Victoria Hernandez
Elevance Health
El Paso,TX
1
Language
15
years of professional experience
Searching for a position in nursing that will permit the utilization of acquired skills and further advance my career. Case Manager experienced in coordinating care for at risk individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others.
Work History
Case Manager
8 Years 8 Months- Evaluating and implementing care plans for members at risk of negative health outcomes related to substance use disorder to enhance overall member wellbeing
- Coordinating care effectively and efficiently to improve treatment outcomes while managing treatment costs
- Completing assessments to identify gaps in care and updated care plans.
- Working with different team members and health plans to achieve best possible outcome for members
- Participating in medical case conferences on a regular basis to address members needs and obtaining input on a specific situation and brainstorming
- Experience with helping managers on associates’ audits, mentoring of new employees, suggesting ways of handling issues or problems that may arise
- Assisting teams during associate shortages by quickly learning new duties to ensure continuous support and service delivery
LTSS Service coordinator
2 Years 10 Months- Star Kids and MMP Medicaid Program
- Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports
- Implemented care plan by facilitating authorizations/referrals within benefits structure.
- Establish short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs
- Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of members' needs, including physical health, behavioral health, social services and long term services and supports
- Established short and long term goals with members, caregivers, family, and healthcare providers; identified members suitable for alternative care levels or waiver programs
- Collaborated with Medical Directors, Physician Advisors, and Inter-Disciplinary Teams to develop care management treatment plans
Case Manager
2 Years 3 Months- Supervised nursing team managing case load of 70 to 120 patients, conducting assessments to ensure appropriate care.
- For re-certification, admission to home health services, resumption of care after a hospitalization,
- LVN and CNA supervisory visits, Administered intravenous therapy to patients
- Administration, Delivered comprehensive wound care for patient recovery, Managed foley catheter placements for patient comfort, Performed pessary care to support patient health
- Coordinated referrals to other disciplines and connected patients with community resources to address diverse needs.
Case Manager
1 Year 2 Months- Supervised in-office and field staff, performed evaluations to assess the need for Home Health Services for the local population, and provided appropriate services based on individual needs.
- As well as serving as a link for community resources available
- Managed quality assurance for clinical notes to ensure accurate documentation across all disciplines
- Coordinated and facilitated weekly case conference meetings to assess patients' conditions and identify necessary services
- Maintained up-to-date nursing licenses to ensure compliance with state regulations. ∙ R.N
- Texas BON Compact License.
Education
A.D Nursing - Nursing
Skills
Clinical leadership
Team mentorship
Care coordination
Complex case management
Interdisciplinary collaboration
Languages
Spanish
Native or Bilingual
Timeline
Case Manager
Elevance Health
03.2018 - CurrentRead More
LTSS Service coordinator
Elevance Health
03.2015 - 01.2018Read More
Case Manager
A.M. Healthcare
11.2012 - 02.2015Read More
Case Manager
Nurses Care Incorporated
09.2011 - 11.2012Read More
Anamarc College
A.D Nursing from Nursing
Read More