Utilization Nurse Experience and Leadership

Mark H. Osborn, MSN, RN

Email: **********@*****.***

LinkedIn: linkedin.com/in/mark-osborn-883827109

Phone: 206-***-****

Location: Baltimore, MD

SUMMARY

Highly qualified Registered Nurse and Lean Six Sigma Green Belt with 20+ years of experience in Pediatric Acute and Emergent levels of care. Proven expertise in enterprise and academic-level clinical education including LMS coordination and reporting, infection prevention, EHR systems (EPIC, NextGen, PointClickCare), and regulatory compliance (OSHA, CDC, CMS) including Plan of Correction post Quality Assurance Surveys. Managed teams of 200+ staff including Directors and Clinical Managers across 21 multi-state facilities with $1.75M budget. Drove enterprise clinical strategy, succession planning, and culture of accountability while ensuring regulatory compliance and quality outcomes to ensure development of quality care team performance. AREAS OF EXPERTISE

Strategic Leadership: Multi-State Operations Enterprise Strategy Succession Planning Culture Development Outlier Intervention

Education and Mentoring: In-Service Education and New Employee Orientation LMS Administration Multi-State Operations Enterprise Strategy

Clinical: Acute & Emergent Care Infection Control & Prevention Regulatory Compliance (CMS, CDC, OSHA) Quality Improvement

Operational: EHR Implementation (EPIC/NextGen) Budget Management ($1.75M) Policy Development Utilization Management PROFESSIONAL EXPERIENCE

RO HEALTH

Area Clinical Supervisor Maryland 06/2025 - 01/2026 Per Diem

● Directed the overall clinical services for the K-12 school health programs, school nurse services, and behavioral health in the State of Maryland providing feedback to management about how to improve procedures for the benefit of nurses and patients

● Established, implemented and evaluated goals and objectives for school and home health services that met and promoted high standards of quality

● Cultivated accountability culture through quarterly performance reviews and succession planning for clinical leadership pipeline

● Conducted initial patient assessments and proceeded accordingly in creating the Plan of Care in coordination with their physician

● Implemented orientation practices for new providers and evaluated methods for improving the process for all future hires

● Provided oversight of all clinical operations ensuring that services comply with local and state regulations YESCARE CORPORATION / CENTURION HEALTH

Statewide Education Coordinator/Ombudsman Maryland 08/2022 - 03/2025

● Directed education programs for 1,000+ clinicians across 21 facilities, ensuring compliance with CCNE/NLN standards

● Provided matrix leadership to 21 multi-state facilities with accountability for in-service education compliance and plan of correction (POC) development supporting survey readiness

● Developed learning metrics and outcomes reporting for 1,000+ care team members, driving retention through competency-based education

● Launched New Employee Orientation covering EMR documentation (NextGen), reducing onboarding time by 30%

● Served as field-based clinical partner providing enterprise-wide education strategy insights across 21 multi-state facilities; represented organization in national clinical education forums

● Managed Learning Management System (LMS) and $1,750,000 training budget

● Coordinated the institution of Infectious Disease Testing and Counseling for HIV and Hepatitis C treatment and prevention for 1000+ Clinicians, along with Linkage to Care Programs for timely and effective treatment in partnership with the Maryland Department of Health

● Directed and executed Corrective Action Plans for Point of Care Testing of Infectious Diseases and Operational Compliance

● Received complaints and grievances from inmates and/or family regarding access to medical care.

● Reviewed documentation and Plan of Care assuring Standard of Care was applied in each complaint/grievance.

● Communicated conclusions and outcomes to complainants and internal stakeholders. Maintained database of grievances and reported results and progress in quarterly compliance reviews

● Applied MCG Criteria and proprietary guidelines to determine medical necessity, cost/benefit, and appropriateness of specialty referrals and procedures after performing remote chart review reducing inappropriate specialty referrals by 8%

● Reviewed complex cases for appeals and dispute resolution; partnered with medical directors to support coverage determinations

● Developed and implemented a statewide Utilization Management program aligned with CMS and payer regulations

● Conducted utilization trend analysis to identify cost drivers and reduce unnecessary specialty referrals

● Performed HEDIS abstraction and validation to support quality and reimbursement optimization

● Collaborated with interdisciplinary teams to improve care transitions and reduce avoidable utilization GENESIS AT LOCH RAVEN

Nurse Practice Educator/Infection Preventionist Parkville, MD 01/2021 - 01/2022

● Trained 200+ staff via LMS/didactic programs; conducted New Employee Orientation that included Infection Control and Bloodborne Pathogen Exposure Prevention, achieved 98% CMS/CDC compliance

● Responsible for tuberculosis testing program, influenza and HBV vaccination programs for staff, residents and volunteers. Maintained accurate records through MDImmunet.org.

● Managed 12+ infection outbreaks; obtained CDC Project Firstline Certification, reduced bloodborne exposures by 30% through OSHA-aligned protocols

● Coordinated skilled nursing COVID response for 250 care team members and 150 residents, ensuring resident care quality and plan of correction compliance with the Maryland Department of Health and the Centers for Disease Control

● Performed MDS assessments improving Medicare reimbursement accuracy MOBOKO HEALTHCARE CONSULTING AND OMBUDS SERVICE

Founder, Lead Consultant 07-2007 - Present

● Review of medical services provided

● Reconciliation of medical billing with provider of services

● Individualized tutoring services for NCLEX preparation and completion COMMUNITY COLLEGE OF BALTIMORE COUNTY

Adjunct Professor - Clinical Instructor Essex, MD 03/2005 - 11/2020

● Courses taught include Pediatrics, Medical/Surgical Nursing II and III

● Mentored and Evaluated 360+ nursing students; 200+ pursued advanced degrees

● Developed Joint Commission-aligned curricula for Hospice/Palliative Care and Incontinence Care programs

● Precepted the learning experiences of Nursing Students in the Pediatric Rotation for the School Nurse role of caring for K-12 students including topics on Safety, Sexual Health, Pregnancy Prevention, and Chronic Disease Management

● Instructed students in applying preventive care guidelines, chronic disease management standards for adults, and evidence-based clinical measures

JOHNS HOPKINS BAYVIEW MEDICAL CENTER

Registered Nurse (Resource Nurse) Baltimore, MD 03/2003 - 11/2020

● Provided acute/critical care across multiple units including Medicine/Surgery, Nephrology, Cardiology, and Oncology; provided Emergency Care in the Pediatric ER to greater than 1200 patients from infant to school-age. Assessed and treated patients in the Psychiatric Holding Unit in the Emergency Department patients experiencing emergent and acute episodes of Major Depressive Disorder, Anxiety, Personality Disorder, Schizophrenia, and Substance Use Disorders.

● Conducted discharge planning and case management to reduce readmissions and ensure cost-effective care transitions.

● Evaluated necessity and value of post-acute services.

● Collaborated with payers and interdisciplinary teams to ensure appropriate resource utilization.

● Trained 50+ staff in IV access/peritoneal dialysis; reduced procedure errors by 40%

● EPIC Credentialed Trainer (2014-2020) ASAP and ClinDoc Modules: Increased charge capture 4% through workflow optimization

EDUCATION

MSN - Nursing Education

Notre Dame of Maryland University: Summa Cum Laude, Sigma Theta Tau Honor Society BSN - Nursing

Seattle University

Contact this candidate