Patient Care Utilization Management
Resume:
ATTRIBUTES
• Articulate in English
• Organized, self-disciplined and punctual
• 22 year veteran of Professional Nursing with skills in crisis management, patient care and clinical diagnosis
• Adaptable, persuasive and single-minded
• Maturity and life experience. May has lived in the South Africa, the Caribbean and South America.
• An ability to manage small groups and achieve great outcomes
• Detail orientated with an ability to follow processes and achieve results. PROFESSIONAL EXPERIENCE
Martha Franks Retirement Community, Laurens SC. (April 2025-present)
• Staff Nurse USRN
Carelon Global Solutions (May 2022–April 2025)
• Nurse Medical Management 1, National Out Patient Department. July 2023-April 2025. Utilization Management, trained for Georgia USA and California USA. May 2022-July 2023.
• Recognition & Awards:
2024 Overall Top Performer
2024 Mid-year Excellence Award
Local CA: Top 1 for Backfill Training Wave 7–2022
Q4 2022 and Q1 2023 Top Performer
National OPA: Mid-year Excellence Award 2024, Certificate of Perfect Quality Score 2024.
• Currently mentoring two Associates from Wave 2D through their preceptorship. Accenture (Oct. 2020–May 2022)
USRN Disability Claim Manager/analyst, covering Continental USA.
• Processing and re-certification of Long-term Disability claims.
• Processing and approval of Short-term Disability and Family & Medical Leave Act
• Responsible for medical claim analysis and approval
• Direct liaison with Doctors, Nursing staff and claimants. USRN Build 4 FY–20 (Dec. 2019–Sept. 2020)
NCLEX passed examination July 30 2020. (Ilinois candidate, Lic. no. 041.501709) GC Services Philippines (Nov. 2014–Oct. 2019)
Quality Analyst (Nov. 2014–Oct. 2019)
• Responsible for call auditing, updates, reporting (Manila site)
• Responsible for the audits of Synchrony US base site (Cove).
• Special tasks: responsible for filing customer complaints resolution process Account Representative (Dec. 2012–Nov. 2014)
• Responsible for inbound and outbound calls for Synchrony Bank (GE Capital Retail Bank) Executive Summary
May is an accomplished professional with a unique blend of expertise in Clinical Instruction, Small Group Supervision, Leadership, and Professional Sales. She is goal-oriented, people-focused, and compassionate, with a strong ability to guide students toward reaching their full potential in clinical settings. Drawing on her extensive nursing background, May excels at identifying critical details, clearly communicating effective strategies, and aligning these strategies with broader business objectives. May Mendoza
San Diego USRN
***********@*****.***
PRC License no. 0293530
USRN License no. 282630
South Carolina
ï 1 Martha Franks Drive
Laurens, SC 29360, USA
Edition: 4 June 2025
Page 2 of 2
EDUCATION
Masters of Nursing (MAN)
Accomplished 27 units (continuing education)
State of Illinois (USA) Professional Nursing License Exam (2020) Philippine Professional Nursing License Exam (1990) Bachelor of Nursing (1990)
Relevant Courses:
• Test for Spoken English. Passed in top Quartile (2004)
• Licenced Intravenous Therapy Nurse
• Teaching Strategies in the Classroom and Clinical area
• Quality Assurance Training in the Care of the Elderly
• Philippines Nurses Association Clinical Refresher Courses. SKILLS
• Clinical Medical procedure and diagnosis
• Product promotions development
• Financial analysis
• Microsoft 365 (Word, Excel, Outlook, PowerPoint). EXPERIENCE
Frensenius Medical Care (2001–2004)
• Clinical coordinator
• Initial patient start-up and education for Peritoneal Homecare Dialysis
• Patient education, patient follow-up, homecare visits, coordination with Specialist Kidney Nephrologists
• Managed Metro Manila region, Cavite and Bulacan for the sales of Peritoneal Dialysis solution
(Kidney Dialysis kit)
• Consistently achieved sale targets and patient targets over this period. Average monthly sales of PHP 1.1m
Regina Carmeli University, Bulacan (1999–2001)
• Clinical Instructor for Maternal and Child Nursing.
• Nursing facilitator for JICA (Japan International Cooperation Agency) for Maternal and Child Care.
• Part-time School Nurse for the University.
Doctor Yanga’s College of Nursing, Bulacan (1990–1998)
• Clinical instructor for Intensive Care and Maternal and Child Care. Santos General Hospital (1990–1992)
• Staff Nurse
• Activity associated with account collections and confirming the location of existing account holders
• Top Agent of the Month August & September 2013
• Top Agent for Quality during April, May and June 2014
• Award for 100% attendance record.
Kester Grant College of Nursing. (Pioneer faculty member) (2004–2012) Quezon City. Clinical Instructor for Maternal and Child Nursing
• Lecturer in Maternal Child Care to 2nd year students
• Supervision of practical nursing care for groups of 12 students
• Instructing students nurses in a professional hospital setting and a simulated clinical setting.
Contact this candidate