Summary
Overview
Work History
Education
Skills
Additional Information
Accomplishments
Certification
Languages
Timeline
Generic

Mario Agda III

Reno,NV

Summary

Experienced nurse with 14+ years of diverse experience in direct patient care, care management, and utilization review. Skilled case manager specializing in care coordination and care transitions planning in an acute care setting. Proactively devises safe discharge plans for patients, demonstrating resourcefulness and a strong knowledge base. Compassionate and hardworking registered nurse dedicated to providing individualized patient care. Committed to delivering best-in-class patient care through effective education and counseling. Demonstrates proven leadership skills focused on increasing and enhancing patient care and satisfaction, while streamlining safety protocols for comprehensive patient care. Detail-oriented utilization review nurse with extensive healthcare experience and expertise in problem-solving due to dynamic patient care planning and understanding of medical coverage guidelines. Well-versed in ICD-10, CPT, and HCPCS coding systems.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Case Manager

Renown Regional Medical Center
09.2023 - Current
  • Coordinated individualized discharge plans to manage safe transition back into community and home environments.
  • Partnered with physicians, nurses, activity therapists, nutritionists, and UR nurses to develop and implement individualized discharge plans and documented patient interactions and interventions in electronic charting systems.
  • Completed psychosocial evaluations and needs assessments.
  • Facilitated timely referrals to alternate levels of care and assisted family or guardian with completion of applications.
  • Solved problems related to abrupt changes in discharge, coordinated updates and communicated discharge plans.
  • Worked with medical teams, patients and families to implement effective treatment plans.
  • Assessed risk factors of patients and made referrals for further services.
  • Assisted patients in accessing housing, financial assistance and other community resources.
  • Coordinated individualized discharge plans to manage safe transition back into community and home environments.
  • Participated in interdisciplinary care conferences to discuss patient care plans and referrals.
  • Coordinated patient discharge planning and follow-up care.

Medical Surgical Registered Nurse

Renown Regional Medical Center
07.2023 - 09.2023
  • Managed patients' pain by implementing pharmacological and non-pharmacological pain management interventions.
  • Started intravenous fluids, administered medications, and documented patient charts by recording food and fluid output and intake.
  • Managed caseload of patients simultaneously by providing bedside care, treatments, IV therapy, and wound care.
  • Educated patients and families on medical-surgical procedures, therapeutic regimens, and pain management techniques.

Medical Surgical Nurse

Sidney Health Center
03.2023 - 07.2023

Employer: Guardian Healthcare Providers Inc.

Hospital Assigned: Sidney Health Center


  • Assessing, planning, implementing, and evaluating patient care plans in consultation with healthcare professionals
  • Evaluating medical information, as well as providing direct and individualized bedside nursing care to pre-and post-surgery patients
  • Preparing, administering and recording prescribed medications
  • Changing dressings, inserting catheters, and starting IVs
  • Adjusting specialized medical equipment as needed, as well as interpreting and recording measurements
  • Monitoring patients' vitals and reporting adverse reactions to medications in a timely manner
  • Collaborating on discharge planning with the healthcare team
  • Answering questions and educating patients and their families on surgical procedures and post-surgery care
  • Maintaining and updating patient files, medical charts, and health records
  • Adhering to best nursing practices, standards, and protocols.

Same Day Clinic Nurse

Sidney Health Center
07.2021 - 08.2022

Employer: Guardian Healthcare Providers Inc.

Hospital Assigned: Sidney Health Center


  • Functions as the primary liaison between patients, staff, and providers
  • Works collaboratively with the interdisciplinary team to meet the needs of the patient
  • Take vital signs, triage patient calls, refill prescriptions, complete necessary prior authorizations, administer oral and intramuscular injections, perform in clinic laboratory test and help support our team of co-workers.

Medical Surgical Nurse

Sidney Health Center
05.2019 - 07.2021

Employer: Guardian Healthcare Providers Inc.

Hospital Assigned: Sidney Health Center


  • Assessing, planning, implementing, and evaluating patient care plans in consultation with healthcare professionals
  • Evaluating medical information, as well as providing direct and individualized bedside nursing care to pre-and post-surgery patients
  • Preparing, administering and recording prescribed medications
  • Changing dressings, inserting catheters, and starting IVs
  • Adjusting specialized medical equipment as needed, as well as interpreting and recording measurements
  • Monitoring patients' vitals and reporting adverse reactions to medications in a timely manner
  • Collaborating on discharge planning with the healthcare team
  • Answering questions and educating patients and their families on surgical procedures and post-surgery care
  • Maintaining and updating patient files, medical charts, and health records
  • Adhering to best nursing practices, standards, and protocols.

Senior Process Executive - Data

Cognizant Technology Solutions Inc.
03.2016 - 12.2018

Working as Preservice / Appeals (Utilization Management) for Blue Cross Blue Shields of Florida.


