Isabel Bague

A dedicated, compassionate, and highly adaptable Registered Nurse with over 15 years of comprehensive experience spanning clinical Operating Rooms, Utilization management and Care Coordination. With strong independent clinical judgement and initiative across diverse healthcare settings, including Day Surgery, Endoscopy and Lasik Coordination. Currently specializing in medical necessity reviews, clinical documentation and hospital to facility care transitions to optimize patient outcomes and organizational goals.

Admission Nurse - Gainsville Rehab/St Johnland Nursing Center - Florida

(2026-04)

• Coordinate and manage patient referrals from hospitals to the skilled nursing facility.
• Provide clinical reviews, secure payer preauthorizations, and ensure timely admission decisions.
• Review hospital clinical documentation thoroughly.
• Verify insurance benefits, eligibility, and specific payer requirements.
• Communicate effectively with hospital case managers and social workers.
• Document all authorization details accurately.
• Utilize EMR systems, including PointClickCare and SigmaCare, for accurate data management.

Initial Clinical Reviewer Nurse - Shearwater Health Philippines - Manila

(2025-11 - 2026-04)

• Conduct concurrent, retrospective, and pre-authorization reviews using MCG criteria to assess the medical necessity and level of care.
• Analyze clinical documentation and apply evidence-based standards to support utilization determinations.
• Communicate review outcomes to providers and payers, including approvals, denials, or requests for additional information.
• Document all reviews, determinations, and communications in accordance with internal and regulatory requirements.
• Provide guidance to clinical teams on MCG criteria and payer authorization processes.
• Participate in audits, quality improvement initiatives, and staff education related to utilization management.
• Stay up-to-date with regulatory changes, payer policies, and updates to MCG guidelines.

OR/DR Staff Nurse - ACE MEDICAL CENTER SARIAYA - Sariaya

(2023-07 - 2023-12)

Operating Room Staff Nurse II - King Abdulaziz Hospital, MNG-HA - Al Ahsa, Eastern Region

(2008-12 - 2018-12)

Operating Room Staff Nurse/Recovery Room Nurse - Delos Santos Medical Center (DLSMC) - Quezon City, Metro Manila

(2003-09 - 2008-09)

Bachelor of Science - Nursing - Delos Santos College (2003-03)

High School - Solana Freshwater Fishery School (1999-03)