JOYCE BERNADETTE AGLUBA
Quezon city
Summary
USRN with 8+ years of experience supporting healthcare operations, clinical documentation review, utilization management, and quality assurance across U.S. and Australian healthcare systems. Experienced in coordinating documentation follow-up, tracking compliance requirements, supporting operational workflows, and maintaining audit-ready records within EMR platforms. Strong attention to detail with proven ability to manage time-sensitive workflows, communicate across teams, and support structured healthcare operations in remote environments.
Overview
2024
2024
years of professional experience
1
1
Certification
Work History
Clinical QA & Documentation Reviewer (Project-Based)
Hazel & Coastal Homecare
Remote
- Analyzed and verified client documentation for accuracy and compliance, ensuring adherence to industry regulations and best practices.
- Streamlined processes for extracting and verifying care plan data, ensuring compliance with documentation standards.
- Ensured meticulous organization of records to uphold audit readiness and assist in compliance evaluations.
- Evaluated existing documentation and facilitated prompt updates to reflect changes in services.
- Monitored and managed documentation tracking systems to optimize healthcare workflow efficiency.
- Managed time-sensitive follow-up tasks to ensure efficient documentation and effective care coordination.
Quality Assurance Review
By Your Side Homecare
- Audited client charts using structured compliance checklists aligned with program requirements.
- Verified service agreements, assessments, care plans, and required onboarding documentation.
- Ensured records met audit criteria, including supervisory visit compliance and DSR completeness.
- Tracked missing documentation and coordinated follow-up prior to review deadlines.
- Supported workflow coordination and documentation accuracy across home care operations.
- Communicated documentation updates and compliance requirements with operational teams.
Team Leader - Utilization Management
Shearwater Health
- Reviewed patient charts within EMR systems for documentation accuracy and clinical guideline alignment.
- Conducted quality checks on case reviews prior to submission within high-volume workflows.
- Tracked workflow performance, turnaround times, and SLA adherence across operational processes.
- Coordinated documentation follow-up with clinical teams to ensure workflow completion.
- Supported reporting and tracking of operational metrics for healthcare program performance.
- Assisted remote healthcare teams through structured workflow support and escalation handling.
Quality Analyst
Shearwater Health
Taguig, Metro Manila, Philippines
09.2022 - 11.2023
- Analyzed clinical workflows and documentation through routine audits, identifying areas for improvement in compliance and accuracy.
- Analyzed documentation processes to pinpoint risks, inconsistencies, and workflow gaps requiring timely escalation.
- Developed and enforced standardized procedures for audits and reporting to ensure consistent workflow outcomes.
- Oversaw comprehensive operational reporting and documentation tracking, ensuring accuracy and accessibility for healthcare teams.
- Organized and updated documentation records systematically to facilitate audit readiness and streamline workflows.
Senior Healthcare Support Executive (Team Lead)
HCL Technologies
04.2018 - 08.2022
- Managed documentation review, claims validation, and healthcare issue resolution workflows.
- Maintained organized records and verified compliance with documentation standards.
- Coordinated workflow follow-up and issue resolution across operational teams.
- Supported healthcare operations through structured documentation and reporting processes.
- Assisted teams in maintaining workflow accuracy within deadline-driven environments.
Utilization Review Nurse
EXL Services
03.2016 - 04.2018
- Reviewed patient records and extracted clinical data for medical necessity determinations.
- Ensured documentation aligned with payer guidelines and submission requirements.
- Maintained high documentation accuracy within deadline-driven healthcare workflows.
- Identified incomplete documentation requiring escalation and operational follow-up.
- Supported utilization management workflows through accurate EMR documentation review.
Education
Bachelor of Science - Nursing
Delos Santos STI College
Quezon City, Metro Manila, Philippines10-2008
Skills
- Clinical Support Operations
- Documentation Review & Validation
- EMR/EHR Documentation
- Healthcare Workflow Coordination
- Audit Readiness & Compliance
- Care Plan & Clinical Chart Review
- Operational Follow-Up & Escalation
- Utilization Management
- Cross-Functional Communication
- Time-Sensitive Workflow Management
Certification
- US Registered Nurse (New York)
- Philippine Registered Nurse
Timeline
Quality Analyst
Shearwater Health
09.2022 - 11.2023
Senior Healthcare Support Executive (Team Lead)
HCL Technologies
04.2018 - 08.2022
Utilization Review Nurse
EXL Services
03.2016 - 04.2018
Quality Assurance Review
By Your Side Homecare
Team Leader - Utilization Management
Shearwater Health
Clinical QA & Documentation Reviewer (Project-Based)
Hazel & Coastal Homecare
Bachelor of Science - Nursing
Delos Santos STI College