Strategic-thinking individual experienced in turning low-performing teams into top revenue producers. Led and managed ACO team that achieved shared savings of $15.2M for the MSSP program. Collaborated and built a transition of care program that decreased readmission rate by 7%. Strong leader and problem-solver dedicated to streamlining case management programs to promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent relationship-building skills. Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.
Work History
Director, Ambulatory CM and Operations
7 Months
Keck Medicine Of USC | 12.2025 - Current
Led strategic initiatives to enhance operational efficiencies across clinical departments.
Directed cross-functional teams to implement patient-centered care models and improve service delivery.
Fostered collaboration with stakeholders to align organizational goals with departmental objectives.
Analyzed process workflows, identifying areas for improvement and implementing best practices.
Developed training programs to enhance staff competencies in clinical operations and patient engagement.
Cultivated partnerships with external organizations to expand service offerings and enhance community outreach efforts.
Developed high-performing teams by providing mentorship, guidance, and opportunities for professional growth.
Enhanced team collaboration through regular communication, goal setting, and performance evaluations.
Established a culture of continuous improvement by fostering open communication channels and empowering employees to voice their ideas.
Facilitated cross-functional collaboration for improved decision-making processes within the organization.
Implemented innovative solutions to solve complex problems, resulting in increased productivity and streamlined operations.
Streamlined processes within the disease management program, resulting in increased efficiency and better resource allocation.
Mentored new team members on best practices for delivering effective disease management interventions, contributing to a high-performing multidisciplinary team.
Developed innovative approaches to engage patients in their own disease management, fostering a sense of empowerment and ownership over their health.
Utilized data-driven insights to inform improvements in the design and implementation of the disease management program, ultimately enhancing patient outcomes.
Director, Care Management Strategic Programs
2 Years 3 Months
Optum, UnitedHealth Group | 08.2023 - 11.2025
Oversees clinical programs: Transplant, Disease Management - CHF, COPD, Renal Care Continuum Program, Transitions of Care, General Care Management and Accountable Care Organization
Transplant: Oversees and manages all aspects of transplant program, ensuring seamless operations and compliance with regulatory requirements. Leads multidisciplinary team in development and implementation of standardized protocols for pre- and post-transplant care. Establishing effective communication channels between transplant teams, patients, and other healthcare providers to optimize patient outcomes.
Disease Management CHF-COPD: Spearheads disease management initiatives for chronic conditions, creating pathways for team to improve patient's overall health and reduce hospital readmissions. Collaborates with healthcare providers to implement evidence-based practices and enhance quality of care for patients with chronic diseases.
Oversaw renal care continuum program, guiding management of care for renal disease patients, coordinating multidisciplinary teams, and overseeing dialysis treatment plans. Created pathways for team to enhance patient health and reduce hospital readmissions while supporting educational programs to improve patient self-management of renal care.
Oversaw integration of care delivery systems within ACO framework, fostering collaboration among healthcare providers to achieve shared savings and enhance patient care. Monitored key performance indicators to assess and report on success of ACO initiatives.
General Care Management: Oversees general care management program that fills gap that does not belong to any other program under strategic care management department. Collaborates with interdisciplinary teams to ensure delivery of high-quality, patient-centered care. This program prevents readmission, increases patient satisfaction and efficiency with care delivery organization.
Works closely with organizational leadership and board of directors to guide operational strategy.
Managed daily operations to ensure efficiency and effectiveness within the organization. and provide corrective feedback to achieve daily and long-term goals.
Supervised office workflow and administrative processes to maintain smooth operations. and administrative processes to keep operations running smoothly.
Oversaw and coordinated workflows to maximize resource efficiency and productivity. to optimize resources.
Worked closely administration to develop and implement best practices to improve patient outcomes.
RN Manager
2 Years 1 Month
Optum, UnitedHealth Group | 07.2021 - 08.2023
Responsible for overseeing ACO unit staff directly responsible for day-to-day operations of care management programs
Supervised and optimized ACO quality improvement, utilization management, and care management activities related to ambulatory case management, social services, home health, health education, and other health care delivery programs.
Worked with all members of ACO team, as well as department leads for Health Enhancement, Quality Improvement and Regional Case Management, to facilitate optimal integration of ACO patients.
Enhanced clinical, quality, financial, and patient satisfaction outcomes for ACO department through targeted initiatives.
Ensured appropriate staffing levels by scheduling on a daily and monthly basis within budgetary guidelines
Monitored compliance in licensing, certification, and competencies.
Evaluated nursing competencies and nursing decisions according to current nursing practice
Mentored and trained teammates in collaboration with Site Administrator, lead clinician and people services department
Functioned as resource and serves as liaison between administration, clinicians, teammates, other departments, patients and vendors
Participated in Nursing Leadership, Nurse Peer review and other committees as needed
Identified and participated in quality improvement projects for the site.
Maintained clinical standards outlined in clinical operations policies and procedures manual. Identifies deficiencies and recommends changes
Engaged in educational programs to enhance nursing and management knowledge.
