Open to opportunities

ROSA DELACRUZ

@rosadelacruz

Message

I’m an RN case manager who improves care outcomes through case management and quality initiatives.

United States

Message

What I'm looking for

I’m looking to strengthen RN case management and care coordination across multidisciplinary teams—improving quality measures, medication reconciliation, and transitional outcomes for adults and geriatrics.

I’m a Registered Nurse with over 10 years of accumulated experience, most recently as an RN HCM for WellMed Networks. I focus on case management for Adult/Geriatrics—evaluating needs, barriers to care, and social determinants of health—while developing acute care plans and making recommendations that strengthen care delivery.

I’m comfortable owning the full care cycle: admissions, post-hospital assessments, discharges, transitional needs, and contingency planning, including medication reconciliation and accurate documentation aligned with state, federal, and payer regulations. I also bring quality and utilization management experience, collaborating with multidisciplinary teams and providers to monitor progress, identify care gaps, and improve health outcomes using EMR tools (TruCare, ECW) and INTERQUAL.

Experience

Work history, roles, and key accomplishments

RN Case Manager Senior Analyst

Mindlance Staffing Firm, Inc

Oct 2025 - Nov 2025 (1 month)

Evaluated member needs, barriers to care, and social determinants of health to prioritize member goals and develop individualized care/service plans with providers. Coordinated care, performed outreach (telephonic/digital/home visits), monitored progress, and adjusted plans while maintaining compliant documentation.

Case Management Care Coordination Medication Reconciliation Utilization Management ICD 10 Coding Medicare Medicaid Clinical Documentation EMR (TruCare ECW)

Nurse Case Manager Senior Analyst

Mindlance Staffing Firm, Inc

Apr 2025 - Jul 2025 (3 months)

Planned, implemented, coordinated, monitored, and evaluated care plans to drive appropriate and cost-effective outcomes. Conducted clinical assessments and prospective/concurrent/retrospective reviews, supported utilization management, and maintained compliance with regulatory and internal policy requirements.

Case Management Clinical Assessment Utilization Management Medical Necessity Review Care Coordination Compliance Policies Patient Education

RN Health Care Manager / Quality RN

WellMed Networks

Mar 2020 - Apr 2024 (4 years 1 month)

Collaborated with multidisciplinary care teams and supported chronic care by educating and advocating for patients and families. Reviewed emergency room records, reconciled medications with PCPs, supported transitional needs and contingency planning, and monitored quality reports to meet quality star measures.

Care Coordination Medication Reconciliation Quality Reporting Patient Education Chronic Disease Management Contingency Plan