Hi, I’m
OSMAR ECLARINAL
CLINIC MANAGER
PASIG CITY,MANGGAHAN
Summary
- My objectives are to broaden my expertise in the the creation of brands, and management. comprehending premium healthcare trends, healthcare leadership, and the presentation of products. Good communication skills, the ability to work well in a team, and the ability to develop relationships with important stakeholders at all organizational levels. An agile learner who can complete assignments on schedule even under pressure.
- Healthcare Administrator with proven to deliver exemplary level of healthcare service delivery to patients. Coordinate admission and discharge of patients. Plan and implement strategies for developing improved health care management. Proven problem solver and excellent communicator. Strong organizational skills, superb understanding of data collection and performance metrics. Recognized for staff development leading to high performing teams.
Overview
26
years of professional experience
53
years of post-secondary education
Work History
Kaiser Medical Center - Robinsons GalleriaQuezon City
Clinic Manager
06.2023 - Current
Job overview
- Responsible for the overall management and coordination of all aspects of the clinic's operations including overseeing staff, ensuring medical equipment and procedures are updated and ensuring a safe and welcoming environment for clients, patients and staff
- Oversees the scheduling of patient appointments, staff shifts, and resources (equipment, supplies, etc.) and ensures the maintenance and proper functioning of clinic facilities and equipment
- Monitors and coordinate repairs and upgrades as necessary
- Ensures medical services and operations comply with applicable regulatory and licensing agencies
- Supervises staff and complete routine performance reviews and work closely with physicians, nurses, and other healthcare providers to optimize patient care and outcomes
- Ensures compliance with all relevant healthcare regulations, standards, and guidelines
- Stay informed about changes in healthcare laws and regulations, updating policies accordingly
- Monitors patient flow and implement strategies to improve efficiency to ensures the delivery of high-quality patient care and excellent customer service
- Implement strategies to enhance patient and client satisfaction and loyalty and addresses patient complaints and concerns promptly and professionally
- Performs other related duties as may be assigned by the immediate superior.
St. Camillus Medical CenterPasig City
Corporate Relations Officer
05.2021 - 02.2023
Job overview
- Is responsible for overseeing the overall activities of the Business Processing and Development Office
- Manage and directs the activities of the Corporate Accounts Office, Philhealth Section, and Collection Section Team
- Develop, establish and maintain strong party relationships with Corporate Accounts and HMO
- Create and negotiate standard deals, and terms of payment, when possible, for each type of organization; Ensure that each account's relationship is covered by a contract or Memorandum of Agreement (MOA) as applicable
- Monitors the performance of staffs, through encouragement and coaching them for professional growth and development, through group activities workshops, seminars, independent study, and other continuing education opportunities
- Prepares special reports as required.
- Supervised, directed and evaluated assigned staff members and newly hired officers.
- Attended personnel meetings and training sessions to improve skills and learn new policies and procedures.
Marikina Doctors Hospital and Medical CenterPasig City
Manager - Business Operations
09.2020 - 04.2021
Job overview
- Responsible for overseeing the overall activities HMO and Industrial, Billing, Credit, and Collection Teams
- Develop, establish, and maintain strong 3rd party relationships with HMOs as potential sources of the increased patient census
- Create and negotiate standard deals, and terms of payment, when possible, for each type of organization; Ensure that each 3rd party relationship is covered by a contract or Memorandum of Agreement (MOA) as applicable
- Monitors the performance of staff
- Encourages the professional growth and development of staff through such activities as workshops, seminars, independent study, and other continuing education opportunities
- Prepares special reports as required
- Ensure that team is effectively and efficiently performing within the bounds of their duties and job responsibilities
- Ensures that organizational processes and the goods and services that result comply with the requirements of standards (e.g., ISO 9001), as well as customer, regulatory, and the organization's requirements
- Evaluate processes for compliance with quality requirements.
- Devised strategies to boost customer sales and drive referrals due to excellent service resulting in new customer relationships.
- Reviewed company's strategic plans and developed departmental goals and standards to support vision.
- Worked in tandem with peers to better understand business process and initiate improvements, helping company achieve goals.
TriCityMedical Center Inc.Pasig City
Supervisor / Internal Quality Auditor - QMS ISO 9001
06.2019 - 09.2020
Job overview
- The first position is a Supervisor of HMO Accreditation responsible for accrediting HMO and industrial clients, maintaining strong relationships with third-party organizations, negotiating deals and ensuring contractual agreements, and monitoring staff performance
- The second position is an Internal Auditor for QMS ISO 9001 responsible for ensuring compliance with ISO 9001, evaluating processes for quality compliance, assisting with audit planning and schedules, and developing audit reports for presentation to top management
- Calibration of audit tools and development of internal testing parameters may also be required.
- Evaluated employee performance and coached and trained to improve weak areas.
