Glenn Odilon A. Obieta, BSN, RN, CCM, CPHQ, CDP

Case Manager

ad0vns@r.postjobfree.com • 914-***-****

White Plain, NY 10603

Summary

Service-driven RN and Case Manager with 20+ years’ career track record of driving healthcare excellence through holistic case management, resource optimization, and process improvement, resulting in improved patient outcomes and satisfaction.

Qualifications Summary

Hands-on experience in developing and implementing impactful quality improvement initiatives dedicated to providing high-quality service and improving patient/organizational outcomes through continuous research and innovation.

Highly analytical with strong organizational skills, adept at anticipating resource needs, prioritizing tasks, meeting tight deadlines, and maintaining quality standards.

Exceptional skills in working with people – peers, teams, patients, industry partners, and other stakeholders – while nurturing a positive work culture of open communication, collaboration, accountability, and excellence.

Committed to maintaining the highest ethical and legal standards in healthcare administration while being a strong advocate for patient privacy and confidentiality.

Education

Master of Science in Nursing, Healthcare Quality and Patient Safety

Grand Canyon University Phoenix, AZ, Expected May 2024

Bachelor of Science in Nursing (BSN)

The University of Eastern Philippines Catarman, Northern Samar

Licenses & Certifications

New York Board of Nursing, New York USA

US RN License: 747710

Valid Until: 07/2026 Issue Date: 04/03/2018

The Commission for Case Manager Certification – Certified Case Manager

Certification Number: 4248275

Valid Until: 05/31/2025 Issue Date: 09/01/2020

National Association for Healthcare Quality – Certified Professional for Healthcare Quality

Certification Number: 332162

Valid Until: 12/2025 Issue Date: 02/2021

Hospital and Community Patient Review Instrument (H/C PRI) Training & Certification

Certification Number: 000*********

Issue Date: 01/31/21

MCG – Care Guideline Specialist (Case Management)

Issue Date: 02/17/2022

Certified Dementia Practitioner

Certification Number: 279194

Valid Until: 09/11/2025 Issue Date: 09/11/2023

Career Experience

Willow Towers Assisted Living 2023 – Present

Director of Health Services - Contract

Manages and supervises the delivery of healthcare services in an assisted living community. Collaborates with healthcare providers to ensure that the care provided meets high standards while adhering to regulatory requirements and budgetary constraints. Develops and implements policies, manages staff, coordinates with healthcare organizations, and ensures compliance with the constantly changing laws and regulations.

St. John Riverside Hospital, Yonkers, NY 2021 – 2023

Nurse Case Manager

Assess inpatient requirements and provide tailored services to meet individual needs effectively. Scrutinize admissions and hospitalization using established criteria and assist with additional day-to-day processes as required. Identify potential care quality issues and recommend solutions to drive continuous improvement.

Collaborate with interdisciplinary medical teams to formulate comprehensive discharge strategies while optimizing resource allocation.

Shearwater Health, Nashville, TN 2017 – 2021

Nurse Case Manager under Matrix Absence Case Management

Analyzed intricate clinical data to pinpoint challenges and define strategic goals. Contributed to regular roundtable discussions to brainstorm and generate innovative ideas for care improvement. Leveraged communication and interpersonal skills to foster productive relationships with internal/external partners.

Ensured 100% regulatory compliance across all documentation by proactively conducting assessments of all clinical documents.

Liaised with healthcare practitioners to procure treatment strategies and reports while delivering medical and disability clinical assessment services.

Exhibited proficiency in Microsoft Office, coupled with an in-depth understanding of workers' compensation statutes and insurance sector case management.

Cognizant Technology Solutions Corp, Barangay Apas, Cebu City 2016 – 2016

QA Auditor – Commercial & Medicare Appeals Process

Partnered closely with the QA Manager to establish, implement, monitor, and oversee the company's adherence to internal and client control requirements. Executed process audits to gauge the performance and efficacy of the quality program. Formulated detailed reports of audit outcomes for presentation to senior management. Identified prime areas for process enhancements aimed at elevating overall quality standards. Participated in external audits.

Systematized and maintained audit records and documents in strict compliance with relevant regulations and standards.

Demonstrated utmost diligence in safeguarding and preserving classified information.

Operated autonomously, with minimal to no supervision.

