MICHAEL GUEVARRA
5690 Glacier Highway Apt. 4 Juneau,AK
Summary
I am US license Nurse, eager to secure a role that presents both a challenge and the opportunity for fulfillment, offering a dynamic environment where my professional and creative qualities can thrive. My commitment to continuous growth in skills and knowledge, coupled with a strong propensity for leadership, positions me as an asset to any healthcare team, driving towards the shared goal of delivering optimum patient care.
Overview
1
1
Certification
16
16
years of professional experience
Work History
Intake Review Nurse
Flagstaff Professional
New York
02.2023 - 03.2025
- Evaluate patient records to ensure compliance with clinical guidelines for post-service care.
- Review and authorize coverage for home health services.
Pos Service Clinical Review Nurse
Carelon Global Solutions Philippines
Philippines
01.2022 - 02.2023
- Responsible in drug review coverage for every patient discharge from hospital confinement.
Clinical Coverage Review Nurse & Inpatient Care Manager
Optum/UHC/Unite Dhealth Group
Taguig
01.2013 - 03.2021
- Managed Prior Authorization for Medicare and Medicaid beneficiaries.
- Expertly navigated Skilled Nursing Facility requirements and protocols.
- Proficient in Functional Independence Measure (FIM) scoring systems.
- Assessed patients against Acute Inpatient Rehabilitation criteria.
- Coordinated comprehensive Discharge Planning strategies.
- Processed prescriptions through Optum Rx with efficiency.
Customer Service Representative
Affiliated Computer Services, Inc. / Xerox Company
10.2011 - 12.2012
- Managed medical claim reimbursements efficiently.
- Administered pre-tax transit card transactions effectively.
Staff Nurse
Santos General Hospital
Malolos
01.2009 - 03.2011
- Adheres to Data Privacy, Proper Communication & Documentation.
- Head to Toe assessment, Assists Doctor's Rounds, Assessing and Proper Carrying out of Doctor's orders, Medication administration, Intravenous therapy, Foley Cath, Strait Cath insertion, Blood Transfusion, Blood Sugar monitoring, Suctioning, NGT insertion, Tube Feeding, Pain assessment & management, Coordination with Team members, Efficient Time Management and Task Delegation, Health Teaching, Ostomy and Wound Care, Pre and Post op monitoring, Code Blue Management, Infection Control, Pressure Ulcer Prevention, Fall Prevention, Patient transfer and transport, Hospital Information System Management.
Education
Bachelor of Science - Nursing
Our Lady of Fatima University
01.2007
Bachelor of Science -
Centro Escolar University
01.2003
High School Diploma - undefined
San Miguel Academy
01.1997
Skills
Data Privacy, Proper Communication & Documentation, HIPPA, EHR/EMR Documentation, Coordination with Team Members, Efficient Time Management and Task Delegation, Health Teaching, Ostomy and Wound Care, Pre and Post op Monitoring, Infection Control, Pressure Ulcer Prevention, Fall Prevention, Hospital Information System Management, Computer Desktop Operation and Microsoft Office Programs, Nursing Skills with Broad Exposure in US Healthcare System
Certification
- Electrocardiogram Observership Training Program
- I.V. Therapy Training Program
- Basic ECG and Arrhythmia Recognition Course
- Basic Life Support Training
- Advance Life Support Training
Language
English
Timeline
Intake Review Nurse
Flagstaff Professional
02.2023 - 03.2025
Pos Service Clinical Review Nurse
Carelon Global Solutions Philippines
01.2022 - 02.2023
Clinical Coverage Review Nurse & Inpatient Care Manager
Optum/UHC/Unite Dhealth Group
01.2013 - 03.2021
Customer Service Representative
Affiliated Computer Services, Inc. / Xerox Company
10.2011 - 12.2012
Staff Nurse
Santos General Hospital
01.2009 - 03.2011
High School Diploma - undefined
San Miguel Academy
Bachelor of Science - Nursing
Our Lady of Fatima University
Bachelor of Science -
Centro Escolar University