Customer Service Case Manager

OMAR B. DIAZ, MSN-APRN-FNP

E-mail: ************@*****.***

Cell: 786-***-**** NPI: 169*******

http://linkedin.com/in/omar-diaz-64727842 CAQH ID# 14969774 Summary of Qualifications

MSN, RN, APRN-FNP, Foreign Medical Doctor with extensive background on the medical field for more than 20 years with emphasis on urgent and emergency settings. Proven ability performing health assessments and preventative health measures within prescribed guidelines and physician instructions. Proficient interpreting and evaluating diagnostic tests to identify and assess patient’s clinical problems and health care needs. Great experience with risk management and high retention ratings in Primary care settings History of excellent work relationships with physicians. Ideal team worker, but able to work independently. Proficient on MRA. Proficient documenting care plans and massive experience in On-Call program and home visits. PROFESSIONAL EXPERIENCE

Univida Medical Centers 01/19/2022- to- current Currently working in Primary care settings in close relationship with our Medical director. We manage a high volume of patient in a daily basis. We provide comprehensive, continuous care focused on a long-term relationship with the patient. We screen, diagnose, and treat common acute and chronic medical conditions. We conduct face-to face encounters as well as Telemedicine modalities as needed Together Medical Center 07/01/2022-to- 12/18/2022 Currently working in Primary care settings in close relationship with our Medical director. We manage a high volume of patient in a daily basis. We provide comprehensive, continuous care focused on a long-term relationship with the patient. We screen, diagnose, and treat common acute and chronic medical conditions. We conduct face-to face encounters as well as Telemedicine modalities as needed. Davila Medical Center 11/02/2020- to-06/30/2022 As a new graduated FNP I was working as a PCP with high volume of patient with more than 700 patient on my case log with high retention level.

Anthem,Inc 11/02/2015-to-10/31/2020 Retro Reviewer Nurse

Proficient in Grievance & appeals process and reviewing prospective, and retrospective medical records. Humana HSO-CarePlus 4/2014-to- 10/31/2015 Utilization Management

Telephonic Case manager

Precert- nurse: Proficient on prior authorization process, Discharging planning, Utilization review, Interqual/ Milliman Care / CMS guidelines: Responsible for cost effective delivery of healthcare services g Telephonic case manager: proficient in TOC, Discharge planning, Utilization review, handling high volume of cases. Excellent customer service skills.

Professional Solution Home Health Agency 07-25 2011- 02/01/2014 Registered Nurse-2013

Case Manager working with all types of insurance: Medicare, Medicaid, HMO and private insurance, Proficient in customer service, OASIS completion, QI, and nursing skills: Wound Vacuum therapy, IV administration. Genesis Home Health Agency 9/2009- 7-

20011 CM for Medicare & Medicaid, HMO & Com

Miami Behavior Health Department-Miami, Florida 2009- 9/2009. Medical experience in several Hospitals Hospital “General Freyre de Andrade”-Cuba 1999-2007 Sup.MilitarMedicineInstitute”Dr. LuisSoto”Havana-Cuba 1998-1999 Hospital “Fructuoso Rodriguez” Havana-Cuba. Sup.Military Medicine Institute”Dr Luis Soto”Havana-Cuba. 1991-1995 EDUCATION

MRU, Master of Science of Nursing, FNP 09/2018-4/2020 University of Sagrado Corazon De Jesus, Puerto Rico : ADN program 2010-2011 Superior Military Medicine Institute–Havana-Cuba Medical doctor 1984-1988 MD. Sup.Institute”Victoria Giron” Preclinic Sciences of Medicine 1982-1984 SPECIAL SKILLS: Computer skills: Word, excel, internet, Power Point. Bilingual, hard worker, team worker, fast learning: English/Spanish. Licensed Registered Nurse 2013.