SERENA LOPEZ

***** ******** **** ** · 832-***-****

adudg4@r.postjobfree.com ·

To Find a rewarding career that offers potential growth, stability, and professionalism.

EXPERIENCE

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HUMAN RESOURCES REQRUITER/COORDINATOR, ST. JOSEPH MEDICAL CENTER

Work directly with and report to the human resources director regarding all HR endeavors

Support HR director in educating employees on and enforcing company policies

Maintain the company’s calendar and schedule any meetings the HR director requires

Assist in the full hiring process of employees, including recruitment, interviews, verifying work-history and references, and tracking of new possible candidates in HRIS

Help with new-hire procedures, including organizing employee orientation, creating new employee files, administering employee handbooks, and ensuring all necessary paperwork is properly filled out and submitted to appropriate persons

Organize, maintain and update employee HRIS information as needed

Track benefit plans, including health care, retirement, Workers Comp, etc.

Make sure all health and safety regulations are followed

Prepare materials and help organize employee performance reviews

Execute all employee termination procedures, including advising employees on their rights and any benefits they are entitled to

Present any new or additional training materials to employees

Help ensure payroll processes are correct

Foster positive employee relations and work to solve any employee issues that surface

Make sure all employee records are filed correctly and kept confidential

Abide by company-enforced HR processes and current employment laws and regulations

Under the leadership of the HR director, be a vital source of human resources information, answering any questions employees may have

1/2015 – 1/2018

BEHAVIORAL HEALTH UTILIZATION REVIEW MANAGER, st. joseph medical center

Completes Managers report daily and participates in corporate Managers Meeting.

Manges Admission and Assessment reports and admission eligibility with management staff.

Manages Continued Stay Criteria and Quality of Care. Responsible LOS report and Justification of LOS over 10 days

Manages and tracks all External Review and Reimbursement Activities.

Coordinates Appeals of Denied Claims, completes appeals request from start to finish, tracks all denials.

Completes pre-authorizations/concurrent reviews/internal UR reviews Consults with various members of the multidisciplinary treatment team concerning required information to complete concurrent reviews.

Managed and Scheduled peer to peer reviews and coordinates urgent/expedited appeals Staff’s individual cases with MDs as needed Follows all standard ARS Utilization Review Department policies and procedures.

Utilizes the UR Census Report on a daily basis Makes all initial calls within 24 hours and follow up calls every 24 hours.

Data entry, records management and assisting with the appeals process Completing detailed daily documentation works with Finance Department regarding client service authorizations.

Communicating frequently with the treatment team other duties as assigned

Facilitate team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary, this includes multidisciplinary meetings and Utilization Review/Case Management meetings. Provides input in such meetings regarding utilization management and discharge planning.

Responsible for evaluating and screening potential admissions to the facility when appropriate.

Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage.

Initiate ongoing communication with the resident and resident’s family to assess discharge needs.

Communicate with physicians to ascertain their plans for a timely discharge. • Document discharge planning as an ongoing review.

Knowledgeable of resident’s financial status, diagnosis and discharge needs. • Responsible for home care needs being met by the time of discharge, with a goal of arrangements completed 24 hours prior to discharge when date of discharge is known

1/2015 – 1/2014

MENTAL HEALTH HOSPITAL LIASION TEAM LEAD, gulf coast mental health authority

Managed and coordinated the in-take and pre-admission screening process. Accurately documents evidence of rehab admission criteria on Pre-Screen evaluation in a timely and legible manner.

Completed and Supervised pre-authorizations/concurrent reviews/internal UR reviews Consults with various members of the multidisciplinary treatment team concerning required information to complete concurrent reviews.

Perform on-site and off-site clinical evaluation to assist Rehab Medical Director in determining appropriateness of patient for admission.

Provides information related to inpatient rehab and program features to patient and family members.

Communicates to patients the expectations and requirements for participation upon admission to the rehab program. Offers each patient and family a tour of the rehab unit; coordinating tour if unable to provide personally.

Secures information relating to patients’ resources and healthcare insurance benefits.

Demonstrates clinical knowledge of rehab admission criteria, leading to appropriate identification of qualified rehab patients.

Advises referral sources on inpatient rehab criteria.

Functions as primary contact for case management and referring physicians. Establishes and maintains effective working relationships with the same referral sources.

Completes face-to-face, in-service educational contacts with physicians, case managers, other interdisciplinary members and other professionals. Serves as an educational resource to patients, family members and caregivers.

Managed and Supervised market analysis, data analysis and development and implementation of business plans for the Rehab Unit. Contributes to the development and maintenance of referral source information such as brochures, flyers, referrals and information kit and other outreach tools.

Proficient in time management. Prioritizes meeting commitments to referral sources. Developed and managed a call-plan to prioritize utilization of time.

Assists in developing the annual strategic plan for the Rehab Unit/Hospital, to include visible community outreach programming and raising community awareness of services available.

Ensured referral sources receive appropriate and timely follow-up communications regarding their patients and hospital programs.

Developed back up system to handle calls when he/she is unavailable.

Managed system that ensures calls are appropriately handled 24 hours a day, 7 days a week.

Other duties as assigned.

10/2014-10/2015

BRISTOW PATH /HARRIS CENTER FORMERLY MHMRA CM DIRECT SUPERVISOR

Work with Psychiatrist on site to assist homeless population with mental health treatment.

Linkage to community resources and provide assistance with gaining housing if desired.

Completion of progress notes and personal directed plans.

Assistance with medication management

CPR certified and PMAB certified

Evaluates performance of case managers. Ensures that project/department milestones/goals are met and adhering to approved budgets.

completed clinical meetings and team building events to promote culture and collaboration in care

Responsible for execution of clinic operations and achieving clinic performance expectations as outlined by management.

Completed corporate calls and all management meetings.

1/2009-5/2014

HARRIS CENTER /MHMRA SERVICE COORDINATOR

Coordinated and worked closely with interdisciplinary team to provide community support services for vulnerable populations with various mental disabilities

Follows guidelines HIPAA, designed to prevent or detect unauthorized disclosure of Protected Health Information.

Promotes a culture of safety for individuals through proper identification, proper reporting, documentation and prevention of medical errors in a non-punitive environment.

Met weekly timeliness of data deadlines 95-100 percent for consumer documentation reports

Collaborated with and developed highly productive working relationships between the community, advocates, government and state officials

Monitored HCS providers/centers for contract compliance regarding state approved services

Prepares and updates records including nature of social problems, patient and family progress, and steps taken; may include pertinent summaries or notes containing related social information of use to patient care personnel.

EDUCATION

12/2009

BACHELORS, texas southern university

Member of PSY KI, Dean’s list graduating year

05/ 2001

HIGH SCHOOL DIPLOMA, westbury christian school

Graduated top 20%, with a basketball scholarship to NMJC and Texas Southern university

SKILLS

Clinical/Social/Human Services

Contract Compliance/Monitoring

Substance Abuse Prevention

Presentation/Evaluation Skills

Conflict Resolution/Counseling

Team Building/Organizing

Confidentiality/Ethical Behavior

Multi-Tasking/Detail Oriented

Leadership/Development

Decision Making/Problem Solving

Oral/Written Communication

Case/Records Management

ACTIVITIES

Currently a member of second Baptist Church, volunteer at Christ Church and St. Joseph Medical Center

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