Coordinated nursing activities and staffing with health-related, therapeutic and support services to streamline service delivery.
Evaluated and monitored care and services throughout shift to improve quality levels.
Enforced nursing practice standards and recommended unit and institution policies and procedures to boost medical care quality.
Determined and nursed special care cases and arranged professional consultation sessions for patients.
Created processes and strategies to achieve shared savings of health plan
Met goals and targets of each ACO health Plan
RN Navigator for ACO MSSP/Anthem
1 Year 9 Months
Adventist Health Glendale | 10.2019 - 07.2021
Assists individuals with navigating health care systems and appointments
Guided individuals in navigating health care systems and appointments
Assists patients with multiple chronic diagnoses, including COPD and asthma, etc.,
Handles high risk patients ; provides solutions and interventions
Provides adequate interventions that resulted in positive outcomes, reduced readmission rates and low ED utilization.
Instructs and discusses plan of care with patients and family members after discharge from hospital
Performs comprehensive assessment of patient to determine plan of care
Reviews charts and monitors readmitted and ESRD patients
Sets and manages patient appointment schedules using Cerner
Works with nurses and other clinical staff to process patients and direct to appropriate departments
Reviews and records progress of patients
Uses facility EMR system to document interventions and outcomes.
Supported patients and families in navigating challenging situations, fostering comfort and promoting recovery
Managed care for high-risk patients to ensure proper treatment and monitoring. ; provides solutions and interventions
Reviews clinical documents to verify accuracy
Delivered interventions that improved patient outcomes, decreased readmission rates, and minimized emergency department utilization
Handles out of network patients both MSSP and Anthem
Accomplishes targets and goals set by team
Achieved team targets and goals by implementing effective strategies and collaboration. set by team
Applies strong leadership talents and problem-solving skills to maintain team efficiency and leads team to meet any daily demand.
Leads weekly clinical huddle team meeting
Provides report of weekly clinical huddle team meeting
Coordinated with recent Anthem Care Update presentation
Complies with annual metrics of ACO
Complies with annual metrics of ACO
Case Manager
1 Year 1 Month
Adventist Health Howard Memorial Hospital | 09.2018 - 10.2019
Developed and implemented comprehensive case management plans to address client needs and goals
Ensured the interdisciplinary care plan aligned with the patient's clinical course and care needs by monitoring diagnostic testing, treatments, and procedures.
Led the coordination of patient care with other disciplines within the care team, monitoring the appropriateness and timeliness of care
Coordinated patient transfers to tertiary centers, ensuring seamless transfer of patient information for continuity of ongoing treatment and services
Provided oversight and collected data required for regulatory and accreditation compliance
Managed frequent emergency department visitors by conducting a focused study review of the previous and current admissions
Coordinated services with other agencies, community-based organizations, and healthcare professionals to provide useful benefits to clients
Developed and implemented comprehensive case management plans to effectively address client needs and achieve desired goals
Managed frequent emergency department visitors by conducting a focus study review of the previous and current admissions
Assisted clients in navigating housing, legal services and public benefits to gain access to valuable resources
Registered Nurse Supervisor
2 Years 3 Months
Northbrook Healthcare Center | 06.2017 - 09.2019
Chronic patient care in skilled nursing facility, adeptly handling all aspects of treatment from medication to wound care to monitoring for 18-25 patients per shift
Provided comprehensive chronic patient care in skilled nursing facility, managing medications, wound care, and monitoring for 18-25 patients per shift
Supervised and coordinated activities of LVNs, CNAs, and non-clinical staff to ensure high-quality patient care
Effectively managed clinical oversight for 44-bed unit
Developed and implemented nursing care plans
Developed patient care plans, including assessments, evaluations and nursing diagnoses
Pharmacological and non-pharmacological management and treatment of various disorders and diseases
Liaised between patients and physicians to ensure patient comprehension of treatment plans
Assessed need for, ordered, obtained and interpreted appropriate lab tests
Closely monitored acute conditions
Monitored patient reactions to drugs and carefully documented progress of individuals
Ensured efficacy of treatments through monitoring of treatment regimens
Monitored fluid intake and output levels
Assisted patients with daily functions
Processed requests for medication refills to ensure timely patient care and provided detailed prescription information to pharmacies
Led nursing personnel for the unit and shift
Scheduled patient admissions and discharges
Coordinated and arranged patient admissions to optimize unit workflow and discharges
Participated in unit-based Quality Assurance Program
Ensured HIPAA compliance
Provided on-call care at all times of day and night
Led and motivated healthcare teams, fostering a collaborative environment to enhance patient outcomes
Nurse Case Manager/ Utilization RN
8 Months
Shearwater Health | 04.2016 - 12.2016
Reviewed clinical claims and proposed hospitalization, home care, and treatment plans for medical necessity per member's policy for workers compensation, guiding and coaching newly hired utilization review nurses
Completed training on ICD10 and ICD9 coding standards to enhance medical documentation accuracy.
