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Customer Safety Expert Witness





Expert No. 748

Texas, Florida, California


•    Seasoned clinical nurse on several clinical units, including Oncology, Women’s Health, Behavioral Health, Telemetry, Med-Surg and more
•    10 years’ experience in Case Management, including training and development
•    Certified Case Manager for Medicare and Medicare Advantage Plans (2001 – Present)
•    HMO and self-funded Employer TPA groups.  
•    UR/UM, Focus on Catastrophic or Complex Case Management 
•    Hospital Case Management, insurance telephonic case management with minor telecommute time. Includes DC Planning functions. Focus on Concurrent Review.
•    Experienced in organ transplants, oncology, concurrent review, general and medically complex patient care. 
•    Experienced in CM, UM, UR, Appeals and Denials, Pre-Determinations and Medical Claim Audit
•    Train RN's and LVN's in the clinical and insurance setting on clinical software, workflow processes and procedures, and Interqual/Milliman

Lifespan Home Health – San Antonio, TX  May 2016 – Present Field RN
•    Admissions, discharges, ROC and Recerts
•    PICC line care, IV Abx admin, wound care 
•    Patient and family education 
The Forum at Lincoln Heights – San Antonio, TX December 2015 – Present 
RN Supervisor and Floor RN, PRN
•    Assist with RN Supervisor coverage on the weekends
•    I handle emergencies in patient care

Buena Vida Nursing Facility – San Antonio, TX November 2014 – January 2015
RN Supervisor
•    Handled emergencies and get patients out to ER
Caprock Home Health – San Antonio, TX August 2015 – September 2015
RN Supervisor
•    OASIS Admissions
•    Post Hospital visits. Discharges. Teaching. IV's, PICC Lines/Central lines, Wound Care, Antibiotics. Overseeing the LVN's who do intake and field work. 
•    Oversee the CLASS State of Texas DADS program 
•    Ensure that patient quality care, billing and operations are completed in a timely manner
•    State and Federal guidelines are adhered to 
•    Oversee the Field RN that makes the supervisory visits, post hospital visits, annual visits and orientation for attendant visits for the CLASS program. 
•    Conduct assessments and supervisory visits 

Interim HealthCare   March 2015 – May 2015
Home Health RN, PRN
•    IV Infusions and make home health visits in the San Antonio and New Braunfels area 
•    IVIG specialty infusions performed.

Trachmasters – San Antonio, TX July 2014 – January 2015
Clinical Instructor, PRN
•    Teach IV Classes and EKG Class 
•    Assist in developing a CNA School 

LifeCare Hospital – San Antonio, TX  August 2014 – December 2014 
RN Case Manager 
•    Inpatient RN Case Manager caring for 13-15 cases. 
•    Discharge planning, insurance reviews, CM assessments and Utilization Review and some social work type duties performed. 
•    Took care of very seriously ill patients and assisted them with transitioning to lower level or higher level of care from LTAC. 
•    Worked closely with nursing staff to help patient meet their goals of care at next level. 
•    Worked closely with family members and physicians also.

Careerpoint College – San Antonio, TX March 2014 – July 2014 
LVN Instructor
•    Maternal Child Clinical, Behavioral Health, Med Surg III 

VIP Care Management Services, Caprock Health Group August 2013 – January 2014 
Senior RN Case Manager 
•    Telephonic case management for the NICU, Hi Risk OB Moms, Pediatric, Adult, Geriatric, Oncology, Transplants, Autoimmune diseases. 
•    Caring for the ill population with A-Z demographics and diseases. 
•    Created all the forms and workflow processes that helped to develop this program. 
•    Personally eveloped the case management report forms and health maintenance program scripts Transplant checklist and Transition forms were created as well as Continuation of Care forms

Sunrise Nursing Facility – San Antonio, TX November 2011 – March 2013 
RN Supervisor (weekends)
•    Manage the building on the weekends 7am-7pm and assist working as a charge RN during the week if needed. 
•    Manage 20 employees every weekend and 100 patients. 
•    Conduct the wound care treatments and assist with IV antibiotic administration and care of the central lines and other tasks as needed. 
•    Supervise all employees and handle all clinical emergencies as they arise. 

Restorative Health Care – San Antonio, TX June 2011 – June 2012 
Field RN
•    Was full time RN doing OASIS admissions and clinical care in the home including IV Abx, pumps, CHF drips, Chest Tube Pleurex drainage in home
•    Heavy Wound Care and Teaching. 
•    Teaching included the major chronic diseases CHF, Diabetes, COPD and other acute illness as well. 

Web TPA, AMWins Group, Inc. 3/2011 – 5/2011
RN Case Manager
•    10 hospitals and 17,000 employees and their dependents
•    Assisted in training other RN’s

Physican's Health Choice/ Well Med – San Antonio, TX  April 2009 – March 2011 
RN Case Manager, Temp 
•    Telephonic Case Manager, Transplant Coordinator and Prior Authorization RN
•    Trained 13 RN Case Managers
•    Served as UR nurse and followed URAC guidelines 
•    Assisted PHC with their UR/UM dept. as well at transplants of all types 
•    Assisted the Case Manager Department

St. Philip’s College – San Antonio, TX August 2006 – September 2011
Clinical Nursing Instructor 

Benefit Planners – San Antonio, TX 2001 – 2006
Complex Case Manager 
•    Catastrophic case management for insurance companies and third-party administrators 

Interim Healthcare (1993 – 1999)
Cleveland Regional Hospital, Staff RN
Memorial Hospital, Staff RN
Methodist Healhtcare, Staff RN: Telemetry, Med/Surg and Oncology 1993 – 1996  

MD Anderson Cancer Center – San Antonio, TX 1990 – 1993 
Leukemia, Lymphoma and Bone Marrow Transplant RN
•    Worked in Level IV Emergency Room 
•    Handle infusions and oncologic emergencies
•    Assisted with procedures as needed in the emergency room.
UTHSC Nursing School at Houston – Houston, TX 1989
Bachelor of Science in Nursing

•    RN, State of Texas 
•    CCM
•    BLS, ACLS

•    Nursing Expert Witness for Medical Malpractice Law Firms January 1993 – Present  
•    Point Click Care Training March 2016
•    DADS Training for RN August 2015
•    Allscripts Training August 2013
•    Medicare and Medicaid Training 2007, 2012 
•    Milliman Guidelines Training  April 2009
•    Brooke Army Medical Center, MEPS Training Certificates August 2007
•    Case Management Society of South Texas 2002 – 2005
•    Legal Nurse Locators (Owner) 1998 to 1999
•    American Association of Legal Nurse Consultants 1998 – 1999 
•    TILE Class (Medicaid reimbursement)  1996
•    Chemo class at MD Anderson Cancer Center  1991

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