Nazaret Hernandez
Jurupa Valley
Summary
Dedicated individual with a passion for healthcare, seeking a position as a Licensed Vocational Nurse in an advanced healthcare unit. Eager to contribute to the growth of the company while expanding skills and knowledge. Committed to providing high-quality care and ensuring the well-being of patients. Excited to be part of a dynamic team that values professionalism and excellence in patient care.
Overview
3
3
years of professional experience
Work History
Licensed Vocational Nurse Case Manager
Memorial Care Select Health Plan
12.2022 - Current
- Coordinated referrals to specialists, facilitating efficient access to necessary services for optimal patient care.
- Inputs all information in referral system and ensures that all information is accurate.
- Process referral authorization from providers in a timely manner, by utilizing established protocols.
- Relays decision status of authorizations and pre-certs accurately to callers.
- Interprets and applies appropriate, UM resources and information available on the Intranet, and in referral system to include but not limited to EOC’s.
- Faxes back to requested provider information needed if not received.
- Communicates with the Enrollment Dept. when incorrect PCP member assignment
- Case Management
- Gathers and assess relevant documentation to compare with MCG/UM Criteria.
- Communicates with Utilization Physician Reviewer for follow-up and resolution of authorization referrals.
- Verifies member insurance eligibility and benefits.
- Interacts effectively with providers, physician reviewers, and other departments using strong verbal and written communication skills on an on-going basis
- Applies UM criteria appropriately to authorization requests
- Apply Timeliness Standards to processing of referrals (ICE Timelines Grids)
- Review and update authorizations as needed
- Requests medical records or other information as needed to justify referrals
- Collaborate with healthcare providers to coordinate and share treatment plans.
- Independently manage care coordination requests, assess member needs, and facilitate appropriate interventions and follow-ups.
- Coordination and follow-up for patient care quality metrics.
Licensed Vocational Nurse
AltaMed
03.2022 - 12.2023
- Managed patient care through closely monitoring respiration, blood pressure, and blood glucose levels.
- Prevented medication errors by meticulously reviewing physician orders and administering medications as prescribed.
- Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.
- Cared for wounds, provided treatments, and assisted with procedures.
- Facilitated effective communication between patients, families, and healthcare providers to ensure continuity of care during transitions between facilities or levels of care.
Licensed Vocational School Nurse
RO HEALTH
12.2021 - 01.2022
- Provided compassionate nursing care to students with acute and chronic medical conditions, ensuring their safety and wellbeing.
- Prioritized student mental health by offering counseling support services in collaboration with qualified professionals when needed.
- Collaborated with teachers and staff to accommodate students'' special needs and promote a healthy learning environment.
- Served as a knowledgeable resource for parents seeking guidance on their child''s immunization status or other pertinent health information.
- Streamlined medication administration processes resulting in reduced errors.
- Developed emergency response protocols that effectively managed critical situations involving student injuries or illnesses.
Education
Vocational-Technical Education
Smith Chason School of Nursing
Los Angeles 09-2021
Associate of Arts - General Education
Cerritos College
Norwalk, CaMedical Assisting - undefined
Southeast Rop
Norwalk, CASkills
- Bi-lingual Spanish
- Highly dependable
- Excellent communication skills
- Expert ICD-10 coding
- Cpr-Certified
- Codes and standards compliance
- Data Entry
- Documentation accuracy
- EMR / EHR
Languages
- Fluent in Spanish
Timeline
Licensed Vocational Nurse Case Manager
Memorial Care Select Health Plan
12.2022 - Current
Licensed Vocational Nurse
AltaMed
03.2022 - 12.2023
Licensed Vocational School Nurse
RO HEALTH
12.2021 - 01.2022
Associate of Arts - General Education
Cerritos College
Medical Assisting - undefined
Southeast Rop
Vocational-Technical Education
Smith Chason School of Nursing
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