Nelly C

Case Manager - 20 Years of Experience - up to 25 miles from 33176


Case Manager

Education Level:


Will Relocate:



NELLY GAZMEN CONROY, RN, BSN Cellular: (305) 926-0725 ------------------------------------------------------------------------------------------------------------------------ CAREER OBJECTIVE: A position in a progressive growing company which affords opportunities and advancement for motivated, hardworking, qualified individuals. ACADEMIC PREPARATION: Bachelor of Science in Nursing University of Santo Tomas, Philippines REGISTRATIONS: Florida State Board of Nursing PROFESSIONAL PRESENTATIONS: Nursing Orientations - Monthly with the newly hired employees Policies and Procedures Order Processing Medication Transcription Nursing Documentation Monthly Staff Meetings QA Risk Management Monthly Budget Presentations – To the Executive Committee ABAQIS Training – To the nursing staff, department heads and to the administrators QIS Process Training – To the nursing staff E-MAR Training – To the nursing staff and to the administrators EXPERIENCES: REGIONAL CORPORATE CLINICAL CASE MANAGER / INTERIM DON PLAZA HEALTH NETWORK 1800 NE 168 Street, Suite 200, North Miami Beach, FL 33162 Excellent achievement in preparing my assigned facilities for the state / federal surveys. Managed in auditing the facilities according to the network’s policies and procedures as well as their adherence to the state, federal standards and regulations to determine the areas of focus. Progressively maintained a close, professional, and cordial working relationship with the Directors of Nursing of each assigned facility (as the regional corporate clinical case manager) and managed to provide education and in-services to the nursing staff as well as to the department heads. Managed to enhance the facilities standard of the nursing care practice and achieved the maintenance of their 5 star rating. Achieved an excellent performance for the 24/7 clinical operations of the nursing department (as an interim DON), according to the DON’s job description and achieved the highest level of the residents care according to the facilities and the networks policies and procedure by following and providing the updated state and the federal guidelines thru the; QIS process, QA, ABAQIS, in-services, orientation, and the highest level of employees education and training. Established and maintained a cordial, respectable, and professional manner with the physicians within the network and the facilities. Lead the way and achieved the best customer service to the residents, families, other departments, and the facilities within the network. Succeeded in leading the way with the provision of a pleasant, homelike, and professional environment in the network. Prepared the facility’s nursing department for the state and federal surveys and achieved excellent survey’s (eliminating any previous citations in all re-surveys, if any). Succeeded in updating my professional knowledge and my nursing standard of practice by attending the latest in-services and seminars that were providing the latest state and federal revisions. Achieved the best survey results within the network as assigned. UTILIZATION REVIEW NURSE, PEDIATRIC CASE MANAGER, TRANSPLANT CASE MANAGER, RN CASE MANAGER SHDC / AHH 9501 NE Second Avenue, Miami, FL Excellent achievement in providing, in a timely manner, the pre-certification of procedures, diagnostic tests, admissions (IP&OP), DMEs, medications, and office visits in accordance with the URAC, HIPPA, Medicare Guidelines, Milliman and Interqual criteria’s. Accomplished and managed the performance of the Medical Director’s / Medical Reviewer’s referrals as deemed appropriate and according to the TPA’s plan documents, patient’s benefits per medical necessities. Medications were certified according to the FDAs standards. Achieved a professional, close working relationship with the TPAs regarding the above, cost containment and according to the patient’s benefits. Pediatric Case Manager / Transplant CM, achieved in obtaining the patient’s consents to participate in CM and followed up the patient’s, for clinical guidance, cost containment, clinical needs per medical necessity until they are medically stable with the strict observance of the above. RN, ORTHOPEDIC CASE MANAGER BCBS/ORTHONET 1311 Mamaroneck Ave. White Plains NY 10605 Miami Office Achieved the excellent performance of my responsibilities as outlined in the