Microsoft Outlook
Anna Mae Ibanez
Iloilo City
Summary
Compassionate service registered nurse with distinguished understanding of nursing and hospital functions. Develop comprehensive pre and post-treatment plans with patients and doctors for quality healthcare of acute orthopedic surgery patients. Committed to patient safety and advocacy. Efficient and trustworthy registered nurse with 9 years and 7 months of experience. Successful at providing fast and accurate assessments and working calmly under pressure.
Dependable Utilization Review Nurse promoting over 9 years of expertise in healthcare industry. Knowledgeable in admissions and stay reviews.
Hands-on professional proudly offering more than 9 years of expertise in nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight and performance improvement.
Smart Utilization Review Nurse considered critical thinker and problem-solver due to dynamic patient care planning and understanding of Medicare guidelines. Known for having great rapport with providers and insurance carriers.
Reliable individual bringing 9 years of experience in healthcare environments. Maintains positive relationships with case managers and providers. Remains polished and calm under extreme stress.
Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Patient-oriented Nurse with 9 years of diverse experience in direct patient care, staff supervision and department operations. Skilled at multitasking and prioritizing patient needs and daily assignments. Offering expertise with Secondary Review specialty.
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.
Tech-savvy innovator with hands-on experience in emerging technologies and passion for continuous improvement. Skilled in identifying opportunities for technological enhancements and implementing effective solutions. Adept at leveraging new tools and methods to solve problems and enhance productivity. Excels in adapting to fast-paced environments and driving technological advancements.
Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level registered nurse position. Ready to help team achieve company goals.
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Graduate with foundational knowledge in nursing and hands-on experience gained through academic projects and internships. Demonstrates strong teamwork, problem-solving, and time-management skills. Prepared to start career and make meaningful contributions with commitment and drive.
Innovative technology professional with several years of diverse experience. Skilled in enhancing systems and aligning technical solutions with business objectives. Proven success in leading projects from start to finish and contributing to organizational growth and success.
Dynamic individual with hands-on experience in nursing and talent for navigating challenges. Brings strong problem-solving skills and proactive approach to new tasks. Known for adaptability, creativity, and results-oriented mindset. Committed to making meaningful contributions and advancing organizational goals.
Overview
12
12
years of professional experience
1
1
Certificate
Work History
Utilization Review Nurse - Secondary Reviewer
Shearwater Health Advisors
02.2024 - Current
- Performed admission reviews based for medical necessity based upon In patient admission specification.
- Obtained authorizations from multiple insurance carriers including Highmark BCBS for various levels of care.
- Devise or identify solutions for irregular requests and issues.
- Supervised and maintained all utilization review documentation through MCG.
- Performed admission reviews based for medical necessity based upon In-patient specification.
- Facilitated workgroup meetings with medical personnel to find effective solutions to issues.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Supervised and maintained all utilization review documentation through MCG.
- Performed prior authorization Secondary Review of services requiring notification for Care Managers.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
Staff Nurse 1: Orthopedic Surgery Department – Male Surgical 4
Al Hada Armed Forces Hospital
11.2013 - 10.2021
- Carefully follow the 6 International Patient Safety Goals.
- Monitor and manage various treatment and care interventions.
- Update physicians on patient condition, progress, test results and assist in developing care plans.
- Performs blood and blood product transfusions and intravenous infusions to address patient symptoms or underlying causes.
- Monitor and record patient condition, vital signs, and recovery progress.
- Administer medications, track dosages and document patient conditions, monitoring responses for adverse reactions and medication side effects.
- Train and mentor new RN hires, student nurses and ancillary staff members on best practices, hospital policies and standards of care, to meet patient service goals, champion standards of care and improve patient overall satisfaction.
- Assist patients with healing and recovery after surgery by closely monitoring and caring for wounds and contraptions, care of traction and cast, answering questions and educating about continued care strategies.
- Prioritize nursing tasks and assignments and accurately reported patient status.
- Counsel patients and caregivers, providing emotional, psychological and spiritual support.
- Maintain personal and team compliance with medication administration standards and patient care best practices.
- Treat patients using pharmacological and non-pharmacological treatment modalities to address various disorders, diseases and injuries.
- Improve patient outcomes and quality of care by determining and suggesting changes to processes.
- Collaborate with doctors to plan post-treatment home care and prevent return hospitalization.
- Develop and adapt individualized treatment plans according to patient recovery goals.
- Used feedback and clinical data to improve care quality and patient outcomes.
