J M

J M Email and Phone Number

A PH, UK, US reg nurse with a vast experience in hospital, medical claims, home health nursing combined. A risk taker and advocate of innovation and excellence while maintaining balance between quality and productivity. @
J M's Location
Birmingham, England, United Kingdom, United Kingdom
About J M

I used to believe that we create our own destiny but it’s our experiences that actually help us hone it. I’m currently practicing as a UK registered nurse in a home that primarily caters for service users with nursing needs and dementia from as young as 60 to 100+ years old - 103 being the oldest which is amazing! I previously worked in one of the leading providers of transformation and outsourcing services (BPO) to Global 1000 companies in multiple industries such as US healthcare, in which I spent the whole of my tenure with, starting as a clinical claims specialist for 2 years and moving up as an assistant manager for operations for 5 years. Having been blessed with an NCLEX scholarship through which I got my US nursing license was a bonus too! Prior to being acclimated to a working environment where I would usually sit on a desk fiddling the buttons on the computer keyboard, talking to clients on the phone with my imperfect but beyond better and more confident spoken English ability, and overseeing people if they are doing the same on their designated stations, I was this very shy, laid back lady who spent the next 2.5 years working in a secondary hospital based in my home city after graduating and becoming a fully pledged nurse. I was sent to battle by initially fighting for the life and recovery of the adult population for the first few months and then sent to assisting in supporting well being, thriving and recovery of the newborn.I also did a bit of freelancing in between my hospital and BPO experience as a bank / agency customer care representative for one of the biggest healthcare insurance companies in the Philippines.My work experience for 12 years (and counting) has not been perfect, and something I did not plan for after graduating, but fulfilling in a way that it made me become more diverse, dynamic and skill full as what my current manager told me. I’ve carried on to be a risk taker in my endeavours and an advocate of innovation and excellence to further support efficiency and productivity while maintaining quality in opportunities that would allow me.Also, when I’m not working or when I feel lazy to go out, I would find myself in the kitchen usually having a great time or sometimes channeling negative energy from a hard day’s work, by crushing 100 cloves of garlic at a time.

