JOHN CARL TULAWIE, RN, BSN
Durham,NC
Summary
Registered Nurse with strong experience in acute care, long-term care, utilization management, and medical coding. Skilled in-patient assessment, care coordination, InterQual/MCG criteria, and accurate clinical documentation. Committed to delivering safe, evidence-based care and supporting interdisciplinary teams.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Clinical Nurse 2
Duke University Hospital
Durham, NC
01.2024 - Current
- Delivered high-acuity patient care, conducted assessments, administered medications, documented care, and collaborated with interdisciplinary teams to enhance patient outcomes.
- Administered medications and monitored responses for safety.
- Assessed patient conditions and documented findings in electronic health records.
- Delivered bedside care on Duke University Hospital inpatient units.
Staff Nurse
Carver Living Center
Durham, NC
11.2022 - 12.2023
- Provided long-term and rehab patient care, monitored patient conditions, administered medications, performed wound care, and verified compliance with facility protocols to support recovery and well-being.
- Delivered personalized nursing care to residents at Carver Living Center
- Distributed prescribed medications and observed resident reactions during daily nursing shifts
- Evaluated resident health conditions and communicated changes to healthcare team members
Utilization Management Nurse
Shearwater Health
01.2016 - 09.2022
- Reviewed clinical documentation for medical necessity, applied InterQual/MCG criteria, and coordinated with providers and payers to ensure regulatory compliance.
- Performed concurrent utilization reviews for inpatient and outpatient cases.
- Reviewed medical necessity using payer guidelines for health plan clients.
- Completed prior authorization requests within Shearwater Health clinical review workflows.
Senior Clinical Reader / Medical Coder
Change Healthcare
03.2017 - 01.2020
- Coded outpatient charts using ICD-10-CM, CPT, and HCPCS guidelines.
- Reviewed charts, abstracted diagnoses, and coded ICD-10 to ensure accurate documentation and support HEDIS compliance.
- Reviewed clinical documentation for accurate claim submission in change healthcare revenue cycle systems.
- Applied payer policies and federal coding standards during record review.
Healthcare Customer Service Agent
Hinduja Global Solutions – Cigna Medical
01.2015 - 03.2017
- Assisted Cigna Medical members with eligibility, benefits, and claim questions.
- Managed client inquiries, verified eligibility, explained policies, ensured service quality.
- Resolved inbound service requests using Cigna procedures and guidelines.
- Documented customer interactions in Hinduja Global Solutions call systems.
Staff Nurse
Sulu Sanitarium
Jolo, Sulu
01.2013 - 12.2013
- Coordinated admissions and discharges, assessed patient needs, implemented individualized care plans, and maintained accurate patient charts.
- Provided nursing care to residents at Carver Living Center daily.
- Administered medications and monitored resident responses.
- Documented assessments and care notes in nursing records.
Medical Ward Nurse
IPHO – Sulu Provincial Hospital
01.2011 - 05.2012
- Delivered direct patient care, monitored patient conditions, educated patients on health management, and maintained accurate medical records.
- Monitored ward patients at Sulu Provincial Hospital and recorded vital signs.
- Administered prescribed medications under IPHO nursing protocols.
- Assisted physicians during rounds and at bedside examinations.
Education
Bachelor of Science in Nursing (BSN) -
Notre Dame of Jolo College
Jolo, Sulu01-2010
Skills
- Patient Assessment
- Medication Administration
- Acute Care
- Care Coordination
- InterQual/MCG
- Clinical Documentation
- Clinical Coding
- HIPAA Compliance
- Interdisciplinary Collaboration
- Patient education
- Patient Education
Certification
- North Carolina Nursing License — No. 351034 10/28/2022 – 12/31/2027
- California Nursing License — No. 95473405 08/19/2026 – 01/31/2028
- Texas Nursing License — No. 1007937 08/04/2020 – 12/31/2027
- Philippine Professional Regulation Commission License — No. 0752747 04/12/2012 – 12/15/2028
TRAINING
- Basic Life Support (BLS) — 01/30/2026 – 01/2028
- Non-Violent Crisis Intervention Training — 10/08/2025 – 10/08/2027
Timeline
Clinical Nurse 2
Duke University Hospital
01.2024 - Current
Staff Nurse
Carver Living Center
11.2022 - 12.2023
Senior Clinical Reader / Medical Coder
Change Healthcare
03.2017 - 01.2020
Utilization Management Nurse
Shearwater Health
01.2016 - 09.2022
Healthcare Customer Service Agent
Hinduja Global Solutions – Cigna Medical
01.2015 - 03.2017
Staff Nurse
Sulu Sanitarium
01.2013 - 12.2013
Medical Ward Nurse
IPHO – Sulu Provincial Hospital
01.2011 - 05.2012
Bachelor of Science in Nursing (BSN) -
Notre Dame of Jolo College