Nina Worley Email & Phone Number

Mcallen, Texas

• Perform duties to act as a liaison between providers, the health plan and corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices.• Serve as primary contact for providers serving as a liaison between the provider and the health plan• Conduct monthly meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on-site and routing to the appropriate party for • Educate providers regarding policies and procedures related to referrals and claims submission; web site education, EDI solicitation and problem solving • Perform Provider orientation

Mcallen, Texas

• Work as a team player with Service Coordinator I and Service Coordinator II to ensure the Star Kid members continuity of care was in place upon the completion of home assessment. • Serve as primary contact for POD and assessed call and implement tasks depending on member’s situation.• Conducted phone assessment and completed annual assessment for assigned members. • Worked very closely with provider (physician offices, hospitals, Home Health, Pharmacy, LPC’s, Therapies, DME contacts in an integrated system to ensure member obtain identified needs.• Communicated with team members and manager at all times and kept them informed.

United States

• McAllen Mass COVID -19 Testing in Month of July 2020 - provided education on how to administer self COVID 19 testing; observed individual accurate testing during “Mass COVID -19 Testing Clinic Site” in Hidalgo County.• CDC COVID-19 Vaccinator Certified• CDC COVID-19 Screener Certified

Edinburg, Texas

Responsible for the delivery of postpartum and newborn discharge education. •provides discharge education related to postpartum and newborn care *Identifies and evaluates instructional materials in all types of media and formats•adjusts content and teaching strategies appropriate patient needs needs.•delivers evidence-based educational materials •Collaborates with newborn nursery staff in an integrated discharge process.

Mcallen, Texas Area

• Performs duties to act as a liaison between providers, the health plan and Corporate. • Provide education on health plan’s innovative contracting strategies• Initiate data entry of provider-related demographic information changes and oversee testing and completion of change requests for the network• Investigate, resolve and communicate provider claim issues and changes• Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics• Perform provider orientations and ongoing provider education, including writing and updating orientation materials.• Conduct monthly face-to-face meetings with the provider account representatives documenting discussion, issues, attendees, actions items, and research claims issues on-site, where possible, and route to the appropriate party for resolution.• Perform training, orientation and coaching for performance improvement within the network and assist with claim resolution.

• Collaborated with Regional Manager for planning, implementation or recruitment, training, evaluation and retention of providers (RN’s and Social Workers).• Pre-Screened potential providers; provided pre-planning sessions of program services, assisted with application process, approval of application on regional level.• Trained new program providers on health care management and coordination of TX Health Steps Case Management clients to achieve optimal clinical and quality outcome of program and client services.• Provided monthly program training on case management services which consisted of case management services to members with chronic or complex conditions including: proactively identifying member that may qualify for potential case management services, conduct assessment of members needs to include family as well. • Provided technical support as requested by providers and quarterly reached out to them to ensure continuity of case management services were running smoothly and assisted as needed.• Participated in outreach activities to recruit/promote case management services for children less than 20 years of age and high risk women in the community.

Edinburg, Texas

• Liaison between Mexican Public Health officials and Health Service Region 11 Public Health officials to integrate and implement bi national plans.• Coordinated and facilitated meeting regarding Early Warning Infectious Disease Surveillance (EWIDS) program.• Demonstrated capacity to provide comprehensive leadership, dependability and reliability as a state public health liaison during various natural events that included: hurricanes, flooding and public health responses in the Rio Grande Valley, Texas.• Recruited and provided public health preparedness training for 1st responders and community volunteers within assigned County.• Able to identify goals and priorities and resolved issues in initial stages.• Provided consultation and facilitation on bi national issues and emergency management initiatives.

, Edinburg, Texas

• Provided nursing care at patients at assigned homes as ordered by physician in the areas of medication administration, treatments, patient and direct staff education.• Able to respond to client’s medical situations or emergency within a reasonable time during on-call nurse duty. • Provided initial client assessments, educated and trained direct staff on each client’s medical condition and treatment and protocol procedure

Edinburg, Texas

Planned and Coordinated SNS Program by integrating with Hidalgo County Emergency and DSHS Region 11 Plan,

Vocational, Lvn

Ics Courses, Ics Courses, 100,200,300,400, 700, 800, Certificates

Pre Requisite Rn, Rn