Reymond Gayahan

Reymond Mendoza Gayahan 4C - 308 Cite Des Jeunes, Gatineau, Quebec, Canada J8Y 6L4 Phone:- / Email:- Career objective: Accomplished Nurse (Hemodialysis and Medical Chart Reviewer) in my home country seeking an opportunity to expand my knowledge and able to contribute my experience in healthcare industry here in Canada. ***permanent resident of Canada, legally entitled to work Education Bachelor of Science in Nursing Laguna College – November 2002 – April 2005 UPH – Dr. Jose G Tamayo Medical University – June 2001 – October 2002 Work Experience Personal Support Worker /Homemaker/ Companion, Comfort Keepers Sept. 2017 to present Job Description: Under the supervision of Client Care Coordinator, and in accordance with comfort keepers established client – focused plan of care. Responsible for non-medical, in – home support services which provide for the comfort, safety and general supervision of clients as well as home management services. Provide companionship to those individuals requiring socialization and/or minimum guidance to assure safe, protected, clean and orderly environment. Provide personal care and support services to clients as assigned on the client’s Plan of Care. Clinical Team Lead, Accenture Inc., August 2016 to July 2017 Job Description: Effectively leads a team of non-voice clinical associates to meet established goals and ensure compliance to Accenture policies and Client Care Management BPO service processes. Serves as team lead for nursing staff that collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for the most complex or elevated medical issues. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources. Utilization Review Nurse (Prior Auth and Post Service), Accenture Inc., June 2012 to July 2016 Job Description: Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and promote effective use of resources. Ensure medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources. Works with medical directors in interpreting appropriateness of care. Hemodialysis Nurse, Kobe Clinic and Dialysis Center, February 2010 to June 2012 Job Description: Responsible for support, observance and delivery of all unit and company policies. Promote and assist in the maintenance of a safe, orderly and clean working environment. Provide safe and effective delivery of patient care in compliance with standards outlined in the unit policy and procedure manuals, as well as regulations set forth by the company. Responsible for reporting all new or unusual incidents, information, complaints or problems to the charge nurse using proper channels of communication. Carry out physician orders in an appropriate manner. Document changes in the patient’s condition, chart all pertinent data in a legible manner and sign entries. Awards - Top Performer in my ProjectMultiple Months of 2015 - Next-Generation Awardee for the health tower in AccentureDecember 2015 Certifications - Basic Life SupportJuly 2017 Professional Licenses - Philippine Registered NurseJanuary 2006 to present Languages Filipino is my native tongue, fluent knowledge of English (able to listen, read, write and speak well). Computer Skills Complete competency with Microsoft Office Touch-typing speed of 40 WPM Extra Skills Extensive Knowledge medical terms Extensive Knowledge in Utilization Review, Claims and medical coding Familiar with avaya and cisco phone system With knowledge in ICD-10 coding Able to understand and protect PHI of the patient Good Customer Service Skills (5 years) Team player Attendance is not an issue. Electronic Medical Record (5 years)**References available upon request