University of Cebu Medical Center, Cebu, Philippines 2015 – 2016

Quality Management Representative / Compliance & Systems Quality Management Supervisor / Staff Nurse

Provided end-to-end management for the daily operations of the SQM and Compliance Program, including the formulation, maintenance, and revision of its policies and procedures. Drafted key reports for management to enable informed decision-making.

Orchestrated internal quality audits, accreditation and licensure efforts, and the ISO 9001:2008 Certification pursuit for the Overseas Workers and Seafarers Center.

Steered the full spectrum of compliance initiatives, in addition to uncovering potential vulnerabilities and implementing effective corrective action plans.

Collaborated cross-functionally to investigate and resolve intricate quality and compliance matters; seeking counsel from the Corporate Lawyer as necessary.

Took charge of addressing alleged violations and orchestrating an efficient system for their resolution.

HCCA Health Connections/ Shearwater Health, Bonifacio Global City, Taguig 2010 – 2014

Quality Assurance Manager (2013 – 2014)

Helmed all aspects of the QA Department, ensuring consistent delivery of high-quality service. Performed root cause analyses to define essential limits and verification protocols. Supported key HR functions of employee recruitment, training, scheduling, and disciplinary actions to build high-performing teams and uphold benchmarks for productivity and quality. Prepared high-priority trend and process failure reports.

Safeguarded the organization from potential risks and sustained top quality of service through the execution of regular compliance audits.

Cultivated expertise and stayed abreast of industry advancements through continuous education and active engagement in professional associations.

Progressed through positions of increased scope and responsibilities due to exemplary leadership, business, and management acumen.

Nurse Team Lead – Specialty Benefits Management (2012 – 2013)

Supported the management and execution of day-to-day operations to optimize program success, maximize customer satisfaction through top-tier service, and meet established productivity and quality metrics. Stayed up-to-date on the continually evolving health plan requirements and operational processes and communicated updates to the team in a timely manner. Monitored and enforced team adherence to required performance standards to ensure optimal productivity. Supported training and retraining initiatives for all new and existing employees. Conducted performance evaluations in line with organizational standards.

Served as an approachable mentor for a team of nurses, providing ongoing guidance, training, and motivation to ensure the meeting and exceeding of performance benchmarks.

Functioned as the bridge between the Clinical Service Manager and the team, tracking daily staffing prerequisites and overseeing a range of reporting functions.

Provided orientation for new team members, allowing employees to feel embedded in the organizational culture and deliver excellent performance.

Facilitated regular team meetings to ensure effective communication, collaboration, and alignment among team members as well as nurture a productive environment for sharing updates, discussing progress, and addressing challenges.

Utilization Management Reviewer – Specialty Benefits Management (2010 – 2012)

Oversaw and processed pre-authorization requests sourced from fax and web channels. Performed preliminary medical assessments to verify the medical necessity of elective outpatient comprehensive imaging requests. Documented pertinent clinical data within the prior authorization system.

Conducted review procedures for pre-authorization-requiring procedures and granted approvals for studies adhering to defined protocols. Escalated cases failing to meet criteria to the Medical Director for further evaluation.

Commended for consistently maintaining strict adherence to all productivity, quality, and service benchmarks, while delivering exceptional customer service.

Actively engaged in ongoing training initiatives, ensuring unwavering adherence to high-performance standards and guideline compliance.

Additional Experience

Quality & Compliance Consultant (project), HCCA Health Connections/ Shearwater Health, Bonifacio Global City, Taguig

Quality & Compliance Consultant (project), University of Cebu Medical Center, Cebu, Philippines

Ambulatory Care Unit Coordinator – Neurophysiology, Oncology, and Endoscopy Unit / Charge Nurse/OIC – Medical Surgical Unit / Acute Care Nurse – Medical Surgical Unit, Chong Hua Hospital, Fuente Osmena Cebu City

Staff Nurse, Gregorio B. Tan Memorial Hospital, Laoang Norther Samar

Units of Experience

Admissions Ambulatory Cardiac Covid-19 Emergency Room General Floor/Med-Surg Labor-Delivery/Post-Partum/Maternity Medical Observation Oncology Ortho/Neuro Renal Rheumatology Step Down/Transitional Surgical Telemetry Urology

Affiliations

Sigma Theta Tau International Honor Society of Nursing (Sigma), Member, 2023 – Present

New York State Nurses Association, Member, 2021 – Present

Technical Proficiencies

Epic Allscripts Meditech ICD-10 Microsoft Office Suite MCG - Indicia Hospital Performance Index

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