Syralou Sedilles Adlaon
Bryan,TX
Summary
Adept at leveraging extensive medical and healthcare expertise from roles at UnitedHealth Group and various healthcare institutions, I excel in clinical assessments and patient care, underpinned by a strong foundation in computer literacy and critical thinking. My proficiency in medical terminologies, guidelines and policies such as LCD, NCD, InterQual, NCCN, CMS and Evicore, combined with effective communication skills, drives high-quality patient outcomes and operational excellence.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Clinical Claim Review Nurse (Utilization Nurse)
Optum, UnitedHealth Group
Cebu City, Philippines
08.2022 - 01.2025
- Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines, ensuring the medical necessity of treatments (e.g., NCD, LCD, InterQual, CMS, NCCN, Evicore, or health plan-specific guidelines/criteria).
- Examine and evaluate patient records to verify the quality of patient care, and the necessity of provided services.
- Offer clinical expertise, and serve as a clinical reference for non-clinical staff members.
- Input and manage essential clinical details within various medical management platforms.
- Keep up to date with regulatory prerequisites and state standards for utilization review.
- Apply clinical reasoning to determine the suitable, evidence-based guidelines.
- Foster efficient and high-quality patient care by effectively communicating with management teams, physicians, and the medical director.
Virtual Assistant
British Company
11.2016 - 12.2021
- Searches for highest selling products online
- Creates product description for the item to be listed
- Edits pictures of the products
- List products on eBay, Amazon, and Shopify
- Communicates with clients if they have inquiries, complaints or if they want a refund
- Communicates with the suppliers and the owner of the company
Dialysis Nurse
Negros Oriental Provincial Hospital
Dumaguete City, Negros Oriental
11.2018 - 03.2020
- Vital signs taking and patient monitoring
- Getting patients' demographic data
- Assisting in different nursing procedures
- Prepare and do after care of hemodialysis machines before and after the treatment procedure
- Assess the hemodialysis patient before, during and after the treatment
- Do skin preparation aseptically and cannulate the AV Fistula sites before the procedure
- Terminate the hemodialysis treatment and ensure the AV sites have been applied with pressure dressings
- Prepare the intrajugular and subclavian catheters before and after the hemodialysis treatment
- Conduct health teachings regarding the patients' conditions
- Be an advocate for the patient
Volunteer Nurse
Negros Oriental Provincial Hospital
Dumaguete City, Negros Oriental
03.2018 - 10.2018
- Vital signs taking
- Getting patients' demographic data
- Assisting in different nursing procedures
- Inserting and removal of intravenous fluid
- Providing medications via optic, Oral, intradermal, intramuscular, sublingual, and subcutaneous route per physician's order and assessing for any adverse reactions to medications given
- Assess patient before, during, and after any nursing procedure
- Conduct health teaching during hospitalization and especially prior to discharge
Institutional Partnership Division Officer
Department of Social Welfare and Development Field Office Negros Island Region
Dumaguete City, Negros Oriental
07.2016 - 09.2017
- Company Overview: National Government Agencies and Expanded Students Grants-In-Aid Program for Poverty Alleviation under the Pantawid Pamilyang Pilipino Program
- Establishes, develops, and sustains partnership with key National Government Agencies to support Pantawid Program implementation, in particular, the provision of basic services, livelihood, and other needs of the beneficiaries
- Represent the regional office and national program management office in meetings, consultations, workshops, dialogues and other similar activities related to partnership development
- Communicates national and regional level policies, guidelines, and agreements to field operations personnel
- Identify potential student-grantees from among the Pantawid Pamilya households and endorse the list to the State Universities and Colleges for screening
- Facilitates and monitors the release of the stipend and other interventions for the grantees
- Facilitate the employment of the grantees who graduated
- National Government Agencies and Expanded Students Grants-In-Aid Program for Poverty Alleviation under the Pantawid Pamilyang Pilipino Program
Area Coordinator
Department of Social Welfare and Development
Carmen, Bohol
11.2015 - 05.2016
- Company Overview: Kapit Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services Millennium Challenge Corporation (KALAHI-CIDDS: MCC)
- Conduct activities that are anchored on the following principles: localized decision-making, empowering, community prioritization, inclusive and multi-stakeholder, demand-driven, simple, and sustainable
- Oversee and facilitate in the conduct of the following activities social preparation and capacity building, project identification and conceptualization, project selection and prioritization and project implementation, monitoring and evaluation
- Strengthen the partnership with the stakeholders especially the Local Government Unit and lobby needs of the community
- Kapit Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services Millennium Challenge Corporation (KALAHI-CIDDS: MCC)
Community Empowerment Facilitator
Department of Social Welfare and Development
Manjuyod, Negros Oriental
08.2014 - 10.2015
- Company Overview: Kapit Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services National Community-Driven Development Program (KALAHI-CIDDS: NCDDP)
- Conduct and facilitate the conduct of the following activities social preparation and capacity building, project identification and conceptualization, project selection and prioritization and project implementation, monitoring and evaluation
- Advocate for the community in voicing out their needs to the local government unit
- Empower the community by conducting training and seminars that will increase their knowledge, enhance and improve their attitude
