Dalceneia Calzado Adamos, RN
Pateros Manila,Manila
Summary
Dedicated healthcare professional with a robust background in quality assurance and clinical education. Designed and implemented effective training programmes, leading to improved staff performance and patient care standards. Committed to continuous improvement in healthcare delivery through strategic collaboration and innovative training solutions.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Training and Quality Specialist
Shearwater Health Philippines
Taguig, Philippines
04.2025 - Current
- Identify training needs by analysing quality metrics, performance audits, and team KPIs (Key Performance Indicators).
- Developed comprehensive training programmes and facilitated sessions using proven learning techniques.
- Create training materials, manuals, and classroom handouts. Conduct onboarding, new hire training, and upskilling sessions.
- Monitor employee work behavior and performance through audits, ensuring consistency and accuracy.
- Maintain documentation for audits, ensure compliance with quality standards, and update training programs when processes change.
- Provided feedback to team members and management based on quality audits, identifying gaps for targeted training.
- Review ongoing processes and suggest improvements based on audit results to enhance efficiency and customer experience.
- Collaborated with Subject Matter Experts (SMEs) to design programme syllabuses that meet learning objectives.
- Evaluated learning outcomes against business needs and implemented plans aligned with objectives.
- Facilitated conferences, meetings and demonstrations for [Type] guests.
Utilization Review Nurse
Calibrated Healthcare
Taguig City, Manila
07.2024 - 03.2025
- Developed excellent working knowledge of industry trends and improvements in processes.
- Prepared a range of written communications, documents and reports.
- Worked alongside team members to meet specific performance targets.
- Developed project plans and set clear deadlines for timely completion.
- Supported colleagues with diverse responsibilities to improve team collaboration.
- Built and maintained courteous and effective working relationships.
Skills Preceptor/Clinical Instructor
HCT Academy
Pasig City
02.2024 - 10.2024
- Guided and instructed clinical nursing students on effective patient care techniques to foster their professional development
- Evaluated student performance against established criteria and delivered constructive feedback to advance clinical practice
- Demonstrated strong clinical expertise and knowledge to effectively assess and evaluate student performance in the clinical setting
- Served as a mentor and role model for students, providing guidance and support throughout the clinical rotation
- Developed and implemented clinical educational programmes that enhanced nursing students' knowledge and skills in the clinical setting
Clinical Coordinator
Conifer
Taguig
08.2023 - 02.2024
- Oversaw daily operations of clinical care team, providing guidance and direction to enhance team effectiveness and patient care delivery.
- Possessed extensive experience in developing and implementing patient care plans as a Clinical Coordinator in a fast-paced, high-volume healthcare setting
- Supervised and trained staff members on best practices in medical field, fostering a culture of continuous improvement and high-quality care.
- Demonstrated ability to effectively communicate with all levels of staff, physicians, and other healthcare professionals
- Executed accurate data entry and documentation of patient encounters, ensuring compliance with regulatory standards and improving record-keeping efficiency
Clinical Documentation Specialist
Accenture
Taguig
06.2022 - 08.2023
- Evaluated clinical documentation to ensure accuracy and compliance with established standards
- Performed clinical documentation improvement activities, enhancing accuracy and completeness of patient records
- Developed and implemented workflow processes to improve documentation accuracy and completeness
- Collaborated with medical staff, facilitating timely completion of patient documentation
- Trained and mentored new Clinical Documentation Specialists on documentation guidelines, ensuring adherence to standards
Accounts Receivable Specialist
Omega Healthcare
Pasig City
01.2022 - 06.2022
- Managed accounts receivable for 200+ clients, ensuring accurate payment recording and minimising discrepancies
- Processed 1000+ invoices monthly, maintaining accuracy and ensuring prompt payment
- Monitored customer payment patterns to facilitate timely collection of receivables
- Developed and implemented efficient and effective process for collection of outstanding receivables
- Resolved customer inquiries, disputes and complaints in a timely and professional manner
Prior-Authorization Nurse
Acess Healthcare
Taguig
07.2021 - 01.2022
- Use clinical nursing judgment to evaluate patient data, provider records, and diagnostic information as well as structured frameworks for making determinations
- Reviewed requests for medical treatments and services to assess insurance qualification
- Reviewed the authorization to verify compliance with regulations, requirements, and contractual obligations of all parties involved
- Communicated with insurance providers to gather additional information
- Coordinated with administrators and healthcare providers to secure necessary information and ensure patients received authorised care
Utilization Review Nurse
Carelon(Legato Health)
Taguig
09.2019 - 05.2021
- Developed, implemented, and monitored utilisation review plans to enhance service delivery and patient outcomes
- Experienced in utilising evidence-based guidelines to determine medical necessity and appropriateness of services
- Reviewed medical records and provided utilisation review services, ensuring compliance with health insurance guidelines
- Utilised various medical databases to research and analyse medical records, supporting informed decision-making in patient care
- Proven ability to collaborate with medical staff to ensure quality, cost-effective care
Medical Coder
SCORP Philippines/LEXICODE-Exela Technologies
Olongapo City
02.2019 - 08.2019
- Coded and processed over 500 medical claims monthly for diverse clients, ensuring compliance with coding standards
- Collaborated with physicians and healthcare professionals to ensure precise and timely coding of medical records, enhancing documentation quality
- Developed and implemented efficient coding processes that improved accuracy and productivity
- Maintained up-to-date knowledge of medical coding rules, regulations and changes
- Maintained accurate patient medical records in compliance with HIPAA regulations, safeguarding patient confidentiality
HEDIS Abstractor
Shearwater Health
Taguig
09.2017 - 12.2018
- Reviewed patient files, documented diagnoses and treatments, and assigned codes to data in alignment with HEDIS domain of care.
