Jennifer Montanez
Chino Hills
Summary
Professional nurse with extensive experience in utilization review. Skilled in analyzing patient care and ensuring compliance with healthcare regulations. Strong focus on team collaboration and achieving optimal patient outcomes. Adaptable and reliable, excelling in dynamic environments requiring precise decision-making and effective communication.
Overview
6
6
years of professional experience
1
1
Certification
Work History
RN Case Manager/Utilization Review Nurse
Memorialcare Medical Foundation
Fountain Valley, CA
12.2024 - Current
- Evaluated healthcare service utilization patterns, addressing obstacles to care and maintaining strict compliance with established hospital and payer standards.
- Analyzed patient charts and organized documentation to ensure effective clinical decisions and efficient insurance processes.
- Coordinated interactions between patients, families, and healthcare providers to enhance comprehension of care strategies.
- Reviewed medical records to ensure compliance with regulatory requirements and best practices in case management.
- Mentored junior staff on case management principles, promoting professional development within the team.
- Collaborated with physicians and other healthcare providers to ensure appropriate resource utilization for complex cases.
- Streamlined care coordination processes to reduce hospital readmissions and emergency department visits.
- Led process improvement initiatives aimed at enhancing efficiency in case management operations while maintaining excellent clinical outcomes.
Inpatient Case Manager
Long Beach Memorial
Long Beach, CA
05.2023 - 12.2024
- Coordinated interdisciplinary care plans to optimize patient outcomes and resource utilization.
- Assessed patients' medical histories and needs to develop effective treatment strategies.
- Collaborated with healthcare teams to ensure seamless patient transitions between care settings.
- Implemented quality improvement initiatives that enhanced patient satisfaction scores significantly.
- Led case review meetings to address complex cases and improve care coordination processes.
- Utilized evidence-based best practices to guide clinical decision-making and optimize patient outcomes.
- Reduced hospital readmissions by identifying high-risk patients and implementing targeted interventions.
Discharge Planner
Saddleback Medical Center
Laguna Hills, CA
12.2019 - 05.2023
- Coordinated patient discharge planning processes to ensure seamless transitions to post-acute care.
- Collaborated with multidisciplinary teams to develop individualized discharge plans tailored to patient needs.
- Implemented effective communication strategies with patients and families regarding discharge instructions and follow-up care.
- Streamlined documentation procedures within electronic health record systems to enhance accuracy and accessibility.
- Coordinated timely discharges by effectively communicating with physicians, nurses, social workers, and other relevant stakeholders.
- Solved problems related to abrupt changes in discharge, coordinated updates and communicated discharge plans.
- Established strong relationships with community agencies, enabling effective coordination of post-discharge support services.
Education
Bachelor of Science - Sociology
California State University, Los Angeles
Los Angeles, CA06-2017
Associate of Science - Nursing
Santa Ana College
Santa Ana, California, CA07-2023
Bachelor of Science - Nursing
California State University, Fullerton
Fullerton, CA12-2025
Skills
- Care coordination
- Discharge planning
- Patient assessments
- Resource utilization
- Referral coordination
- Quality improvement
- Healthcare regulations
- Utilization review
- Excellent communication and organizational skills
- Adapts to both independent and team environments
- Effective prioritization skills
- Reliable and punctual
Accomplishments
Decreased length of stay by 1 point with MCMG/GNP-managed care patients.
Coached other members in the department on the principles of lean leadership.
Certification
- Registered Nurse, CA License #95387837
- BLS/ACLS
- Lean Leadership
Languages
Spanish
Native or Bilingual
Timeline
RN Case Manager/Utilization Review Nurse
Memorialcare Medical Foundation
12.2024 - Current
Inpatient Case Manager
Long Beach Memorial
05.2023 - 12.2024
Discharge Planner
Saddleback Medical Center
12.2019 - 05.2023
Bachelor of Science - Sociology
California State University, Los Angeles
Associate of Science - Nursing
Santa Ana College
Bachelor of Science - Nursing
California State University, Fullerton