- Kapit Bisig Laban sa Kahirapan - Comprehensive and Integrated Delivery of Social Services National Community-Driven Development Program (KALAHI-CIDDS: NCDDP)
Community Health Nurse
Department of Health
Jimalalud, Negros Oriental
01.2013 - 12.2013
- Company Overview: Registered Nurses for Health Enhancement and Local Service (RNHEALS) Program
- Vital signs taking
- Getting their demographic reports
- Assisting in different minor operations
- Administering medications via optic, oral, intramuscular, sublingual, and subcutaneous route per physicians order
- Assess pregnant women at the barangay level
- Assessing the needs of the people in the community such as health needs
- Assisting in suturing and dressing
- Assisting in giving immunizations to newborns and children
- Giving health care lectures about dengue prevention, family planning, and first aid to the barangays and schools in the municipality
- Conducts surveys and assists in the implementation of the Department of Health Programs such as Garantisadong Pambata, Kalusugang Pangkalahatan, TBDOTS and etcetera in the barangays and schools in the municipality
- Registered Nurses for Health Enhancement and Local Service (RNHEALS) Program
Volunteer Nurse
Negros Oriental Provincial Hospital
Dumaguete City, Negros Oriental
10.2012 - 12.2012
- Vital signs taking
- Getting patients' demographic data
- Assisting in different nursing procedures
- Inserting and removal of intravenous fluid
- Providing medications via optic, oral, intradermal, intramuscular, sublingual, and subcutaneous route per physician's order and assessing for any adverse reactions to medications given
- Assess patient before, during, and after any nursing procedure
- Conduct health teaching during hospitalization and especially prior to discharge
Municipal Camp Coordinator
Municipal Social Welfare and Development Office
Jimalalud, Negros Oriental
04.2012 - 10.2012
- Coordinate to different government and private institutions with regards to the allocation of needs to the people affected by the earthquake
- Distribute immediate support such as relief goods to the affected areas
- Assess the needs of the people who were affected by the calamity
- Assist in the relocation of the affected communities
- Conducts training and information caravan with regards to health and communicable diseases
- Make weekly reports regarding the current situation of all camps activated for settlement to the regional office
Nursing Student Internship
Silliman University
Dumaguete City, Philippines
06.2007 - 03.2011
- Negros Oriental Provincial Hospital, Psychiatric Ward, Talay (Psychiatric-Mental Health Nursing)
- Purok 6, Dauin, Negros Oriental (Community Health Nursing)
- Silliman Medical Center, Dumaguete City (Medical-Surgical Nursing, Maternal Nursing)
- Negros Oriental Provincial Hospital, Dumaguete City (Medical-Surgical Nursing, Perioperative Nursing, Maternal Nursing, and Pediatric Nursing)
- City Central School, Dumaguete City (School Health Nursing)
Education
College - Nursing
Silliman University
Dumaguete City, Philippines03-2011
Secondary -
Infant King Academy
Jimalalud, Negros Oriental, Philippines03-2007
Elementary -
Bae Elementary School
Bae, Jimalalud, Negros Oriental, Philippines04-2003
Skills
- Computer Literacy (Word, Excel, Powerpoint, Spreedsheet)
- Knowledgeable in Local Coverage Determination, National Coverage Determination, InterQual, CMS, NCCN, and Evicore
- Good written and verbal communication skills
- Knowledgeable in medical terms
- Good critical thinking
Accomplishments
- Graduated as the Batch Valedictorian, 03/01/03
- Graduated as a Class Honor, 03/01/07
- Consistent Class Honor from Second Year up to Fourth Year, 2004-2007
- President of the Mother Ignacia Club of Infant King Academy, 2004-2007
- Active Member of the Silliman University College of Nursing Association, 06/01/07 - 03/31/11
- Registered Nurse Since, 12/18/11
- Certified Phlebotomist, 03/01/12
- Certified Basic Life Support and Advance Cardiac Life Support Provider, 03/01/12
- International English Language Testing System (IELTS) Passer, 07/01/16
- National Council on Licensure and Examinations Passer (United States Registered Nurse), 07/31/17
References
- Mrs. Grace Baring, Chief Nurse, Negros Oriental Provincial Hospital, Dumaguete City, Negros Oriental, +639194307128
- Hon. Hazel T. Billones, Mayor of Jimalalud, Negros Oriental, +639177269135, +639177006105
- Mr. Hillton John V. Edrial, Provincial Social Welfare and Development Officer, Dumaguete City, +639778316052
- Angelica Joven Martinez, Supervisor at Optum-Philippines, Makati, Philippines, +639179460440
Hobbies and Interests
- Reading Books
- Watching TV and Movies
- Singing
- Taking Pictures
Personal Information
- Age: 34
- Height: 5'4
- Weight: 72 kgs
- Health Status: Good
- Place of Birth: Guihulngan, Negros Oriental
- Date of Birth: 12/29/90
- Marital Status: Married
- Religion: Roman Catholic
Certification
- Registered Nurse in the State of Texas
- Registered Nurse in the Philippines
Languages
English
Professional
Filipino
Professional
Timeline
Clinical Claim Review Nurse (Utilization Nurse)
Optum, UnitedHealth Group
08.2022 - 01.2025
Dialysis Nurse
Negros Oriental Provincial Hospital
11.2018 - 03.2020
Volunteer Nurse
Negros Oriental Provincial Hospital
03.2018 - 10.2018
Virtual Assistant
British Company
11.2016 - 12.2021
Institutional Partnership Division Officer
Department of Social Welfare and Development Field Office Negros Island Region
07.2016 - 09.2017
Area Coordinator
Department of Social Welfare and Development
11.2015 - 05.2016
Community Empowerment Facilitator
Department of Social Welfare and Development
08.2014 - 10.2015
Community Health Nurse
Department of Health
01.2013 - 12.2013
Volunteer Nurse
Negros Oriental Provincial Hospital
10.2012 - 12.2012
Municipal Camp Coordinator
Municipal Social Welfare and Development Office
04.2012 - 10.2012
Nursing Student Internship
Silliman University
06.2007 - 03.2011
College - Nursing
Silliman University
Secondary -
Infant King Academy
Elementary -
Bae Elementary School
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