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Valeree Ann Ceniza

@valereeannceniza

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Registered nurse specializing in utilization review, prior authorization, and evidence-based clinical documentation.

United States

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What I'm looking for

I’m looking for a role in remote utilization review or care coordination where I can apply evidence-based guidelines, complete clinical documentation reviews, support prior authorizations, and strengthen medical necessity decisions while ensuring regulatory compliance.

I’m a Registered Nurse with 5+ years of diverse clinical experience spanning utilization review, medical-surgical nursing, endoscopy, dialysis, and acute care. I focus on clinical documentation review, medical necessity determinations, utilization management, and applying evidence-based guidelines to support coverage decisions.

I bring a strong track record in case management and care coordination through comprehensive chart reviews, interdisciplinary collaboration, and maintaining regulatory compliance. I document findings in electronic medical record systems and educate clinical staff on utilization management processes and documentation requirements.

I’m well positioned for remote utilization review, case management, clinical documentation improvement, care coordination, and prior authorization roles—bringing strong analytical skills, clinical judgment, and attention to detail to support high-quality, cost-effective healthcare delivery.

Experience

Work history, roles, and key accomplishments

Registered Nurse – Medical-Surg

Centerpoint Health

Oct 2025 - Jun 2026 (8 months)

Delivered adult medical-surgical nursing care in an acute care environment, including patient assessments, monitoring, and physician-ordered treatments. Maintained electronic medical records, collaborated with interdisciplinary teams, and supported patient education and quality improvement initiatives.

Medical Surgical Nursing patient assessment IV Therapy Wound Care Patient Education Electronic Medical Records (EMR)Interdisciplinary Collaboration Quality Improvement

Utilization Review Nurse

Shearwater Health Inc.

Feb 2021 - May 2024 (3 years 3 months)

Conducted utilization review by reviewing clinical documentation and patient records to determine medical necessity for home health services. Documented findings in electronic medical record systems and collaborated with physicians and providers to obtain additional clinical information when needed.

Utilization Review Clinical Documentation Review Clinical Chart Review Evidence Based Guidelines Regulatory Compliance Electronic Medical Records (EMR)Interdisciplinary Collaboration Coverage Recommendations

Registered Nurse – Endoscopy

University of Cebu Medical Center

Jun 2018 - Sep 2019 (1 year 3 months)

Provided endoscopy nursing care across pre-procedure, intra-procedure, and recovery phases, including patient assessments and monitoring. Assisted physicians during diagnostic and therapeutic procedures, supported infection prevention/sterilization compliance, and educated patients on preparation and discharge instructions.

Endoscopy Nursing Recovery Monitoring Patient Education Discharge Instructions Support infection prevention

Dialysis Registered Nurse (Trainee)

Fresenius Medical Group

Jan 2010 - Present (16 years 6 months)

Assisted with hemodialysis treatments for patients with chronic kidney disease, including monitoring before, during, and after sessions. Supported medication administration per dialysis protocols and maintained documentation while following infection prevention and patient safety practices.

Patient Monitoring patient assessment Clinical Documentation infection prevention Patient Safety