Mary Melstar Llavore
Pob. Sur, Sigma Capiz,Philippines
Summary
Experienced Clinical Services Nurse skilled in patient assessment, utilisation review, and care coordination. Delivers effective case reviews and clinical documentation while ensuring clear communication with physicians. Specialises in patient advocacy and safe care transitions, adapting to varying caseloads with sound clinical judgement. Committed to providing compassionate and accurate support in all patient interactions.
Overview
1
1
Language
1
1
Certification
6
6
years of professional experience
Work History
SPE Clinical Services
Cognizant Technology Solutions
Cebu City
04.2023 - Current
- Clinical Knowledge & Judgment: Ability to interpret medical records, understand clinical guidelines, and evaluate treatment plans against medical necessity criteria.
Proficiency with Clinical Criteria Frameworks: Hands-on experience with industry-standard guidelines like InterQual and MCG (Milliman Care Guidelines). - Advocated for patients and families by clearly communicating coverage details, discharge planning, and transition options, ensuring understanding and support.Critical Thinking & Decision-Making: Rapidly analyzing clinical evidence to make accurate, defensible level-of-care determinations (e.g., Inpatient vs. Observation).Coordinated case management by aligning UM evaluations with discharge planning and care transitions, minimising unnecessary stay delays.Time Management & Prioritization: Handling high-volume reviews efficiently while meeting strict statutory and payer turn-around time (TAT) deadlines.
- Advocated for patients and families by clearly communicating coverage details, discharge planning, and transition options, ensuring understanding and support. Critical Thinking & Decision-Making: Rapidly analyzing clinical evidence to make accurate, defensible level-of-care determinations (e.g., Inpatient vs. Observation). Coordinated case management by aligning UM evaluations with discharge planning and care transitions, minimising unnecessary stay delays. Time Management & Prioritization: Handling high-volume reviews efficiently while meeting strict statutory and payer turn-around time (TAT) deadlines.
Medical Ward Staff Nurse
Capiz Doctor's Hospital
Roxas City
10.2022 - 04.2023
- Conducted patient assessments to determine their care requirements and devised suitable care plans.
- Documented patient care services by charting in patient and department records accurately.
- Provided emotional support to patients and their families, helping them cope with illness and recovery.
- Worked with a consistently positive, friendly bedside manner to enhance patient experiences during difficult times.
COVID Ward Staff Nurse
Capiz Doctor's Hospital
Roxas City
04.2021 - 09.2022
- Responded promptly to emergency situations, applying critical thinking and clinical skills to deliver immediate care.
- Collaborated with multidisciplinary team members to plan and implement patient care plans effectively.
- Maintained a safe, clean, and comfortable environment for patients, adhering to infection-control policies.
- Worked with a consistently positive, friendly bedside manner to enhance patient experiences during difficult times.
- Maintained continued personal development through regular training, maximising nursing capabilities and competence.
Hemodialysis Staff Nurse
Capiz Doctor's Hospital
Roxas City
11.2020 - 03.2021
- Monitored patients for any adverse reactions during dialysis and responded promptly to emergencies.
- Responded promptly to emergency situations to deliver life-saving care and stabilise patients for additional treatments.
- Assessed, troubleshot and made sound decisions to treat critically ill patients.
- Coordinated with multidisciplinary team to develop individualised care plans for dialysis patients.
- Provided education and support to patients and their families regarding kidney disease and dialysis treatment.
- Supervised, trained and mentored new nurses on nursing requirements and procedures.
Education
Bachelor of Science - Bachelor of Science in Nursing
Central Philippine University
Jaro Iloilo City01-2019
Skills
- Utilization review
- Care transition management
- Patient evaluations
- Care management
- Clinical records
- Physician communication
- Patient advocacy
- Critical decision making
- Interdisciplinary collaboration
Languages
English
Upper Intermediate
B2
Certification
- 11/2021: PHRN 2019 (License no 0925612)
- 08/2022 Certified Nephrology Nurse License CNN 2022 (Acc. no 08112213890)
- 10/24/2026: USRN NMI (R231594)
- 03/04/2024: Texas RN (1143262)
References
- Jose Victor, Borja, RN, CNN, Head nurse (CDH Hemodialysis), Roxas City
- Lea Alayon RN, MAN, PhD Chief Nurse (CDH), Roxas City
- Norly Natividad RN Head of Infectious Control (CDH), Roxas City Capiz
- Robert Michael Pantoja (Cognizant) Taguig, Manila
Timeline
SPE Clinical Services
Cognizant Technology Solutions
04.2023 - Current
Medical Ward Staff Nurse
Capiz Doctor's Hospital
10.2022 - 04.2023
COVID Ward Staff Nurse
Capiz Doctor's Hospital
04.2021 - 09.2022
Hemodialysis Staff Nurse
Capiz Doctor's Hospital
11.2020 - 03.2021
Bachelor of Science - Bachelor of Science in Nursing
Central Philippine University