- MCG (Milliman Care Guidelines)
- InterQual
- CMS Guidelines
- Windows OS Proficiency
- Microsoft Office Proficiency
- Acute and Long-Term Care Management Expertise
- Patient Discharge Coordination
- Precertification Management
- Case Management
- Proficient in EMR Systems
- Home Health Care Expertise
- Auditing Expertise in Verint
Certification
Registered Nurse (Texas Compact License)
Affiliations
- Prior member of Texas Riviera Area of Case Manager's Association and past board member.
- Engaged with Humana Open Mentoring for Best Practices for Public Speaking & Presentations, Connecting People to Mentors, Designing Better Processes and Medicare Product and Services Care Management.
- Member of Humana Office of the Nursing Leadership Collaborative (ONLC) and Leadership Symposium since 2017.
- Active member of Homeless Issues Partnership, Inc.
- Passionate advocate for the homeless & less fortunate in the Corpus Christi area. Vast knowledge of community resources for the Corpus Christi, TX area including food pantries, meals, drug rehab facilities, shelters, clothing, medical equipment, health & dental services, mental health services & other providers.
- Key contact for local community, churches and other organizations resources.
References
References available upon request.
Work Preference
Work Type
Full TimePart TimeContract WorkWork Location
RemoteImportant To Me
Company CultureWork Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Interests
Volunteerism
Timeline
Utilization Management Nurse 2 (Post-Acute)
Humana, Inc.
10.2018 - 04.2024
Manager TOC Team
01.2014 - 09.2018
Clinical Advisor-RN
11.1995 - 01.2014
Clinical Team Leader
Care One
10.1994 - 04.1995
Nurse Manager
Health Source America
05.1994 - 08.1994
Clinical Coordinator
04.1994 - 10.1994
Field RN
11.1993 - 05.1994
Patient Care Coordinator
Humana, Inc.
11.1991 - 11.1993
PSYCHIATRIC "POOL" RN Staff RN
Southside Community Hospital
04.1991 - 11.1991
Vacation Relief Industrial Nurse
Manpower Temporary Services
04.1991 - 11.1991
ICU "Pool" RN
Humana Hospital (DRMC)
04.1990 - 11.1991
Staff/Charge Nurse-RN Acute Coronary Care Unit II
Spohn Shoreline Hospital
02.1989 - 03.1990
Office Nurse for Dr. William David Jack, II
Cardiology Associates
10.1985 - 02.1989
Staff/Charge RN Acute Coronary Care Unit I
Spohn Shoreline Hospital
07.1983 - 10.1985
Staff/Charge RN 9B
04.1982 - 05.1983
Charge RN 9&10 Tower
St. Luke's Hospital
05.1981 - 04.1982
Nurse Assistant
UTMB Child Health Center
03.1980 - 05.1981
Stretch assignments
Bachelor of Science - Nursing
University of Texas School of Nursing at Galveston
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