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Home Health Case Manager

Mission, Texas, United States
July 05, 2018

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**** **** **., *******, ** **572 l 956-***-**** l

Professional Highlights

** ***** ********** ** ** RN

4+ Years Director of Nursing

Teambuilding & Supervision

Patient Stress Reduction

Maintain professional relations


Bilingual – English/Spanish

10+ Years Case Manager in Home Health

Microsoft Word and Excel

Communication – Oral/Written

Accurate, detail-oriented, productive

Medical Coding ICD-9 and CPT

RUGS Certified

In Depth Medical Terminology

Telemetry Performance-Procedures

Patient Monitoring and Education

Attention to Detail

CPR Certified

Professional Experience

Driscoll Children’s Health Plan

McAllen, TX


The RN will focus on person-centered care planning and assess all member’s services and support needs.

Assure timely community-based Long Term Services and Supports (LTSS) to prevent, delay, or reduce the progression of chronic conditions and need for institutionalization and maintain members safely in the community.

Service coordination is a collaborative practice that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member’s health and human service’s needs.

Advocate and manage resources to promote quality and cost-effective interventions and outcomes.

Facilitate clinically appropriate and fiscally responsible patient care through communication with the physicians involved in the members care, family, care giver, and all other members of the health care team.

The service coordination process is holistic in its coverage of the member’s situation and addresses medical, physical, behavioral, emotional, financial, psychosocial, and other needs, as well as that as the support system.

Work with Health Homes and high volume primary care providers to assist with coordination of STAR Kids member’s.

Assess for PDN, PCS and Therpy needs of member.

Produce Authorizations as needed

Works with Waiver programs CLASS, MDCP, YES…etc.

Superior Health Plan

McAllen, TX


Assess, plan, implement, coordinate, monitor, and evaluate the services required to meet the member’s health needs with a high attention to details which may impact quality of life.

Facilitate relocation and ensure the member has appropriate support of family, care givers, and all other members of the health care team to support a smooth transition.

Assist individual enrolled in various waiver programs and explain those programs appropriately.

Knowledgeable with the State of Texas’ managed care and managed Medicaid process.

Also Knowledgeable with Medicare process; MNLOC/RUG certified.

Data entry into TruCare software program used to document assessments.

Frequent use of Microsoft Excel spreadsheets and outlook for emails and appointment scheduling.

AxisPoint Health (Formerly McKesson Health Solutions) McAllen, TX

CBPN RN Nov. 2011 – Oct. 2015

Provide a complete continuum of quality care through close communication with members via telephone.

Support members with condition education, medication reviews and connections to resources as needed.

Conduct initial assessments with client and families and/or guardian.

Complete many administrative tasks, including intake, data entry, and submission of documentation.

Establish and maintain therapeutic relationships with clients and familiies.

Serve as advocate for children and adolescents with special needs acting as liaison between patient/family and center.

Provide crisis intervention for clients and families.

Ensure clients participate or are offered all components or services offered through the program.

Maintained a calm, caring and positive environment throughout the shift time.

Handles the queries and problems of the patients and families.

Hidalgo County Health and Human Services


Registered Nurse Feb. 2011 – Sept. 2011

Primary care of pregnant women seeking prenatal services including pap smears, birth control, injections.

Counseling and education for birth control, STD education, self examination and overall women’s health

STD clinic involved treatments, education, medicatons and testing.

Prenatal counseling, education and monitoring. Tuberculosis treatment and medication distribution.

Millenium Comfort Home Health

McAllen, TX

Director of Nurses / Assistant Administrator Oct. 2010 – Dec. 2010

Manage home health operations on a day to day basis and implement policies and procedures.

Quality control of nursing staff to ensure timeliness, quality patient care, and proper documentation.

Constant communication with Doctors regarding any changes to patient conditions or deterioration.

Coordinated schedules and supervised LVNs and Home Health Aides.

Maintained home health establishment policies and procedures manual.

South Texas Healthcare (Dallas Satellite Office)

Dallas, TX

Assistant Director of Nurses Oct. 2010 – Dec. 2010

Establish procedures for operations, service quality, reliability and safety.

Maintained personnel records, administrative records, policy and procedures manual.

Coordination of patient care, public information, materials and activities.

Skilled nursing visits requiring strong nursing skills by an RN.

Renaissance Nursing Services, LLC

McAllen, TX

Director of Nurses – Administrator May 2009 – Feb. 2010

Direct oversight of all clinical services including nursing, staff education, respiratory therapy, rehabilitation, medical records, ancillary staff and procedures for operations, service quality, reliability and safety.

Provided structure over staffing, and management to successfully improve productivity, communications, and accuracy of operations without incurring additional expenses.

Streamlined efficiency and productivity of services and time management with staff.

Care Plus Home Health Care

Weslaco, TX

Director of Nurses – Administrator May 2009 – Feb. 2010

Was able to successfully prepare and pass CHAP Certification which required demanding attention to detail, policy review, implementation and compliance with federal guidelines.

Prepared facility/staff for all internal quality standard surveys.

Upheld 100% compliance with privileging process within facility.

Quality control, policies and procedures, and supervison of nursing staff.


Priority Care, Alton, TX – Director of Nurses Nov. 2007 - Dec. 2008

IPH Home Health Services, McAllen, TX – RN/Case Manager March 2006 – July 2007

Angelitos Home Healthcare Services, Rio Grande City, TX – Director of Nurses Dec. 2005 - March 2006

IPH Home Health Services, McAllen, TX – RN/Case Manager Dec. 2003 – Jan. 2005

Rio Grande Regtional Hospital, McAllen, TX – Staff RN, Labor and Delivery Sept. 2003 – Jan. 2004

Valley Regional Medical Center, Brownsville, TX – Staff RN, Labor and Delivery Dec. 2002 - Jan. 2004

Healthcare Unlimited, INC., McAllen, TX – RN Field Nurse Aug. 1999 - Jan. 2002

Edinburg Regional Medical Center, Edinburg, TX – RN Field Nurse June 1998 - Aug. 1999


University of Texas Pan American, Edinburg, TX

Associate Degree in Nursing May 1990


Sonia Martinez, RN


Mary Cantu, RN


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