  • Serves as a reviewer for UM staff that conduct pre / appeals authorizations
  • Collaborates with healthcare providers to promote the most appropriate, highest quality member outcomes, and to optimize member benefits
  • Oversees initial benefit determinations and medical necessity reviews in accordance with MCG policies and procedures
  • Oversees initial clinical information presented meets medical necessity criteria or requires additional medical necessity reviews
  • Consults with UM Medical Director to review requests that do not meet medical necessity
  • Oversees reviews to ensure accuracy/timeliness of appropriate written correspondence to providers and/or members in accordance with UM policies and procedures
  • Adheres to company policies and procedures regarding confidentiality and privacy
  • Exhibit coordinating skills along with strong problem solving, facilitation, and analytical skills

Nurse Consultant

EXL Service Inc
01.2014 - 10.2015

Working as Pharmacy Precertification Nurse Reviewer (Utilization Management) for Aetna


  • Serves as a reviewer for UM staff that conduct pharmacy pre authorizations
  • Collaborates with healthcare providers to promote the most appropriate, highest quality member outcomes, and to optimize member benefits
  • Oversees initial benefit determinations and medical necessity reviews in accordance with CPB guidelines
  • Oversees initial clinical information presented meets medical necessity criteria or requires additional medical necessity reviews
  • Consults with UM Medical Director to review requests that do not meet medical necessity
  • Oversees reviews to ensure accuracy/timeliness of appropriate written correspondence to providers and/or members in accordance with UM policies and procedures
  • Adheres to company policies and procedures regarding confidentiality and privacy

Charge Nurse/ Medical Surgical Nurse

OSPA-Farmers Medical Center
04.2009 - 12.2013
  • Assisted in endotracheal intubation
  • Performed nursing procedures (vital signs taking, intravenous line insertions, nasogastric / orogastric tube feedings, hemogluco testing, peritoneal dialysis administration and monitoring, catheterization, suctioning, etc)
  • Actively participated in Nursing rounds and patient endorsements
  • Observed for signs and symptoms, and instituted immediate nursing actions, and documented them on chart
  • Carried out and transcribed doctor’s orders
  • Administered prescribed medications through oral, inhalation, subcutaneous, intradermal, intramuscular, intravenous, optic, otic, and rectal routes
  • Carefully monitored patient’s responses to drugs and treatment with proper documentation
  • Assisted the physician with any diagnostic and therapeutic procedures and treatments (endotracheal intubation, nasogastric / orogastric tube insertions, chest thoracotomy tube insertions, intra-osseous line insertions, IV cut-downs)
  • Performed wound care as necessary or applicable
  • Provided health teachings to the patient and their immediate family members
  • Activated a code and performed cardio pulmonary resuscitation
  • Rendered post mortem care on expired patients
  • Carried out and transcribed doctor’s orders
  • Collaborated effectively with an interdisciplinary team of medical professionals like medical technicians, dietitians, physical therapists, medical interns and others.

Volunteer Nurse

Sacred Heart Hospital
11.2008 - 02.2009
  • Assisted in insertion of peripheral intravenous lines
  • Administered medications per inhalation, oral, sublingual, intramuscular, intradermal, subcutaneous, intravenous, optic, otic, and rectal routes
  • Assisted in catheterization (straight catheter, Foley catheter, and condom catheter)
  • Assisted in endotracheal intubation
  • Assisted in nasogastric and orogastric tube insertions
  • Administered feeding per nasogastric and orogastric tubes
  • Assisted in performing gastric lavage
  • Suctioned secretions per endotracheal and tracheostomy tubes
  • Rendered wound care
  • Monitored, and reported any changes in the patients’ status to physicians
  • Provided health teachings to the patients and their families
  • Implemented discharge planning / instructions set by the physician, and re- evaluated patients’ conditions
  • Administered STAT ordered meds as soon as possible
  • Checked emergency cart supplies and ensured it is complete

Education

Bachelor of Science - Nursing

Remedios Trinidad Romualdez Medical Foundation
Tacloban City, Philippines
2005

Skills

  • Discharge planning coordination
  • Discharge scheduling
  • EMR / EHR (Epic)
  • Utilization review
  • ICD-9, ICD-10, Interqual, MCG, CPB
  • Insurance verification
  • Medical record updating
  • Interdisciplinary collaboration
  • Care coordination
  • Strong clinical judgment
  • Complex patient cases
  • Patient assessment
  • IV management
  • Medication administration
  • Inpatient care
  • Documentation and reporting
  • Disease prevention
  • Patient discharge procedures
  • Educational materials and resources
  • Patient support

Additional Information

  • U.S. License: California (Active), Nevada (Active)

Accomplishments

  • Clinical Skills - Monitored patients' respiration activity, blood pressure and blood glucose levels in response to medical administration.
  • Documentation - Ensured charting accuracy through precise documentation.
  • Surgical Preparation - Assisted in patient surgery preparation by administering proper medication, monitoring patients' conditions and charting abnormalities.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Supervised team of 3 staff members in the medical surgical ward.
  • Achieved high productivity rate for medical claims by completing utilization review with accuracy and efficiency.

Certification


  • Licensed Registered Nurse in California
  • Licensed Registered Nurse in Nevada
  • Passed IELTS ( International English Language Testing System) conducted by British Council.






Languages

English
Full Professional
TAGALOG
Native or Bilingual

Timeline

Case Manager

Renown Regional Medical Center
09.2023 - Current

Medical Surgical Registered Nurse

Renown Regional Medical Center
07.2023 - 09.2023

Medical Surgical Nurse

Sidney Health Center
03.2023 - 07.2023

Same Day Clinic Nurse

Sidney Health Center
07.2021 - 08.2022

Medical Surgical Nurse

Sidney Health Center
05.2019 - 07.2021

Senior Process Executive - Data

Cognizant Technology Solutions Inc.
03.2016 - 12.2018

Nurse Consultant

EXL Service Inc
01.2014 - 10.2015

Charge Nurse/ Medical Surgical Nurse

OSPA-Farmers Medical Center
04.2009 - 12.2013

Volunteer Nurse

Sacred Heart Hospital
11.2008 - 02.2009

Bachelor of Science - Nursing

Remedios Trinidad Romualdez Medical Foundation
Mario Agda III