- Conduct a detailed review of medical charts and insurance claims for hospitalizations, medical office visits, and other procedures
- Organised patient records, identifying relevant data for HEDIS measures to ensure compliance and quality of care.
- Assessed quality of care measures defined by NCQA for the HEDIS audit.
- Created written communications and reports to convey key information effectively to stakeholders.
Clinical Instructor
Gordon College
Olongapo City
06.2006 - 03.2009
- Developed and delivered targeted teaching sessions enhancing understanding of clinical specialty
- Evaluate students' clinical performance and provide feedback
- Guided medical students and health professionals in clinical skills and knowledge application
- Collaborated with clinical instructors and medical staff to implement best practice standards
- Maintain patient confidentiality and adhere to relevant professional regulations
Staff Nurse
James L. Gordon Memorial Hospital
Olongapo City
08.2004 - 03.2007
- Provided safe, effective, and compassionate care to diverse patient population at ABC Hospital
- Collaborated with other healthcare professionals to develop and implement individualized patient care plans
- Supported physicians in patient care through administration of medications and treatments
- Documented patient histories, vitals, and lab results using EMR systems
- Actively managed patient flow to ensure timely access to care
- Demonstrated expertise in anticipating and responding to emergent clinical situations
Education
Master of Arts - Nursing
Bataan Peninsula State University
Bataan06-2006
Bachelor of Science - Nursing
St. Jude College
Metro Manila04-1995
Secondary Education High School -
St. Joseph's School
Olongapo City04-1991
Skills
- EMR/EHR
- Epic
- Cerner
- AthenaNet
- EClinical Works
- Practice Fusion
- In-House Medical Encoding
- HEDIS Measures
- NASCO
- Order Facilitator
- Technical Literacy
- System
- Software/Tools
- Microsoft proficiency
- MS Office
- Indexing
Affiliations
- Philippine Nurses Association, Active Member
- SIX SIGMA PH
- CCSWB
Languages
English
Tagalog
References
- Leslie Gonzales, Accenture Inc., 09209760914
- Mario L. Cabral Jr., Shearwater Health, 09562112190
- Maribel Gagelonia, Brgy Kaypian, San Jose Del Monte, Bulacan, 09203055576
Certification
- Certified Professional Coder- AAPC
- BLS/ACLS provider- AHA Certified
Accomplishments
- Streamlined workflow by consolidating lengthy processes and redundant documentation that resulted in more effective and timely completion of projects.
Hobbies and interests
- Playing guitar, Singing Karaoke and Watching Netflix movies
Timeline
Training and Quality Specialist
Shearwater Health Philippines
04.2025 - Current
Utilization Review Nurse
Calibrated Healthcare
07.2024 - 03.2025
Skills Preceptor/Clinical Instructor
HCT Academy
02.2024 - 10.2024
Clinical Coordinator
Conifer
08.2023 - 02.2024
Clinical Documentation Specialist
Accenture
06.2022 - 08.2023
Accounts Receivable Specialist
Omega Healthcare
01.2022 - 06.2022
Prior-Authorization Nurse
Acess Healthcare
07.2021 - 01.2022
Utilization Review Nurse
Carelon(Legato Health)
09.2019 - 05.2021
Medical Coder
SCORP Philippines/LEXICODE-Exela Technologies
02.2019 - 08.2019
HEDIS Abstractor
Shearwater Health
09.2017 - 12.2018
Clinical Instructor
Gordon College
06.2006 - 03.2009
Staff Nurse
James L. Gordon Memorial Hospital
08.2004 - 03.2007
Master of Arts - Nursing
Bataan Peninsula State University
Bachelor of Science - Nursing
St. Jude College
Secondary Education High School -
St. Joseph's School