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Click here or scroll down to respond to this candidate Candidate's Name
Street Address Heimer #1003
San Antonio, Texas Street Address
Cell# PHONE NUMBER AVAILABLE
Objective: To obtain a RN position in the healthcare field.
Skills: Highly skilled career professional with over 30+ years practical experience in the healthcare
industry successfully performing a variety of managed care roles.
Supervisor Community Connector Molina Healthcare Aug 2015 Present
Manages and evaluate team members in the performance of various activities. Monitor staff productivity
and performance indicators. Conduct regular monthly staff meetings. Complete quality audit review for
all staff. Assist team in improving skill, creativity and problem solving. Provide coaching, counseling and
employee development. Provide daily assignments of members needing services to Community
Connector within their SDA. Approve time cards and monthly mileage /travel reports. Work with
Manager to ensure staffing and service levels, and maintain customer satisfaction. Travel to each SDA
twice a year for ride along with Community Connector per State guidelines.
Senior Case Manager Tenet Health System Baptist Medical and Northeast Baptist 2012 2015
Responsible for the adult and geriatric floors by managing psychiatric and chemical dependency.
Responsible for providing review of medical records through telephonic or written review to appropriate
vendor. Used appropriate screening criteria, knowledge and clinical judgment. Followed guidelines and
referred cases to Medical Advisors when appropriate. Ensured patients access to quality behavioral
healthcare in a cost effective setting according to contract.
RN Case Manager Amerigroup 2012-2012
Responsible for performing care management within the scope of licensure for members with complex
and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating
care plans designed to optimize member health care across the care continuum. Performed duties
telephonically with members. Conducted assessments to identify individual needs and a specific care
management plan to address objectives and goals as identified during assessment. Interfaced with
Medical Directors on development of care management treatment plans. Assisted in problem solving
with providers, claims or service issues.
RN Case Manager Community First 2010-2011
Responsible for performing care management within the scope of licensure for members with complex
and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating
care plans designed to optimize member health care across the care continuum. Performed duties
telephonically with members. Conducted assessments to identify individual needs and a specific care
management plan to address objectives and goals as identified during assessment. Interfaced with
Medical Directors on development of care management treatment plans. Assisted in problem solving
with providers, claims or service issues.
RN UM CONSULTANT/Case Manager Aetna Insurance 2006-2010
Responsible for performing care management within the scope of licensure for members with complex
and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating
care plans designed to optimize member health care across the care continuum. Performed duties
telephonically with members. Conducted assessments to identify individual needs and a specific care
management plan to address objectives and goals as identified during assessment. Interfaced with
Medical Directors on development of care management treatment plans. Assisted in problem solving
with providers, claims or service issues.
LVN/RN Case Manager Christus Santa Rosa Hospital 2000-2005
Responsible for the adult floors in the medical surgical area. Responsible for providing review of medical
records through telephonic or written review to appropriate vendor. Used appropriate screening criteria,
knowledge and clinical judgment. Followed guidelines and referred cases to Medical Advisors when
appropriate. Ensured patients access to quality behavioral healthcare in a cost effective setting according
to contract.
St. Philips College 2004 Associates Nursing
Texas Womans University BS Community Health
1989 LVN St. Philips College- Fort Sam Houston Army Program Active Duty
1987 91A Fort Sam Houston Program Active Duty
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