Paul Borja, RN
Sacramento,United States of America
Summary
Results-driven Director of Care Management known for unparalleled productivity and efficiency in task completion. Specialize in strategic planning, patient advocacy, and interdisciplinary team leadership. Excel in communication, problem-solving, and adaptability, ensuring seamless operations and high-quality care management outcomes.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Director of Care Management
Adventist Health Lodi Memorial
10.2023 - Current
- Develops, manages, and oversees the annual care management budget
- Prepares and evaluates monthly, quarterly, and annual reports of the department's functions
- Monitors and reports on changes in Medicare regulations and documentation issues to physicians and others as needed
- Maintains relationships and contractual oversight with key stakeholders, local, state, and federal agencies
- Oversees RN Case Managers and Medical Social Workers
Director of Care Management
Adventist Health Dameron Hospital
Sacramento, United States of America
10.2023 - Current
- Develops, manages, and oversees the annual care management budget
- Prepares and evaluates monthly, quarterly, and annual reports of the department's functions
- Monitors and reports on changes in Medicare regulations and documentation issues to physicians and others as needed
- Maintains relationships and contractual oversight with key stakeholders, local, state, and federal agencies
- Oversees RN Case Managers and Medical Social Workers
Advisory Board Member to Adjunct Professor
California Coast University
08.2019 - Current
- Responsibilities include teaching undergraduate and graduate courses via online platform
- Monitoring and maintaining the course gradebook
- Administering examinations
- Reviewing course content and is responsible for curriculum development
Assistant Nurse Manager
Kaiser Foundation Hospital
04.2015 - 10.2023
- Manages the operations of 24-hour departments that may be at multiple locations
- Ensures Assistants and staff provide the highest quality of care and are in compliance with the Nursing Practice Act, The Joint Commission, federal, state, and local requirements
- Establishes, implements, and maintains patient care and service standards to meet members and internal clients' expectations
- Designs and evaluates processes to improve systems and patient care results across the continuum of care
- Develops and monitors budgets for the appropriate use of human and material resources
- Monitors financial performance and identifies and implements strategies to reduce costs and improve quality of care/service
- Determines the appropriate staff mix for department and develops processes to screen, interview, hire, train, and maintain the competency of all department staff
- Ensures ongoing staff development
- Manages and resolves human resource, employee and department safety, and risk management issues
- Develops, implements, and monitors departmental policy and procedures which support the organization's goals and business objectives and ensures they are met
- Oversees and develops standards of care and standards of practice, directs fiscal management, and quality improvement activities
Various Positions
Various
04.2005 - 04.2015
- Home Health Nurse Case Manager, Gentiva Healthcare
- Health Plan Case Manager, River City Medical Group
- Director of Nursing, Woodside Healthcare
- Director of Staff Development/Infection Control, Asbury Park Nursing and Rehab
- Assistant Director of Nursing, Arden Rehab and Nursing Center
RN Case Manager to Staff Nurse II
Dignity Health Mercy General
03.2010 - 09.2014
- September 2013-September 2014, Staff Nurse II, Neurology/Spine/Telemetry/Epilepsy Monitoring Unit
- March 2010-September 2013, RN Case Manager
Education
Doctor of Education -
Hodmas University College
Somalia07.2024
Doctor of Nursing Practice -
The University of America
07.2022
Doctor of Philosophy in Organizational Leadership -
Northwestern Christian University
02.2020
Graduate Certificate in Organizational Leadership -
California Coast University
05.2016
Master of Business Administration in Healthcare Management -
California Coast University
07.2013
Undergraduate Certificate - Healthcare Management
Ashworth College
07.2012
Bachelor of Science in Nursing -
San Juan De Dios Educational Foundation, Inc. (College)
04.2004
Skills
- Cerner, EPIC, SCM, Point Click Care EHR, Allscripts
- Lean Six Sigma Black Belt and Champion
- BLS and ACLS, Telemetry Monitoring
- ICD-9 and ICD-10 Medical Coding and Billing
Certification
- Certified Managed Care Nurse (CMCN), American Association of Managed Care Nurses, 01/2024
- Registered Nurse #10084, Guam Board of Nurse Examiners, 11/2023
- Fellow of the Association of the Directors of Nursing Administration (FACDONA), National Association of the Directors of Nursing Administration, 11/2022
- Certified Nurse Manager Leader (CNML), American Organization of Nurse Executives, 12/2018
- Accredited Case Manager-RN (ACM-RN), American Case Management Association, 11/2018
- Case Management Administrator Certified (CMAC), American Case Management Association, 01/2017
- Nursing Case Management-Board Certified (CMGT-BC), American Nurse Credentialing Center, 11/2016
- Fellow of the American Academy of Case Management (FAACM), American Academy of Case Management, 09/2014
- Certified Case Manager (CCM), Commission on Case Management Certification, 01/2013
- Registered Nurse (RN), California Board of Registered Nursing, 10/2007
- Certified Director of Nursing Administration- LTC, National Association of Directors of Nursing Administration, 09/2007
- Director of Staff Development (DSD) #4236, California Department of Public Health, 08/2007
- Licensed Vocational Nurse #214320 (LVN), California Bureau of Vocational Nursing and Psychiatric Technicians, 04/2005
Awards and Recognition
- Certificate of Appreciation, CMSA Sacramento Chapter, Board Director, 03/2024
- #Aidin CM Spotlight Award, Aidin, 02/2024
- Certificate of Recognition, California Coast University, For Advisory Board Membership in the Schools of Administration and Management, 05/2023
- Certificate of Appreciation, Kaiser Permanente, Presenting the Importance of Certification, 05/2023
- Raise the Roof Award, Kaiser Permanente, 07/2021
- Certificate of Appreciation, Kaiser Permanente, Rapid Improvement Event on Skilled Nursing Facility Discharges, 03/2017
- Mercy Touch Awards, Dignity Health Mercy General Hospital, Total of 6 Awards from 2010-2014, 01/2014
- Values in Action Nominee, Dignity Health Mercy General Hospital, 06/2012
- Inductee, Sigma Theta Honor Society of Nursing, California State University Sacramento Chapter, 01/2010
Languages
- English, Fluent
- Tagalog, Native
Timeline
Director of Care Management
Adventist Health Lodi Memorial
10.2023 - Current
Director of Care Management
Adventist Health Dameron Hospital
10.2023 - Current
Advisory Board Member to Adjunct Professor
California Coast University
08.2019 - Current
Assistant Nurse Manager
Kaiser Foundation Hospital
04.2015 - 10.2023
RN Case Manager to Staff Nurse II
Dignity Health Mercy General
03.2010 - 09.2014
Various Positions
Various
04.2005 - 04.2015
Doctor of Education -
Hodmas University College
Doctor of Nursing Practice -
The University of America
Doctor of Philosophy in Organizational Leadership -
Northwestern Christian University
Graduate Certificate in Organizational Leadership -
California Coast University
Master of Business Administration in Healthcare Management -
California Coast University
Undergraduate Certificate - Healthcare Management
Ashworth College
Bachelor of Science in Nursing -
San Juan De Dios Educational Foundation, Inc. (College)
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