Tatiana Figuerres
Grand Junction
Summary
Results-driven utilization review case manager with a proven track record in client advocacy and support. Expertise in conducting clinical assessments and developing tailored care plans that address unique client needs. Strong ability to collaborate with multidisciplinary teams while adapting to dynamic situations, ensuring optimal outcomes for clients. Committed to enhancing the quality of care through strategic planning and dedicated support.
Overview
10
10
years of professional experience
Work History
Utilization Review Case Manager
Health Solutions West
10.2023 - Current
- Conducted utilization review consisting of ASAM assessments to verify medically necessary care is received in correct setting.
- Increased efficiency of the utilization review process through regular communication with insurance companies for timely authorizations.
- Served as a liaison between healthcare providers, insurance companies, and clients for efficient resolution of coverage issues or denials following a utilization review assessment.
- Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
- Facilitated successful transitions between levels of care by developing detailed discharge plans and coordinating resources.
- Provided leadership, guidance and support to staff members.
Detox Worker
Mind Springs Health
03.2022 - 10.2023
- Consistently met deadlines under pressure while maintaining high-quality work output in a fast-paced environment.
- Completed detailed documentation of all client inventory while maintaining proper storage of narcotics, weapons, and personal belongings.
- Utilized crisis intervention techniques to handle and diffuse emergency situations in organized manner.
- Cleaned and straightened work areas to maximize productivity and safety.
- Maintained up-to-date knowledge of current and emerging compliance regulations.
Operations Associate
Sensei Farms Lanai AG
08.2020 - 01.2021
- Oversaw daily operations, ensuring timely completion of tasks and adherence to company policies and procedures.
- Executed and maintained quality control processes to meet criteria and standards and increase customer satisfaction.
- Monitored and maintained irrigation systems to optimize water levels for crops.
- Harvested and processed thousands of crops to be shipped out daily.
Office Assistant
Colorado Mesa University
11.2019 - 05.2020
- Interacted with students by phone, email or in-person to provide information and schedule appointments.
- Maintained staff directory and company policy handbook for human resources department.
- Welcomed office visitors and alerted staff to arrivals of scheduled appointments.
Natural Resources Field Assistant
Pulama Lanai
06.2018 - 08.2019
- Decreased population of endemic species by 5%
- Monitored weed, disease and pest growth throughout agricultural fields with varying crops and environmental conditions
- Mixed and applied pesticides and fungicides as needed to protect crops from long-term damage and promote growth and proliferation
- Worked long days outside despite adverse weather, completing projects with caution and attention to meticulous data collection
- Used hand saws and power equipment to remove unwanted and diseased trees.
- Evaluated sites and devised strategic plans for rebalancing ecologies with native and non-invasive species.
Laborer
Pulama Lanai
06.2016 - 08.2016
- Prepared job sites by removing debris and setting up materials and tools.
- Loaded, unloaded, and moved material to and from storage and production areas.
- Dug trenches, ditches and holes to allow for utility, water and sewer installation and proper foundation for structures.
Crew Member
Mcdonald's Corporation
10.2015 - 05.2016
- Provided excellent customer service by greeting customers and meeting quality expectations.
- Food preparation and cash handling skills.
- Training experience at Manager position.
- Worked to achieve customer satisfaction goals of McDonald's cooperation.
Education
Bachelor of Arts - Criminal Justice
Colorado Mesa University
05.2021
High School Diploma -
Lanai High & Elementary School
05.2015
Skills
- Experienced with Microsoft Office tools
- Expertise in utilization review processes
- Cultural awareness
- Approachable demeanor
- Knowledge of HIPAA regulations
- QAPI data management
- Effective team collaboration
- Effective written communication
- Staff training
- Experience in hands-on work
Accomplishments
QMAP - Qualified Medication Administration Personnel
CPI - Crisis Prevention Institute Certificate
CPR & First Aid - National Certificate
Timeline
Utilization Review Case Manager
Health Solutions West
10.2023 - Current
Detox Worker
Mind Springs Health
03.2022 - 10.2023
Operations Associate
Sensei Farms Lanai AG
08.2020 - 01.2021
Office Assistant
Colorado Mesa University
11.2019 - 05.2020
Natural Resources Field Assistant
Pulama Lanai
06.2018 - 08.2019
Laborer
Pulama Lanai
06.2016 - 08.2016
Crew Member
Mcdonald's Corporation
10.2015 - 05.2016
High School Diploma -
Lanai High & Elementary School
Bachelor of Arts - Criminal Justice
Colorado Mesa University
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