Richard Sibayan

- Creates staff ranking systems based on contract seniority provisions and employee availability forms
- Documents discussions with staff and management to ensure contract compliance; may testify at arbitrations or legal proceedings
- Negotiates with staff to cover vacant shifts
- Interprets CBAs to minimize overtime and premium pay costs, ensuring seniority is considered for vacation and time-off requests
- Generates and maintains a computerized 28-day master schedule for all nursing shifts
- Addresses urgent staffing and payroll issues
Provides information to payroll to ensure employee compensation aligns with CBAs and KP policies.
- Interprets and processes coded timecards for bi-weekly payroll

- Managed high-volume inbound calls, efficiently identifying member needs and resolving inquiries using established scripts and resources
- Provided comprehensive member support, including facility and provider information, select lab results, appointment scheduling, and message relay to providers
- Facilitated seamless care coordination by transferring members to Advice Nurses when necessary
- Effectively collected and documented member information
- Resolved escalated issues originating from facility teleservice teams, ensuring positive member experiences

- Created and maintained comprehensive industrial claim files within internal systems for all medical services related to the treatment of industrial injuries and illnesses
- Obtained, validated, and updated all necessary patient, employer, and carrier information required for the creation, completion, and maintenance of legally compliant industrial medical reports, utilizing internal applications and systems

- Managed over 20 active project stories daily using JIRA, facilitating team progress and ensuring smooth sprints (2-4 week cycles)
- Developed monthly PowerPoint presentations containing key data insights for budgeting and securing initial approval for 10+ projects, enabling their progression to production
- Compiled and analyzed data from 2-5 sources using Microsoft Word and Excel to proactively inform core team members and stakeholders, ensuring data accuracy for production implementation