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
Fountain Valley, CA
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
Huntington Beach, CA
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
Long Beach, CA
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