Conducted comprehensive reviews of workers' compensation claims to ensure compliance with regulations., Utilization review, Medical Review/Medical Nurse Review, Nurse review, Coding, Intake Nurse Medical Coordinator, and Clinical data/Clinical Case Management
Reviewed Service, Quality and Training Program Management Provided guidance and coaching to other RNs and participated in the orientation of newly hired RNs
Executed various administrative tasks to support departmental operations and team objectives.
Bedside Nurse
2 Months
Medical City | 01.2016 - 03.2016
Assessed and ordered lab tests based on patient needs
Provided chronic patient care in cardio-neuro unit, managing medication, wound care, and monitoring for 4-6 patients per shift
Assessed need for, ordered, obtained and interpreted appropriate lab tests
Monitored fluid intake and output levels
Assisted with bathing, dressing, feeding, lifting and transferring
Assisted patients with daily functions
Authorized drug refills and communicated detailed prescription information to pharmacies, ensuring timely patient access to medications
Collected and prepared blood, tissue, and other laboratory specimens for lab testing, contributing to accurate diagnostic results
Scheduled patient admissions and discharges Generated leads through targeted outreach strategies Lead Generation Expert
OR Nurse/Dermatology Nurse
3 Months
Shimmian Manila Surgicenter | 02.2010 - 05.2010
Performed dermatology procedures
Performed OR cosmetic surgeries
Supported patients during recovery process to ensure comfort and effective healing
Recorded detailed procedure notes and compliance requirements for accurate medical documentation
Conducted inventory checks on medical supplies to ensure adequate stock levels.
Educated patients and families on discharge care to promote understanding and adherence to recovery protocols
Followed infection control procedures
Made inventories with the supplies
Private Nurse & Healthcare Teacher
2 Months
ACME Gas Corporation | 02.2010 - 04.2010
Provided comprehensive care to ill or injured employees, ensuring timely recovery and support
Identified workplace risk factors and implemented targeted interventions to enhance employee health and safety Acted as a private nurse for the chairman of the board
Provided effective counseling to promote health maintenance in health maintenance and disease management
Liaised between patients and physicians to ensure patient comprehension of treatment plans
Healthcare Account Manager
1 Year 1 Month
Coastal Training Technologies Corporation | 08.2008 - 09.2009
Managed sales for healthcare training division across Asia, Australia, and Middle East, focusing on client engagement and market expansion
Assessed client needs to lead traditional and new media sales initiatives, enhancing customer relationships and service offerings
Coordinated exhibit for Hospital Management Asia 2008 at Shangri-La Hotel Manila, showcasing innovative healthcare solutions to key industry stakeholders
Collections Agent
2 Months
NCO Financial Systems Incorporated | 08.2007 - 10.2007
Collected debts and payments on past due bills.
Tracked client information using credit bureaus and databases utilizing credit bureau information, background checks, loan documents and other paperwork or databases
Managed customer accounts to ensure timely payments and reduce outstanding balances.
Negotiated payment plans with clients to facilitate debt resolution and improve collection rates.
Utilized CRM software to document interactions and track account status effectively.
Education
High School Diploma
St Paul University | Quezon City, Phillipines | 2003
Bachelor of Arts - Science and Nursing
Trinity University of Asia, St. Luke's College of Nursing | Quezon City, Phillipines | 2007
Skills
Excellent in time management
Performance Metrics
Organizational Goal Development
Very organized
flexible and analytical
Excellent communication
documentation and interpersonal skills
Case Management
Disease management
and Nursing
Highly motivated
Proficient use of Programs: Cerner
EPIC
NextGen
Allscript
TouchWorks
Curo
Essette
PCX
and IDX
Knowledgeable of Microsoft Office applications
Proficient in written and oral English
Discharge Planning
Clinical Leadership
Decision Making
Conflict Resolution
Timeline
Director, Ambulatory CM and Operations
Keck Medicine Of USC
12.2025 - CurrentRead More
Director, Care Management Strategic Programs
Optum, UnitedHealth Group
08.2023 - 11.2025Read More
RN Manager
Optum, UnitedHealth Group
07.2021 - 08.2023Read More
RN Navigator for ACO MSSP/Anthem
Adventist Health Glendale
10.2019 - 07.2021Read More
Case Manager
Adventist Health Howard Memorial Hospital
09.2018 - 10.2019Read More
Registered Nurse Supervisor
Northbrook Healthcare Center
06.2017 - 09.2019Read More
Nurse Case Manager/ Utilization RN
Shearwater Health
04.2016 - 12.2016Read More
Bedside Nurse
Medical City
01.2016 - 03.2016Read More
OR Nurse/Dermatology Nurse
Shimmian Manila Surgicenter
02.2010 - 05.2010Read More
Private Nurse & Healthcare Teacher
ACME Gas Corporation
02.2010 - 04.2010Read More
Healthcare Account Manager
Coastal Training Technologies Corporation
08.2008 - 09.2009Read More
Collections Agent
NCO Financial Systems Incorporated
08.2007 - 10.2007Read More
Trinity University of Asia, St. Luke's College of Nursing