Veronica V. Peraza has over 20 years of experience as a registered nurse, with extensive experience in utilization management, case management, and care coordination roles. She currently serves as the UM Department Manager for Alameda Alliance for Health, where she oversees clinical operations and ensures efficient healthcare delivery. Prior to this role, she held several leadership positions involving utilization review, care management, and discharge planning for hospitals and health plans in California. Peraza has a Master of Science in Nursing degree and certifications in ACLS and BLS.

1. Veronica V. Peraza | Registered Nurse | MSN
Summa ry Conceptual talent for seeing the big picture. Pinpointing the organizational
objective, and setting goals and priorities to achieve it. Energetic, enthusiastic
and dependable person. Strong interpersonal, communication, and
organizational skills. Detail- oriented, able to work in a fast paced environment
and manage multiple tasks. Excellent manage m e nt skills. Proven ability to
exercise good judgment and contribute to efficient operations.
Professional
Experience
09.2013 – Present: Alameda Alliance for Health, Alameda, California
UM Department Manager
• Responsible for clinical operations for the Utilization Management Department, assisting in the
coordination of all medical activities involving UM related functions.
• Responsible for UM and CM to ensure efficient healthcare to Members, maintaining
turnaround times, as well as meeting and/or exceeding parameters set by the Health plans and
regulatory guidelines.
• Reviewed network coverage, ensuring high quality of services to meet the needs of Members.
• Worked with treatment teams to maintain coverage, monitor quality issues, and provide assistance
through in-service or information to Providers as needed.
• Analyzed utilization, referral and claims information, gathered statistical data, worked closely
with physicians.
• Responsible for monthly reporting of denials, appeals, UM trends, as well as daily summary of UM
activity.
• Sit on Departmental and Interdepartmental committees and meetings, including Utilization Review
Committee, Pharmacy, QM/CM, software and Policy/Procedures.
• Coordinated systems necessary for safe and appropriate discharge as well as utilization
management practices
• Collaborated with other teams to coordinate care for patients in the Hospital and upon discharge.
02.2012 – 09/2013: Brown and Toland, San Francisco, California
Lead UM/Care Manager
• Assisting UM/Care Managers with complicated patient assessment and utilization management
• Served as a liaison between B&T and facilities’ care managers and patients
• Planning, implementing, coordinating, monitoring and evaluating the options and services
necessary to meet the member’s health needs across the care continuum and to provide quality
cost-effective outcomes
• Daily problem solving
• Assuring that members are at the appropriate level of care from admission through discharge and
are provided a timely discharge planning
• Communicating with health care providers to insure seamless transition of patients to appropriate
levels of care and rendering of necessary services in a timely manner.
• Participated in patients/family meetings to coordinate discharge planning and follow up care
12.2010 – 02.2013: Kaiser Permanente, San Francisco, California
Care Coordinator / Case Manager/ Discharge Planner
• Performing daily admission and concurrent Utilization Reviews using “Midas” guidelines.
• Coordinating health care services to meet patient’s individual needs.
• Monitoring the progression of the plan of care and facilitate discussion with multidisciplinary
team
• Providing information to patients, families, physicians regarding the provisions of care
• Ensuring continuity of care through communication in rounds and written documentation
• Meeting with the patients and families to coordinate discharge planning and follow-up care.
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2. Veronica V. Peraza | Registered Nurse | MSN
09.2008 – 11.2010: El Camino Hospital, Mountain View, California
Case Manager / UR Manager
• Responsible for clinical operations for the Utilization Management Department, assisting in the
coordination of all medical activities involving UM related functions.
• Responsible for UM and CM to ensure efficient healthcare to Members, maintaining
turnaround times, as well as meeting and/or exceeding parameters set by the Health plans and
regulatory guidelines.
• Reviewed network coverage, ensuring high quality of services to meet the needs of Members.
• Worked with treatment teams to maintain coverage, monitor quality issues, and provide assistance
through in-service or information to Providers as needed.
• Analyzed utilization, referral and claims information, gathered statistical data, worked closely
with physicians.
• Responsible for monthly reporting of denials, appeals, TARs, UM trends, as well as daily
summary of UM activity.
• Sit on Departmental and Interdepartmental committees and meetings, including Utilization
Review Committee, Pharmacy, QM/CM, software and Policy/Procedures.
• Coordinated systems necessary for safe and appropriate discharge as well as utilization
management practices
• Collaborated with other teams to coordinate care for patients in the Hospital and upon discharge.
• Participated in patients/family goals meeting to coordinate discharge planning and follow-up care.
02.2010 – 09.2010: Santa Clara County Jail, San Jose, California
Assessme nt / Booking Nurse / Shift Supervisor (Per Diem)
• Coordinate/Supervise the entire patient care team during the shift to ensure
effective and efficient delivery of healthcare services to inmates.
