Elvia Viera

As a Utilization Management Medical Case Manager at CalOptima, I provide comprehensive care coordination and utilization review for underserved community members with complex and non complex medical needs. I have a LVN license and my work background consist of hospital, home health, and clinic experience which enables me to perform clinical assessments, interventions and critical thinking reviews. I also have skills in insurance denials, team leading, and case management which helps me ensure quality and cost-effective care for members.

I have over 15 years of health care experience with 5 being in Utilization management. Previously worked as a Utilization Review Nurse at Network Medical Management before joining CalOptima in 2019. I have a (pending Spring 2024) Bachelor's degree from California State University San Marcos, an Associate's degree from Santa Ana College, and a Case Management certificate from University of California San Diego extension.

I am passionate about improving the health and well-being of diverse and underserved populations, and I value teamwork, collaboration, and continuous learning.

Nurse Case manager seeking a leadership position in utilization management or a position of utilization review nurse.

UM - medical reviews out patient.

Case management- care coordination.