Case Manager Medical Director
Resume:
Bertie Aleman
San Antonio Tx. 78238
ad15y4@r.postjobfree.com
EXPERIENCE
Molina HealthCare- Letter Team
June 2015 - PRESENT
RU department.
Denial and Approval Letter Team for Marketplace,Medicare and Medicaid
Long Term Care
Humana, San Antonio-Authorization nurse
June 2010 - June 2015
Process provider Auth requests for Private insurance and Medicare
Including processing denials with medical director instruction
Community First Health Plan— Case Manager
July 2005 - June 2010
Process referrals, responsible for special needs and diabetic
Members
South Texas Blood and Tissue Center- Apheresis Nurse
2000-2005
Processed possible platelet donors. Venipuncture.
Care of donors before, during and after automated donation.
EDUCATION
SAISD Vocation School of Nursing, San Antonio, Tx.
LVN Licence
School Name, Golden West College CA
Nursing
Skills:
Medicare, Star, Star-Plus, Medicaid, Marketplace
Microsoft. Word,Excel. CCA
Milliman,Interqual
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