Prior Authorization Mental Health
Resume:
JEZZ BHEL TUGADE-ROS, RN
***** ********* **, ***** *********, CA 91605
E-mail address : ****************@*****.***
Mobile Number : +1-818-***-****
HIGHLIGHTS OF QUALIFICATIONS
EMPLOYMENT HISTORY
Position Title : Nurse, Medical Ward
Employer : Las Pinas Doctors Hospital (200 bed capacity)
Address : Las Pinas City, Philippines
Date of Employment : February 2018 to May 2018
Job Description : Take care of patients' physical and mental health throughout the treatment process. Monitor the health conditions of patients and prepare them for relevant treatment. Follow any progress in a patient's health and record them to aid.
Position Title : Sr Associate Ops USRN – Clinical Review Nurse
Employer : WNS Global Services Philippines Inc.
Address : 22F Axis One Northgate Cyberzone, Alabang Muntinlupa City, Metro Manila
Date of Employment : Nov 14, 2019 to Nov 2,2023
Job Description : Prior authorization reviews, and retrospective reviews for diagnostic imaging
and cardiac procedures. Evaluates the appropriateness and medical necessity of medical treatment. Prior authorization reviews for outpatient requests like diagnostic imaging, surgery, MRI, CT, CTA, MRA, ECHO, Revascularization, Stress test, Cardiac Revascularization and Stent, etc. Gather medical information to evaluate the necessity of medical treatment and functional capabilities. Ensure timely processing of utilization issues, and/or referral decisions. Compare medical information to establish criteria / guidelines and determine the appropriateness of procedures.
Position Title : Utilization Management Nurse Generalist
Employer : Evolent Health International Incorporated
Address : 11 th Floor One Ayala East Tower, Ayala Avenue Corner EDSA, San Lorenzo, Makati City
Date of Employment : November 6,2023 to May 2024
Job Description : Prior authorization reviews, and retrospective reviews for Oncology medication including radiation oncology. Gather clinical information needed for every oncology drug and medication. Initiate intake requests for Oncology. Evaluates the appropriateness and medical necessity of medical treatment. Performs max dosing for the patients.
EQUIPMENT HANDLED
EDUCATION AND CERTIFICATIONS
EDUCATION
University of Perpetual Help System-Dalta
Las Pinas City
Bachelor of Science in Nursing
2016 – 2018
The Sisters Of Mary School-Girlstown
Talisay City, Cebu
2007 – 2010
Oslob Central Elementary School
Oslob, Cebu
2000 – 2007
CERTIFICATIONS
PROFESSIONAL LICENSE AND EXAMS PASSED
Philippine Nursing Licensure Exam 2018
PHRN License No. 0911363 - valid until 11/03/2025
National Council Licensure Examination 2019
USRN Colorado License No. 1688535 – valid until 09/30/2025
PERSONAL INFORMATION
Date of Birth : November 3,1993
Gender : Female
Marital Status : Married
Nationality : Filipino
Contact Person and Number In Case of Emergency : Leoncio Ros +1-818-***-****
CHARACTER REFERENCES
Maxwell Laquio
Quality Analyst
JP Morgan Chase & Co.
*************@*****.***
Angela Balderama
US RN
**********@*****.***
Kenneth Jim Lucot
US RN
********.*****@*****.***
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