Case Managers Utilization Review

WANDA J. ECHEVARRIA ORTIZ

Tel: 787-***-****

Urb. Santa María, C/Santa Lucia K-12, Toa Baja, PR

Email: ****************@*****.***

OBJETIVE

Looking for a job in which I can execute my skills and knowledge, applying them considering human values and exercising them with a deal of empathy and respect. Provide an excellent service for the benefit of the company and the people in my charge. PROFESSIONAL EXPERIENCES

2020 - present NUC UNIVERSITY - CCU Bayamón, PR

Professor of Bachelor of Nursing Science

• Teach and train Bachelor students in Nursing Sciences.

• Design educational plans, exams, and assessments.

• Evaluate students by meeting objectives and according to the syllabus and program. 2022 - present HOSPITAL DOCTORS CENTER CAROLINA Carolina, PR Utilization Review Supervisor

• Supervises Case Managers.

• Develops operational processes ensuring that the provision of services is carried out quickly, effectively and with quality.

• Analyzes clinical records with deficiencies in the Utilization processes identified by the Case Managers to establish if the treatment offered is indicated.

• Addresses special situations that affect the service that could not be resolved by the Case Managers.

• Identifies problems related to administrative and technical Utilization processes that may affect the services provided and establishes corrective actions in coordination with the Utilization Manager.

• Interacts with the Medical Plan Auditors and evaluates the findings indicated in the concurrent review and, if necessary, in the retrospective review. 2015- 2022 SAN JORGE CHILDREN & WOMEN’S HOSPITAL San Juan, PR Medical Review and Utilization Coordinator

• Case management

• Review and audit of records of admitted patients

• Monthly statistics

• Discussion of cases with external auditors.

2011 - 2014 SAN JORGE CHILDREN & WOMEN’S HOSPITAL San Juan, PR Generalist Nurse (General Pediatrics)

• Take sample of blood and fluids.

• Measurement of vital signs.

• Administration of oral and intravenous medications and blood products or derivatives.

• Documentation of the treatment and management of the patient on file. EDUCATION

2019 – 2024 NOVA SOUTHEASTERN UNIVERSITY San Juan, PR Doctor in Education with Instructional Technology and Distance Education 2016 – 2017 NATIONAL UNIVERSITY COLLEGE

Master of Nursing Science with a Specialty in Education Bayamón, PR 2012 - 2014 CEM – CENTRO DE ESTUDIOS MULTIDISCIPLINARIOS Bachelor's Degree in Nursing Sciences Bayamón, PR

CREDENTIALS

Permanent Nurse License, Specialist in Nursing Sciences with functional role in Education, Master's Degree in Nursing Sciences with Specialization in Education. CPR, HIPPA Law, OSHA, Preventive Intervention Techniques and Nurse College Membership. SKILLS AND ABILITIES

Minimum supervision required, responsible and honest. Dynamics, leadership, teamwork, and good communication. Extensive knowledge in computers: Word, Excel, Power Point, Publisher, Canvas. English and Spanish language proficiency (oral and written). REFERENCE

Will be provided upon request.

Contact this candidate