MARIA ANGELA ALETIN
Sun Valley,CA
Summary
Skilled Registered Nurse with over ten years of diverse clinical experience in delivering holistic, patient-centered care. Proven ability to enhance patient outcomes through effective team collaboration and a commitment to professional development.
Expertise includes clinical assessment, patient education, and interdisciplinary communication. Career objectives focus on further elevating the standard of care in dynamic healthcare environments.
Overview
13
13
years of professional experience
Work History
Nurse Case Coordinator
Pacifica Hospital Of The Valley
Sun Valley, CA
02.2025 - Current
- Developed and implemented patient care plans in collaboration with healthcare team members.
- Maintained current knowledge of community resources available to meet the needs of patients and families.
- Provided case management services to ensure continuity of care across multiple settings.
- Coordinated referrals for specialty services and home health care needs.
- Facilitated communication between physicians, nurses, social workers and other healthcare providers involved in the care plan.
Quality Assurance & Appeal Nurse
Propeer Resources
Schertz, TX
01.2023 - 01.2025
- Performed quality assurance audits on completed utilization review cases.
- Assessed the appropriateness of medical services and procedures based on clinical documentation and criteria.
- Adhered to evidence-based standards when making decisions regarding resource utilization.
- Maintained up-to-date knowledge of changes in healthcare regulations, policies, and evidence-based practices.
- Provided feedback to healthcare providers on clinical documentation improvement to support utilization review.
Behavioral Health Registered Nurse
Tallahassee Memorial Hospital
Tallahassee, FL
10.2022 - 12.2022
- Established trusting relationships with clients by maintaining professional boundaries while being empathetic towards their needs.
- Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
- Collaborated with multidisciplinary team members to develop individualized treatment plans.
- Collaborated with psychiatrists, psychologists and other healthcare professionals to ensure quality patient care.
- Provided comprehensive nursing care to patients with a variety of mental health issues.
Medical Surgical Registered Nurse
Mandaluyong City Medical Center
Mandaluyong, Philippines
05.2021 - 06.2022
- Monitored vital signs, assessed patient condition and notified physicians of any changes or concerns.
- Administered treatments, therapies, and medication according to prescribed methods and protocols.
- Conducted specified laboratory tests to help detect conditions and determine diagnosis.
- Performed comprehensive assessments to identify patient needs, devise care plans, modify care solutions, and support patient rights.
- Specialized in nursing care for patients requiring continuous and comprehensive observation and acute trauma patients with multitudes of injuries.
- Maintained a safe environment by following infection control policies and procedures.
Behavioral Health Registered Nurse
Livelife Homecare
, Philippines
07.2020 - 04.2021
- Performed psychosocial assessments, including histories and physicals.
- Established trusting relationships with clients by maintaining professional boundaries while being empathetic towards their needs.
- Collaborated with multidisciplinary team members to develop individualized treatment plans.
- Collaborated with psychiatrists, psychologists and other healthcare professionals to ensure quality patient care.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
Prior Authorization - Utilization Review Nurse
United Health Group-Optum Global Solutions
Taguig, Philippines
09.2018 - 07.2020
- Interpreted benefit plans, medical necessity criteria, policy language, and state regulations for proper utilization of services covered under a health plan. (e.g., Milliman Care Guidelines, InterQual, Policy Plan Language)
- Reviewed patient medical records to determine if requested services are medically necessary and appropriate for the diagnosis.
- Conducted comprehensive reviews of patient records to ensure medical necessity and compliance with healthcare standards.
- Monitored pre-authorization requests to ensure that all necessary information was received prior to approval or denial of services.
Medical Surgical Nurse
St. Luke's Medical Center
Taguig, Philippines
12.2015 - 01.2018
- Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
- Administered treatments, therapies, and medication according to prescribed methods and protocols.
- Performed comprehensive assessments to identify patient needs, devise care plans, modify care solutions, and support patient rights.
- Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
- Collaborated with other health care team members to facilitate quality patient care.
Special Education Teacher
Paco Catholic School
Paco, Philippines
06.2012 - 09.2013
- Developed and implemented individualized education plans for students with special needs.
- Instructed students in standardized subjects as well as general learning strategies and skills for social development and character.
- Demonstrated appropriate behaviors using behavior modeling and positive reinforcement techniques.
- Served as an advocate for special education students within the school system.
Education
BACHELOR OF SCIENCE - NURSING
SAN BEDA UNIVERSITY
Manila, Philippines04-2012
Skills
- Utilization review/management
- Insurance verification
- Compliance procedures
- Inpatient care
- Quality improvement
- Healthcare regulations
- Care coordination
- EMR systems
- Basic life support
- Psychiatric assessment
- Behavior modification
- HIPAA compliance
LICENSES: REGISTERED NURSE, BSN
- CALIFORNIA, ISSUED: 03/07/2024
- TEXAS, ISSUED: 11/27/2019
- NEVADA, ISSUED: 11/09/2023
- FLORIDA, ISSUED: 09/08/2022
References
- Julie Beyer, AVP Clinical Operations, jbeyer@propeer.com, 888-972-7053
- Tamra Giordano, RN Clinical Liaison, 850-431-5424
- James Patrick Velera, MAN, BSN, RN RN Supervisor, +63 917-149-0923
Languages
English
Full Professional
Timeline
Nurse Case Coordinator
Pacifica Hospital Of The Valley
02.2025 - Current
Quality Assurance & Appeal Nurse
Propeer Resources
01.2023 - 01.2025
Behavioral Health Registered Nurse
Tallahassee Memorial Hospital
10.2022 - 12.2022
Medical Surgical Registered Nurse
Mandaluyong City Medical Center
05.2021 - 06.2022
Behavioral Health Registered Nurse
Livelife Homecare
07.2020 - 04.2021
Prior Authorization - Utilization Review Nurse
United Health Group-Optum Global Solutions
09.2018 - 07.2020
Medical Surgical Nurse
St. Luke's Medical Center
12.2015 - 01.2018
Special Education Teacher
Paco Catholic School
06.2012 - 09.2013
BACHELOR OF SCIENCE - NURSING
SAN BEDA UNIVERSITY
Similar Profiles
Dede TsuruokaDede Tsuruoka
Chief Communications Officer at Pacifica Hospital of the ValleyChief Communications Officer at Pacifica Hospital of the Valley
Christopher RodriguezChristopher Rodriguez
Emergency Room Technician at Pacifica Hospital of the ValleyEmergency Room Technician at Pacifica Hospital of the Valley
Ana MartinezAna Martinez
Medical Biller/Collector at Pacifica Hospital of the ValleyMedical Biller/Collector at Pacifica Hospital of the Valley