Abigail Villareal

RN (ADN) with 20+ years across acute, post-acute, and regulatory settings. Skilled in medical necessity review, clinical documentation evaluation, and InterQual/Milliman criteria. Proven remote collaborator seeking utilization management or clinical review opportunities.

RN Case Manager - Gentle Partners in Hospice - San Antonio

(2025-10 - 2026-02)

• Developed individualized interdisciplinary care plans collaborating with physicians, social workers, and hospice aides
• Managed caseload of 5–6 patient visits/day, applying medical necessity criteria to determine appropriate level of care
• Applied clinical judgment to perform comprehensive assessments of clinical information and treatment plans

Registered Nurse III – HCSSA - Texas Health and Human Resources - San Antonio

(2023-01 - 2024-10)

• Conducted regulatory compliance surveys and incident investigations for home health and hospice providers statewide
• Authored deficiency reports ensuring adherence to state and federal guidelines using WellSky, TEAMS, and Outlook
• Evaluated clinical documentation for completeness, accuracy, and quality-of-care standards

Progressive Care/Telemetry Registered Nurse - Methodist Hospital Texsan - San Antonio

(2022-04 - 2025-12)

• Interpreted EKGs and monitored cardiac rhythms, identifying acute changes and initiating evidence-based interventions
• Documented medical necessity and clinical justification for advanced therapies to support regulatory and payer requirements
• Collaborated with interdisciplinary teams to coordinate care, ensure guideline adherence, and apply escalation protocols

Associate Degree in Nursing - Nursing - Galen College of Nursing (2022-01) San Antonio

Diploma in Vocational Nursing - Vocational Nursing - Brightwood College (2018-01) San Antonio