• Answering emergency calls of inmates and performing procedures
according to the protocol.
Organize and assign staff .
01.2008 - 09.2008: V.A. Hospital, Palo Alto, California
Behavioral Health Unit Nurse Manager
• Responsible for administration and evaluation of nursing care, program implementation, personnel
management and overall operations in collaboration with Ambulatory
Specialty Clinics
• Responsible for delivery of quality patient care, including documentation, demonstration
of clinical competence and continuous Quality Improvement Projects.
• Responsible for direct coordination of staffing, supplies and equipment for nursing services
• Established policies and procedures, administration of the Acute Inpatient Behavioral Health
Unit in accordance with the Joint Commission and VA Policy. Responsible for monitoring
compliance of these policies.
• Works with Nursing Education Department and Ambulatory Care Program Specialists
to identify and promote staff development and enhance staff competencies.
• Collaborated with the Medical Director for Program Development
• Collaborated with the Interdisciplinary Team in planning, directing and implementing
patient care.
• Responsible for overall administration and supervision of Acute Locked Psychiatric
Unit nursing staff.
• Participated in outpatient research programs.
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3. Veronica V. Peraza | Registered Nurse | MSN
10.2005 - 05.2008: Saint Francis Memorial Hospital, San Francisco,
California
Behavioral Health / Conscious Sedation Nurse (Per Diem)
• Admitting patients for the chronic pain manage m e nt procedures, including
spinal nerve stimulator trial and epidural injections.
• Assisting physicians, administering conscious sedation and monitoring
patients during procedures.
02.2004 - 05.2009: Health South Surgery Center, San Jose, California
Operating Room / Recovery Registered Nurse
• Patient care during immediate preoperative, intra- operative and
postoperative phases.
• Scrubbing and circulating during various outpatient surgeries.
• Recovering patients after various plastic surgeries.
• Patient, family teaching.
• Wrote CPG (Clinical Practice Guidelines) for numerous outpatient surgeries.
08.2005 - 12.2005: San Quentin State, San Quentin, California
(internship)
• Patient care in Psychiatric and Emergency clinic, patient education,
participating in psychotherapy groups.
• Wrote new clinical practice guidelines for patient’s care in the prison
setting according to court orders.
• Created insulin administration protocol and education material for diabetic
02.2003 - 01.2004: California Pacific Medical Center, San Francisco, California
Operating Room / Transplant Registered Nurse
• Patient care on the transplant/step down unit .
• Patient care during immediate preoperative and intra- operative phases .
• Patient family teaching.
11.2001 - 09.2003: UCSF Medical Center, San Francisco, California
Operating Room Patient Care Assistant
• Assembled, arranged and connected surgical equipment for surgical
procedures (cases) .
• Assisted nurses with instruments, supplies and equipment during cases .
• Delivered blood products and specimens to the Laboratories .
• Assisted recovery room nurses .
• Transported patients.
12.1998 - 09.2001: ORACLE, Redwood Shores, California
QA Team Lead — Company specializes in outsourced electronic document
delivery providing its customers with the ability to reach thousands of recipients
with high volume email and IP fax broadcasting.
• Participated hands on in every aspect of the product testing .
• Interviewed, hired, trained and mentored a group of 3 QA Engineers .
• Prepared the document standards and document workflow .
• Provided strong QA leadership to create a dynamic, highly productive and
integrated QA team .
• Worked with engineering team to define testing accountability and testing
criteria on new and existing projects.
• Managed test tasks and project demands in order to meet project deadlines.
09.1996 - 11.1998: Biotherapy Clinic, San Francisco, California
Nutrition Counselor Assistant
• Provided administrative support for a Nutrition Counselor.
• Collected and recorded patient information and nutritional history.
• Prepared patients for medical procedures
• Maintained medical records.
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4. Veronica V. Peraza | Registered Nurse | MSN
05.1987 - 12.1989: Navy Veterans Hospital, Moscow, Russia
Operating Room / Recovery Room Nursing Aide
• Assisted MDs and RNs in Operating room during various procedures
• Carried out patient care procedures for patients in Post Anesthesia/Recovery
room .
• Assisted RNs in performance of wound care .
• Assisted patients with personal hygiene and ADLs.
• Communicated with patients’ relatives.
• Refilled and organized medical supplies cabinets.
Educatio
n
06.2003 - 12.2003 (Certificate) CPMC RN OR Training Program Certified by
AORN 2002
2001 - 2005 MSN (RN) - University of San Francisco, California
1995 - 1998 BS - San Jose State University, San Jose, CA
1990 - 1994 College of San Mateo, San Mateo, California
ACLS, BLS certification
References provided upon request.
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