URAC, HIPPA, Medicare Guidelines as well as the Interqual criteria. Excellent achievement in establishing a close, professional working relationship with the Medical Director, regarding the necessary referrals in the areas not specified in the Interqual. Maintained professional, cordial working relationships with the onsite nurses and the Medical Director regarding the patients in the hospital for furthering appropriate authorizations of the patient’s length of stay per medical necessity and discharge planning. DIRECTOR OF NURSING Larkin Hospital, 7031 SW 62 Ave, Miami FL 33143 Medical Surgical / Telemetry / Forensic Excellent achievement in the 24/7 management and operation of the units in adherence to the JCAHO standards in the maintenance of adequate staffing. Adhered to the units budgeted guidelines as well as policies and procedures. Succeeded in providing a professional, friendly, team nursing, and home like training atmosphere in delivering excellent patient care for the satisfaction of the patients and their families. The Nursing Department achieved 100% survey results without any recommendations. ASSISTANT DIRECTOR OF NURSING MIAMI JEWISH HOME AND HOSPITAL 5200NE2nd Ave, Miami, FL 33137 Long Term Care, SNF, and the Hospital Successfully achieved the management of assigned responsibilities, according to the facility’s policies and procedures as well as the state and the federal regulations, by insuring the proper transition of the residents from the nursing home, to the hospital, from the hospital to the SNF, and back to the nursing home as appropriate. Succeeded in insuring that the staff and the facility were in compliance with all of the above by providing nursing care, according to the standard of nursing care practice, for the achievement of a safe, comfortable and professional environment for the residents and their families. DIRECTOR OF NURSING MEDICAL / SURGICAL SERVICES, DIALYSIS, REHABILITATION SERVICES, HOSPICE, ONCOLOGY, GASTRIC BYPASS UNIT, SURGICAL AMBULATORY CARE UNIT, ARTHRITIS UNIT, DIABETIC UNIT Coral Gables Hospital, 3100 Douglas Road, Coral Gables, FL 33134 Excellent achievement in the operations and responsibilities according to the hospitals policies and procedures, the state, the federal government, and the JCAHO standard of nursing care practice for the following departments; Medical Surgical, Orthopedic, Arthritis, Diabetic, Oncology, Physical Therapy (Inpatient and Outpatient), Surgical Ambulatory Services, OP Dialysis, the initiation of the Gastric Bypass Unit (to include the acquisition of the special furnishings and equipment’s geared to the patients outlook) and also the initiation of the Inpatient Hospice Units (Vitas and Catholic). Succeeded in the integration of the hospice policies, procedures, and guidelines with the hospital’s policies and procedure. Achieved in eliminating the utilization of agency nurses, enforced cost containment, and continued to maintain customer satisfaction. Received an award for the best budget within the company. The above were all strictly enforced and all my units achieved excellent JCAHO surveys without any recommendations. ASSISTANT HEAD NURSE MEDICAL SURGICAL, ORTHOPEDICS, UROLOGY MERCY HOSPITAL, 3663 South Miami, FL 33133 Excellent achievement in assisting the Head Nurse in the department’s daily operations, management, charge duties, and staffing. Established and maintained a professional working relationship with the doctors in their daily rounds and staff supervision ensuring the adherence to the hospital’s / units policies and procedures plus the JCAHO standard of the nursing care practice. CERTIFICATIONS: * In Search for Excellence * Diabetic Update * Working Beyond Fear * Motivational Seminar * IV Nurse Certified * Urology Seminar * Supervisory Management Course (Leadership Skills) * Supervisory Management Course (Management Principles * Modern Management Techniques * Managing Quality Health Care System * Nursing Management * Quality Resource Management * Case Management Internal and External * Cobra Review * PPS, MDS Seminar * Hospital Process and Management * QA Ten Step Process and Documentation * N6R QA-QI Legal /Ethical Issues * ABAQIS Training * MDS 3.0 Certified * Certified Clinical Risk Manager REFERENCES: Joyce Galbut, CNO, Plaza Health Network, (305) 778-1600 Rosella Villanueva, Director Utilization Management, Strategic, (786) 715- 4597 Adrienne Raville, Regional Clinical Manager, 914-681-8800 ext. 122