Meade Cesar Alaestante
Stevenson
Summary
Professional nurse with extensive experience in utilization review. Skilled in analyzing patient care and ensuring compliance with healthcare regulations. Strong focus on team collaboration and achieving optimal patient outcomes. Adaptable and reliable, excelling in dynamic environments requiring precise decision-making and effective communication.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Nurse
Signature Health Care of South Pittsburg
06.2023 - Current
Utilization Management Nurse
United Health Group/Optum Global Solutions Philippines
08.2016 - 04.2023
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
- Performed prior authorization review of services requiring notification.
- Followed all personal and health data procedures to effectively comply with HIPAA laws and prevent information breaches.
- Optum, part of UnitedHealth Group family of businesses, is a leading information and technology-enabled health services business. Dedicated to modernizing the health care system and improving the lives of people and communities.
Staff Nurse
National Kidney and Transplant Institute
11.2011 - 08.2016
- Medical - Surgical, Renal Transplant ward
Staff Nurse under RN HEALS program
Department of Health
11.2011 - 12.2012
- Assessed physical, psychological, physiologic and cognitive status of patients.
- Performed various nursing intervention such as IV therapy, medication administration, wound dressing, vital signs monitoring, catheter insertion, airway management and specimen collection.
- Updated patients charts to keep records current and support accurate treatments.
- Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.
- Collaboration with health care team.
- Specialty, Tertiary hospital and a Government owned and Controlled Corporation under the Department of Health. It is a 300 bed capacity ward not including the beds at Dialysis Center which is the biggest in the Philippines.
Hemodialysis Nurse
Romel Cruz Dialysis Clinic
01.2011 - 04.2011
- Assessment of patient, cannulation, setting machine parameters as well as starting and tearing down of machines.
- Stocking supplies, monitoring patients vital signs every 30 mins, water checks, drawing Heparin, good nursing judgments were used daily.
- Educated community members about Diabetes, Kidney and Heart disease.
- A private owned dialysis clinic with testing laboratories, with 32 bed capacity Primary Hospital.
Education
Bachelor of Science - Nursing
Our Lady of Fatima University
Valenzuela City03-2009
Skills
- InterQual criteria
- Telephonic nursing
- Utilization management
- Case management
- Utilization review
- Clinical assessment
- Physician consultations
- Prior authorization
- Discharge planning
- Patient care plans
Certification
- Registered Nurse (USRN) in state of AL -MSL
- Expire on July 2027
- American Heart Association Basic Life Support (CPR and AED) Program
- Expire on November 2027
Languages
English
Full Professional
Timeline
Nurse
Signature Health Care of South Pittsburg
06.2023 - Current
Utilization Management Nurse
United Health Group/Optum Global Solutions Philippines
08.2016 - 04.2023
Staff Nurse
National Kidney and Transplant Institute
11.2011 - 08.2016
Staff Nurse under RN HEALS program
Department of Health
11.2011 - 12.2012
Hemodialysis Nurse
Romel Cruz Dialysis Clinic
01.2011 - 04.2011
Bachelor of Science - Nursing
Our Lady of Fatima University