Jesus Baez Rn Bsn Email & Phone Number

Seattle, Washington, United States

- Responsible for providing clinical review of cases using standard criteria to determine the medical appropriateness of inpatient.- Perform initial, concurrent, and discharge reviews of all cases, including: using medical guidelines to determine the medical appropriateness of inpatient services; assessing, interpreting, and responding to the needs or requirements of patients; identifying, escalating and resolving complex cases or issues as required.- Review charts for appropriateness and correct admission status (inpatient, observation, bedded outpatients).- Coordinate care and discharge planning.

Seattle, Washington

— Utilization Management RN for Amerigroup WA State Medicaid.— Collaborate with medical director, ancillary staff, & provider networks to review precertification request for medical necessity (DME, planned inpatient/outpatient surgery, therapy, transportation, and more).— Review of all precertification requests for medical necessity in compliance with NCQA standards of care including multiple states.— Provided training and support to RNs and ancillary staff new hires.— Subject matter expert with ownership of standardization of documentation for reviews including training.

New York, New York, United States

— Case Management RN for Amerigroup NY FIDA (Dual Medicaid/Medicare).— Ensures member access to services appropriate to their health needs.— Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.— Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra- contractual arrangements.— Coordinates internal and external resources to meet identified needs.— Monitors and evaluates effectiveness of the care management plan and modifies as necessary.— Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.— Assists in problem solving with providers, claims or service issues.

Greater New York City Area

- Assessed ongoing service needs and care plans of Amerigroup Managed Long Term Care members- Arranged home visits to facilitate effective service planning and implementation of services- Assessed appropriate levels of care and services for members to more accurately provide cost effective care - Collaborated with providers, caretakers, and business contractors to support member's care - Collaborated with each member to develop a plan of care detailing services being received and sources- Provided assistance with use of appropriate community resources as well as making referrals in accordance with business and regulatory policies and regulations of NY State.- UAS Review, Onboarding of new members, Social Work Referral

Bronx, New York

- Charge nurse. - Circulated/Scub (Ortho, Podiatry, Urology, Dermatology, Ophthalmology, General Surgery Cases).

New York, New York

- Circulated and Scrubbed in General Surgery. Temporary position.

Greater New York City Area

- Assist customers with customizing products to fit their needs. - Provided full setup of computers, iPods, iPhones, and other Apple products. - Educated customers on features and qualities of products.

Bachelors In The Science Of Nursing, Nursing

Nursing Student

Full Stack Web And Mobile App Development

Enrolled in NuCamp’s Full Stack Dev online bootcamp.