Experience

Blue Cross Blue Shield of Texas

• United States
• Insurance
• 300 - 400 Employee

• Utilization Management Review Nurse

  • Dec 2018 - Present

  Richardson, Texas Completing Authorizations/Determination requests for acute inpatient stay/surgery,OP therapies/SN, DME, outpatient. Completing MCG certification

• Holidtic Healthcare Nurse Case Manager

  • Jun 2017 - Dec 2018

  Dallas, Texas Case managing members and their families.



Evolution Healthcare (Envision)

• Nurse Navigator/ Remote Telemonitoring Nurse ( LVN)

  • Mar 2015 - May 2017

  Dallas, TX LVN in the capacity of a nurse navigator in a telephonic healthcare setting. Duties including remote telemonitoring with the Vivify Remote Telemonitoring system via tablet video calls and telephone for multiple clients with differing SLA’s and patient needs/education, Medicare Chronic Care Management monthly calls, inbound triage calls, patient education via coaching calls. Multi- state licensure (non- compact- FL, GA, AL, CA, NV, PA, NY, OH, IN, NY, OK). EMD certification. Business model… Show more LVN in the capacity of a nurse navigator in a telephonic healthcare setting. Duties including remote telemonitoring with the Vivify Remote Telemonitoring system via tablet video calls and telephone for multiple clients with differing SLA’s and patient needs/education, Medicare Chronic Care Management monthly calls, inbound triage calls, patient education via coaching calls. Multi- state licensure (non- compact- FL, GA, AL, CA, NV, PA, NY, OH, IN, NY, OK). EMD certification. Business model includes home visiting providers, logistics scheduling team, nurse navigator teams with inbound and outbound patient interaction and pharmacy. Utilized Cerner, Logis. DeVero Show less



Parallon

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Revenue Integrity Analyst

  • Sep 2013 - Mar 2015

  Irving, TX LVN in the capacity of Revenue Integrity Analyst. Analyzing audits and edits that are effected by CMS regulations for Medicare, Medicaid and commercial insurances. Chart audits, reviewing coding and improving the patient/healthcare business revenue while ensuring integrity and compliance. Utilized multiple software programs



Texas Premiere HHC

• LVN Field Nurse

  • Mar 2011 - Nov 2013

  Garland, TX LVN in the capacity of field nurse, providing direct patient care in patient’s home with a diverse patient population including a large group of Cambodian patients requiring use of translator, learning Cambodian phrases, special attention to cultural, religious and educational needs. Coordination with RN care manager, patient’s physician.