J M's Current Company Details
Adult Nursing

Adult Nursing

A PH, UK, US reg nurse with a vast experience in hospital, medical claims, home health nursing combined. A risk taker and advocate of innovation and excellence while maintaining balance between quality and productivity.
J M Work Experience Details
  • Adult Nursing
    Registered Nurse
    Adult Nursing Apr 2021 - Present
    United Kingdom
    > running a shift and handing over efficiently and effectively> acting up for the deputy home manager and/or home manager in their absence> conducting care staff supervisions> supervising and supporting new staff members / employees> coordinating referrals to various health professionals including routine, urgent, emergent cases> conducting care reviews and updating care plans> participating in FNC / CHC review , CQC assessments> performing clinical and nursing functions > escalating or deescalating client challenging behaviours> maintaining and improving professional knowledge and competence through training and development> maintaining health and safety in the care unit according to related standards and policy> contributing to staffing assessment and needs through attempts for quality and productivity improvement> performing other tasks as deemed needed by the company or management such as : a) safe moving and handling of people and objects - certified trainer with award in education and trainingb) helping out in producing outputs for monthly deliverables such as unit reports, medication audits
  • Exl Service Philippines, Inc.
    Assistant Manager
    Exl Service Philippines, Inc. May 2015 - Aug 2020
    Recognised Top Performer (EXL Global Healthcare Awards and Recognition)Catered to one of the competitive Fortune 500 health companies based in the US. Contributed in migrating another Fortune 500 company mixed back office business that started in 2018 through due diligence.Handled a team of up to 25 resources that mainly worked in clinical claims reviews under Medicare and Commercial health insurance products.Acted as SME for process improvement initiatives from lean six sigma to green belt projects and automation such as DigiCA (Digital Clinical Assistant), a NASSCOM Annual Technology winner, 2019, for Artificial Intelligence and Machine Learning (credits to EXL Digital Transformation Team)Functions : > monitoring daily operations and ensuring that parameters are running according to SLAs> communicating and planning with upper management on challenges and strategies to improve overall performance such as in quality and productivity> updating upper management and team of overall performance> communicating with clients on team performance through periodic business reviews> participating in hiring and training processes> conducting coaching and appraisals> initiating work ethics and compliance by enforcing systems, policies and procedures> assigning cases and schedule to the team> handling complaints and escalations by de-escalation or escalation as necessary> maintaining work relationships within the company and with the client> catering for and participating in client visits, presentations and business benchmarking> performing other functions as deemed relevant
  • Exl Service Philippines, Inc.
    Lead Assistant Manager
    Exl Service Philippines, Inc. Dec 2019 - Apr 2020
    Philippines
    A Yellow Belt, Lean Six Sigma trained – certification stayed pended due to the quarantine situation, when process improvement/excellence initiatives were placed on hold; Was selected as Process Excellence lead in transition for a Healthcare campaign to start in April 2020 but plan changed when organisational re-structuring took place.Functions:> reporting directly to the QPE Manager> advocating and driving process improvement and excellence by working hand in hand with other pillars of the business such as Operations, Transactional Quality, Training, and Workforce Management> observing processes for identification of opportunities, analyse them for process improvement and reviews possible action plans with appropriate leaders> documenting and presenting proposed process improvement projects to appropriate leaders and champions> coordinating timely completion and delivery of the projects that primarily focus on productivity and/or quality enhancement using lean methodology> supporting lean six sigma classes and training that are delivered and led by the QPE Manager> working with other parties such as Automation and Robotics and Business Analytics for digital optimisation of overall operational processes that would ensure better performance in quality and customer/client satisfaction> performing other tasks as deemed relevant
  • Exl Service Philippines, Inc.
    Nclex Trainer
    Exl Service Philippines, Inc. Jun 2016 - Sep 2016
    Philippines
    Passed NCLEX with EXL’s sponsorship program and did some part time sprint in training future US registered nurses by contributing to enhancing NCLEX foundation and test taking strategies.Functions : > coaching of PH registered nurses who are NCLEX ready (with Authorization To Test)> supporting the NCLEX campaign across healthcare vertical that aims to create a USRN pool within the industry> arranging and conducting qualifying and predictor exams for the nurses who are enrolled in the program> monitoring progress of the nurses in preparation for the actual exam> addressing weaknesses and pointing out strengths of the nurses based on the results of their predictor exams> assisting formal classes that are done by the full time lecturers / trainers> contributing to the creation of learning materials such as virtually customized modules that would aid in memory retention and conceptual understanding of the nurses> assisting in compliance to deliverables such as training and attendance reports, plotting of review /tutorial schedules, and other admin work as needed
  • Exl Service Philippines, Inc.
    Clinical Claims Specialist
    Exl Service Philippines, Inc. Jun 2013 - May 2015
    Philippines
    Catered to one of the competitive Fortune 500 health companies are based in the US.Consistent Top Performer.Acted as a subject matter expert. One of the members of the pilot team for clinical review mixed back office process that started in 2013.Functions : > receiving a claim/request that has been pended and routed to Medicare or Commercial queue and reviewing or triaging it as appropriate> requesting clinical information from providers and receiving it via fax/phone/email and attaching it to the appropriate claim / request> liaising with appropriate clinical advisor when a provider representative opts to provide clinical information over the phone> validating information on claim/request received via phone/fax/web/IVR/web-IVR and updates it as appropriate> coordinating with other associates to address provider concerns and to ensure claims processing as appropriate> guiding providers and addressing their queries or concerns and de-escalating orescalating deemed appropriate> informing providers of the determination made on claim/request and advising them on the next steps> sharing ideas and raising clarifications on the process to the quality specialists and team leaders> acting as support to other associates to address questions or clarifications on the process> participating in team huddles in the discussion of weekly/monthly performance> welcoming constructive performance feedback done in coaching sessions with the team leader or manager> contributing to promoting environment that is conducive to work> performing other duties that may be assigned by a team leader, manager or account/business lead
  • Centrotech Inc
    Customer Care Representative
    Centrotech Inc Jan 2013 - Jun 2013
    Philippines
    Catered to one of the biggest pioneers of Health Maintenance Organization(HMO) in the Philippines.Functions : > initiating and completing member referrals> facilitating issuance of appropriate availment forms to members> determining coverage or noncoverage of availments according to authority limits, otherwise elevated to PCC supervisor> discussing coverage or non-coverage of availments to members> issuing letters of authorisation once coverage and requirements have been met> receiving and handling availment queries from members> resolving availment complaints of members, otherwise elevated to PCC supervisor> facilitating availments of VIP members as advised by the PCC supervisor> preparing and submitting pertinent reports as maybe assigned by the PCC supervisor> performing other duties as assigned by the PCCsupervisor, assistant manager for the PCCs, roving team or department headfrom time to time
  • Manuel V Santiago Medical Center
    Neonatal Intensive Care Nurse
    Manuel V Santiago Medical Center Jun 2010 - Jul 2012
    Philippines
    Cases Handled: preterm/post term without complications; preterm neonates with complications such as respiratory depression and retinopathy of prematurity; large for gestation / diabetic neonates with hypoglycaemic complications; cleft lip and cleft palate; small for gestation neonates; infection /sepsis primarily due to distress during delivery
  • Manuel V Santiago Medical Center
    Medical Surgical Nurse
    Manuel V Santiago Medical Center Feb 2010 - Jun 2010
    Philippines
    Cases Handled : cardiovascular, endocrine, genitourinary, EET, digestive, musculoskeletal, infectious diseases, medico-legal, surgical cases

J M Education Details

  • Colegio De La Inmaculada Concepcion De La Concordia, Manila
    Colegio De La Inmaculada Concepcion De La Concordia, Manila
    Nursing
  • Tanza National Comprehensive High School
    Tanza National Comprehensive High School
    Special Science Class

Frequently Asked Questions about J M

What company does J M work for?

J M works for Adult Nursing

What is J M's role at the current company?

J M's current role is A PH, UK, US reg nurse with a vast experience in hospital, medical claims, home health nursing combined. A risk taker and advocate of innovation and excellence while maintaining balance between quality and productivity..

What schools did J M attend?

J M attended Colegio De La Inmaculada Concepcion De La Concordia, Manila, Tanza National Comprehensive High School.

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