k price
@kprice
I’m a Texas-licensed LVN with 22+ years in case management, regulatory compliance, and zero-error clinical documentation.
What I'm looking for
I’m a Texas-licensed LVN with 22+ years of progressive healthcare case management, regulatory compliance, and clinical documentation expertise. I’m known for translating complex clinical data into compliant, actionable case files while maintaining ZERO-ERROR documentation standards across high-volume caseloads. I’ve also built deep strength in vocational rehabilitation support functions like intake screening, policy interpretation, and inter-agency coordination.
In my current role as a Clinical SME / Lead LVN, I provide comprehensive case management support for Med-Surg and Home Health populations, maintaining detailed electronic case files with 100% regulatory compliance and zero-deficiency audit results. I lead intake screenings and needs assessments to determine eligibility and appropriate resource allocation, and I manage high-stakes logistics tied to trust/PFO administration. I serve as a primary liaison between clinical teams, insurance payers, and service providers—resolving case-level discrepancies to keep service delivery uninterrupted.
I also bring payment integrity leadership from my work as a Clinical Review Specialist / Payment Integrity Lead, where I prevent improper payments through meticulous forensic claim investigations. Through defensible audit ecosystems, I’ve achieved a 99.8% documentation accuracy rate and prevented over $200,000 in improper payments, while collaborating cross-functionally to turn case data into process improvements. Throughout my career—including roles in prior authorization, nursing QA, and payer liaison compliance—I’ve aligned with the Texas Workforce Commission’s mission to help people with disabilities achieve employment prosperity through coordinated, person-centered services.
Experience
Work history, roles, and key accomplishments
Payment Integrity Lead LVN
Healthcare Audit Solutions Inc.
Oct 2024 - Present (1 year 7 months)
Led forensic claim investigations and case file audits to prevent over $200,000 in improper payments through meticulous review. Built defensible audit ecosystems achieving 99.8% documentation accuracy and streamlined compliance reporting with reliable audit trails.
Lead LVN Case Management
Beauty Bey Ministries, Inc.
Jan 2023 - Present (3 years 4 months)
Provided comprehensive Med-Surg and Home Health case management, maintaining detailed electronic case files with 100% regulatory compliance and zero-deficiency audit results. Conducted intake screenings and needs assessments and served as a primary liaison to resolve case-level discrepancies.
Managed a high-volume specialty caseload, completing individual needs assessments and clinical screenings processing 50+ cases daily with zero backlog. Prevented downstream payment disputes by interpreting complex payer policies and eliminating $120,000 in annual billing errors through pre-payment review safeguards.
Med-Surg LVN QA Coordinator
Winthrop Manor LTC & Rehabilitation
Jan 2022 - Jan 2023 (1 year)
Directed nursing workflows and ensured zero-error medication administration records through rigorous case documentation and quality assurance for high-acuity rehabilitation residents. Completed routine case file reviews and prepared regulatory survey technical reports with 100% on-time submission.
Compliance & Payer Liaison Supervisor
Merdia Healthcare Group
May 2016 - May 2022 (6 years)
Orchestrated end-to-end payment integrity audits and case file reviews, recovering $85,000 in erroneous payments while strengthening compliance controls. Built and scaled a 5 FTE analyst team, reducing onboarding time by 40% through standardized training and managing MOUs/LOAs to ensure payer documentation met regulatory requirements.
Education
Degrees, certifications, and relevant coursework
TEXAS CAREERS
Licensed Vocational Nurse (LVN) Diploma, Nursing
2003 - 2004
Completed a Licensed Vocational Nurse (LVN) Diploma Program in San Antonio, Texas.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Website
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Skills
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