Jean Sarah Maria Magsambol
Salinas
Summary
Highly adaptable Utilization Review Nurse dedicated to providing exceptional skills in the hospital case environment. Smart and bilingual with developed interpersonal and time management skills. Seeking challenging role in setting devoted to quality patient care. Skilled utilization review nurse offering talents in continuous assessments and clinical records oversight. Pleasant individual with several years in the nursing field. Ready to join new company that appreciates attention to detail and exemplary clinical review skills.
Motivational Supervisor with many years of experience monitoring, coordinating and allocating employee efforts to achieve organizational goals. Proven track record with continuous improvement, performance growth, and schedule management.
Offering strong foundation in leadership and team coordination, with passion for learning and developing in supportive environment. Contributes proactive approach to problem-solving and conflict resolution, combined with ability to quickly grasp new concepts and procedures. Ready to use and develop communication and organizational skills in Staff Supervisor role.
Energetic Supervisor successful at motivating and building positive team dynamics to accomplish aggressive goals. Dedicated to open, communicative culture where employees feel empowered to contribute to company's success.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Supervisor/Staff
Swaner Guest Home Inc
02.2023 - Current
- Provided compassionate and personalised care to patients in their homes, ensuring their comfort and well-being
- Assisted with activities of daily living (ADLs) such as bathing, grooming, dressing, and toileting
- Administered medications according to prescribed schedules and documented patient responses
- Monitored vital signs including blood pressure, pulse rate, temperature, and oxygen saturation levels
- Managed medical equipment and supplies inventory to ensure availability for patient needs
- Collaborated with healthcare professionals to develop and implement individualised care plans for patients
- Documented patient observations accurately and timely in accordance with established protocols
- Provided emotional support to patients and their families during challenging times
- Performed light housekeeping duties including cleaning, laundry, meal preparation, and grocery shopping for clients
- Maintained a clean and organised environment in the client's home to promote health and safety standards
- Collaborated effectively with interdisciplinary teams including nurses, therapists, social workers, etc
- Implemented new protocols and procedures to improve efficiency and ensure compliance with regulatory standards
- Managed a team of residential staff members, providing guidance and support to ensure efficient operations
- Implemented new scheduling system that improved staff coverage and reduced overtime expenses
- Developed and implemented training programs for new hires, resulting in a decrease in on boarding time
- Oversaw the maintenance and repair of residential properties, ensuring timely completion of work orders
Utilization Review RN
Akua Behavioral Health, Inc.
07.2020 - 06.2023
- Analyse the condition of each patient carefully and decide if the patient still needs to stay in the facility
- Examining medical treatments and interventions to avoid payment denial and optimizing reimbursements by assessing the treatment’s appropriateness, effectiveness, timing, and setting.
- Concurrent review for patient's continued stay in the facility
- Examine treatment plans with a critical eye.
- Medical approval for new admissions
- collaborate with other nurses, physicians, and health care providers while searching for essential information to confirm the patient’s insurer authorizes services.
- works with insurance companies to provide preauthorization information.
QA/QI Pre billing
Ambulnz
08.2017 - 05.2020
- Review Patient Care Report (PCR), sending suggested revision that needs to be made by the EMTs to make sure it passed the insurance protocol
- Forwarding charts to billing once passed
- Assessing of medical necessity of the patient
Customer Support Specialist
Concentrix
08.2014 - 06.2017
- Customer support and Technical Support for an android phone company
- Filing claims and tickets, troubleshooting and general care
Customer Support Specialist
Teletech
01.2012 - 12.2014
- Customer Support Specialist - Telecommunication campaign (US based) handling customer queries, basic troubleshooting, billing issue, filing claims, general care
Education
Master of Science - Nursing
St. Paul University
Tuguegarao, City01-2025
Bachelor's - Nursing
Cavite State University
Indang, Cavite05.2005
Skills
- CRM tools
- HIPAA-certified
- Billing issues
- Account management
- Problem analysis
- Quality assurance
- Detail-oriented
- Problem solving
- Critical thinking
- Microsoft Office
- Medical chart review
- Schedule development
- Complex Problem-solving
- Decision-making
- Documentation and reporting
- Goal oriented
- Verbal and written communication
- Staff management
- Task delegation
- Training and mentoring
- Strategic planning
- Inventory control
- Staff development
- Attention to detail
- Employee motivation
- Staff discipline
- Analytical thinking
- [Software] experience
- Coaching and mentoring
- Safety protocols
- Task prioritization
- Organizational development
Languages
English
Professional
Education
Indang, Cavite,Calamba City,Laguna
Contact
Salinas, CA 93906
Certification
- Assisting with Medication San Andreas Regional Center Oct 29, 2024
- Restricted Health Care Condition San Andreas Regional Center Oct 25, 2024
- Metabolic Syndrome Management of Adult-Onset Diabetes Emmanuel Pascua RN, BSN, MBA Nov 11, 2024
- Person-Centered Thinking San Andreas Regional Center Feb 22-23 2024
- Home Management of Individual after Post Inguinal Hernia Surgery Emmanuel Pascua RN, BSN, MBA April 15, 2024
- Residential Services Orientation San Andreas Regional Center Nov 4-6, 2024
- Dysphagia San Andreas Regional Center January 13, 2025
Timeline
Supervisor/Staff
Swaner Guest Home Inc
02.2023 - Current
Utilization Review RN
Akua Behavioral Health, Inc.
07.2020 - 06.2023
QA/QI Pre billing
Ambulnz
08.2017 - 05.2020
Customer Support Specialist
Concentrix
08.2014 - 06.2017
Customer Support Specialist
Teletech
01.2012 - 12.2014
Bachelor's - Nursing
Cavite State University
Master of Science - Nursing
St. Paul University
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