- Monitor and educate nursing students and medical interns on proper care procedures and prioritization strategies.
- Act as patient advocate and implemented total patient care through team nursing process.
- Deliver high-quality nursing care to patients on 14-bed medical-surgical unit.
- Reach out to patients to convey laboratory results and provide care instructions.
- Facilitate patient flow during emergency situations, directing evacuations, admissions and transfers.
- Conduct post-operative reviews, tracked patients' vitals and monitored fluids to reach optimal care targets.
- Counsel caregivers and families on end-of-life planning and educated on patient care options.
- Advance nursing competencies through participation in simulation exercises and practice improvement projects.
- Maintain optimal ventilator settings and operations to meet patient care needs.
- Coordinate and manage care for patients undergoing myocardial infarction screening and anticoagulation therapies.
- Develop and maintain quality care systems and standards and implement medical protocols and guidelines.
- Supervise staff of 3 nurses, delegating assignments and monitoring quality of care.
- Plan and spearhead in-service educational programs focusing on fall safety, contraptions and skin care and adherence to core measures.
- Conduct restraint audits according to organizational guidelines and generate reports for nursing leadership review and analysis.
- JCI, CBAHI, and NDNQI accredited
- Telephone +966 12 754 1610, Fax +966 12 754 1328
Education
Bachelor of Science - Nursing
St. Anthony College
Roxas City, Philippines03.1994
Skills
- Charge nurse and staff nurse rotation
- Nursing staff leadership
- Staff development and preceptorship
- Orthopedic surgery acute patient pre and post - surgery care and management
- Vascular care understanding
- NDNQI Pressure Injury representative
- Wound care nurse representative
- Nurse auditor for medical records
- Department nurse representative for preventive medicine
- Immunization skills
- Strong medical ethics
- Bi – lingual in English and Arabic
- Culturally – sensitive care
- IV therapy and venipuncture certified
- BLS certified – American Heart Association
- ACLS certified – Saudi Heart Association
- Life-sustaining machines
- Handling ventilated patients
- SBAR communication
- Electronic health records management
- Medical and surgical patient management
- Patient admission and discharge
- Thorough nursing assessment
- Nursing care planning from admission to discharge
- Healthcare consultation and referral
- Medications, blood transfusion, IV drug therapy and chemotherapy administration
- Patient and family education and counseling
- Patient and family support
- Coordinating referrals and collaboration with multidisciplinary team
- Pain Management
- Care of traction and cast
- Infectious disease control
- Gastrostomy tube care
- Tracheostomy care
- Seizure management
- Diabetes management
- ELNEC training (End-Of-Life-Care)
- Interpersonal and written communication
- Patient care plans
- Communication
- Utilization review
- Performing assessments
- Documentation and reporting
- Medical coding
- Quality improvement
- Discharge planning coordination
- Utilization management
- HIPAA compliance
- Needs assessment
- Medicare
- Records analysis
- Plan of care support
- Inpatient care
- Discharge planning
- Patient transfers and transitions
- Physician consultations
- Compliance procedures
- Insurance verification
- Healthcare regulations
- Clinical assessment
Software
Microsoft Teams
MCG
TalentLMS
FortiClient VPN
VMware Horizon
Predictal
Certification
- New York Board of Nursing – United States of America Registered Nurse License Number 835181 valid until 05/31/2028 Unencumbered.
- District Of Columbia Board of Nursing - United States of America Registered Nurse License Number RN500006558 valid until 05/31/2027 Unencumbered.
- Delaware Board of Nursing - United States of America Registered Nurse License Number L1-0073666 valid until 09/30/2027 Unencumbered
- Professional Regulation Commission - Philippines Registered Nurse License Number 0252745 valid until 05/03/2027.
- Saudi Commission for Health Specialties - Saudi Arabia Registered Nurse License Number 14-T-N-0009596 valid until 2022-08.
Languages
English
Advanced (C1)
Arabic
Intermediate (B1)
Timeline
Utilization Review Nurse - Secondary Reviewer
Shearwater Health Advisors
02.2024 - Current
Staff Nurse 1: Orthopedic Surgery Department – Male Surgical 4
Al Hada Armed Forces Hospital
11.2013 - 10.2021
Bachelor of Science - Nursing
St. Anthony College
Photography and Travel
Work-life balance is an integral part for my overall well being. I believe I can see the soul through my lens. That is why I like to travel and take photographs, it balances my sanity.