Irma Rangel

*** ****** #****

San Antonio, Texas 78232

Cell# 210-***-****

Objective: To obtain a RN position in the healthcare field.

Skills: Highly skilled career professional with over 30+ years practical experience in the healthcare

industry successfully performing a variety of managed care roles.

Supervisor Community Connector Molina Healthcare Aug 2015 Present

Manages and evaluate team members in the performance of various activities. Monitor staff productivity

and performance indicators. Conduct regular monthly staff meetings. Complete quality audit review for

all staff. Assist team in improving skill, creativity and problem solving. Provide coaching, counseling and

employee development. Provide daily assignments of members needing services to Community

Connector within their SDA. Approve time cards and monthly mileage /travel reports. Work with

Manager to ensure staffing and service levels, and maintain customer satisfaction. Travel to each SDA

twice a year for ride along with Community Connector per State guidelines.

Senior Case Manager Tenet Health System Baptist Medical and Northeast Baptist 2012 2015

Responsible for the adult and geriatric floors by managing psychiatric and chemical dependency.

Responsible for providing review of medical records through telephonic or written review to appropriate

vendor. Used appropriate screening criteria, knowledge and clinical judgment. Followed guidelines and

referred cases to Medical Advisors when appropriate. Ensured patients access to quality behavioral

healthcare in a cost effective setting according to contract.

RN Case Manager Amerigroup 2012-2012

Responsible for performing care management within the scope of licensure for members with complex

and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating

care plans designed to optimize member health care across the care continuum. Performed duties

telephonically with members. Conducted assessments to identify individual needs and a specific care

management plan to address objectives and goals as identified during assessment. Interfaced with

Medical Directors on development of care management treatment plans. Assisted in problem solving

with providers, claims or service issues.

RN Case Manager Community First 2010-2011

Responsible for performing care management within the scope of licensure for members with complex

and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating

care plans designed to optimize member health care across the care continuum. Performed duties

telephonically with members. Conducted assessments to identify individual needs and a specific care

management plan to address objectives and goals as identified during assessment. Interfaced with

Medical Directors on development of care management treatment plans. Assisted in problem solving

with providers, claims or service issues.

RN UM CONSULTANT/Case Manager Aetna Insurance 2006-2010

Responsible for performing care management within the scope of licensure for members with complex

and chronic care needs by assessing, developing, implementing, coordination, monitoring and evaluating

care plans designed to optimize member health care across the care continuum. Performed duties

telephonically with members. Conducted assessments to identify individual needs and a specific care

management plan to address objectives and goals as identified during assessment. Interfaced with

Medical Directors on development of care management treatment plans. Assisted in problem solving

with providers, claims or service issues.

LVN/RN Case Manager Christus Santa Rosa Hospital 2000-2005

Responsible for the adult floors in the medical surgical area. Responsible for providing review of medical

records through telephonic or written review to appropriate vendor. Used appropriate screening criteria,

knowledge and clinical judgment. Followed guidelines and referred cases to Medical Advisors when

appropriate. Ensured patients access to quality behavioral healthcare in a cost effective setting according

to contract.

St. Philips College 2004 Associates Nursing

Texas Womans University BS Community Health

1989 LVN St. Philips College- Fort Sam Houston Army Program Active Duty

1987 91A Fort Sam Houston Program Active Duty

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