- Created successful work schedules for each team member to maintain deadlines and fully staff shifts.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
HPPI - Health Plan Philippines Inc.Pasig City
Supervisor - Medical Department
05.2018 - 03.2019
Job overview
- The Medical and Providers Relation Supervisor is responsible for supervising all medical staff to ensure customer satisfaction and providing quality personalized services
- They also act as a liaison between HPPI and healthcare providers and oversee customer service delivery in compliance with defined metrics of service
- Additionally, cost-effective medical utilization, accurate claims adjudication, and proper servicing of confined members are within their jurisdiction
- The Manager is also responsible for managing liaisons' work assignments and compliance, conducting training to professionalize service delivery, and coordinating the needs of VIP members and special patients
- Lastly, they orient and provide information on the accreditation of new providers, both doctors and hospitals Ensuring efficient and timely 24 / 7 customer service delivery that adheres to and complies with defined metrics of service
- Overseeing accurate adjudication to achieve cost-effective medical utilization both with the medical and claims department
- Proper servicing of confined members including live patient orientation, assistance, and discharge facilitation from hospitals
- Checking of claims, documents, and reports before submission to the Medical Director; Orient and provide information on the accreditation of new providers, both doctors and hospitals
- Managing liaisons' work assignments, daily deliverable, and compliance with the work instruction manual, protocols, and company policies; Conduction of training of liaisons to professionalize service delivery and client handling; Coordination of needs of VIP members and special patients.
- Created successful work schedules for each team member to maintain deadlines and fully staff shifts.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.
- Maintained compliance with company policies, objectives, and communication goals.
IntellicareMakati City
Supervisor - Patient Relations Officer Department
08.2005 - 01.2017
Job overview
- The PRO Supervisor is responsible for supervising all Patient Relations Officers and ensuring the proper implementation of service agreements to achieve customer satisfaction through quality personalized services
- They also check and coach PRO staff on their corporate duties and responsibilities on a daily basis.
- Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
- Evaluated employee performance and coached and trained to improve weak areas.
- Monitored workflow to improve employee time management and increase productivity.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Enforced rules and regulations outlined in company manual to set forth expectations comprehensibly and consistently.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Mentored newly hired employees on operating equipment and safety and developed training manual to use for reference.
- Conducted routine inspections to check quality and compliance with established specifications.
- Solicited customer feedback to identify and improve on areas of weakness.
ValucareHealth Inc.Pasig City
Hospital Liaison Officer
09.2002 - 01.2005
Job overview
- The Hospital Liaison Officer's role is to visit all confined members of Valucare and provide them with necessary instructions concerning their confinement
- This includes explaining their contract benefits as agreed upon by their company and Valucare
- The Liaison Officer serves as a patient advocate, ensuring that members receive the best possible care for their conditions
- This person helps coordinate services between the healthcare provider and the patient, assisting with billing issues, scheduling appointments, and communicating any concerns to the appropriate parties
- Additionally, the Hospital Liaison Officer ensures that patients are aware of all their options for treatment and recovery, helping them make informed decisions about their healthcare
- Overall, the Liaison Officer plays a crucial role in ensuring that members of Valucare have a positive healthcare experience and receive the care they need.
- Helped clients set appointments, discussed plans and followed up to check on concerns.
- Communicated with family, pharmacies, hospice care, discharge planners, and other professionals to complete seamless transitions.
- Participated in improvement planning to optimize services and improve future care.
- Worked with hospitals and facilities to outline discharge plans.
MaxicareMakati City
Claims Analyst / Underwriter Team Leader
08.1997 - 08.2002
Job overview
- As Team Leader Underwriter, the primary responsibility is to provide guidance and supervision to the underwriters under your team
- You need to ensure that all of their tasks are regulated and reviewed thoroughly before the member's contract renewal
- You will be accountable for meeting the service level agreements and maintaining high-quality standards while ensuring that the underwriters provide the best- in-class service to the members
- As a Senior Claims Analyst, your primary responsibility is to receive and review all claims processed by the junior analyst
- You will counter-check the validity of all claims, including regular and reimbursement claims (In-Patient and OPD Claims)
- You must have a good understanding of the claim processing workflow and a comprehensive knowledge of the health insurance industry's regulations
- You will need to investigate disputed claims and ensure timely resolution of all pending claims
- Your role is critical in maintaining the integrity of the claims processing system, resulting in high member satisfaction
- You will also need to maintain relationships with healthcare providers and work closely with the underwriters' team to ensure timely and accurate processing of claims.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Identified key areas not performing well and implemented effective, new processes.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Analyzed information gathered by investigation and reported findings and recommendations.
Education
GREENVILLE COLLEGEManila
MBA from Operations Management And Supervision
10.2022 - Current
DE OCAMPO MEMORIAL COLLEGEManila
Bachelor of Science from Nursing
1988.May - 1992.Apr (3 years & 11 months)
ROOSEVELT MEMORIAL HIGH SCHOOLManila
High School Diploma
05.1984 - 03.1988
SAN JUAN ELEMENTARY SCHOOLSan Juan CIty
from Primary Education
06.1979 - 03.2023
Skills
Report writing
undefinedEmployment Experiences
- 06/05/23, Present, Clinic Manager, Kaiser Medical Center - Robinsons Galleria, 2ndFlr.Robinsons Galleria, Ortigas Edsa, Quezon City
- 05/03/21, 02/29/23, Corporate Relations Officer, St. Camillus Medical Center, 116 Eulogio Amang Rodriguez Avenue Santolan, Pasig City
- 09/01/20, 04/30/21, Manager, MarikinaDoctors Hospital and Medical Center, 10Evangelista Road, Santolan, Pasig City, 1610
- 06/04/19, 09/15/20, Supervisor / Internal Quality Auditor - QMS ISO 9001, TriCityMedical Center Inc., 269 C. Raymundo Ave, Maybunga, Pasig City, 1607
- 05/24/18, 03/05/19, Supervisor, HPPI - Health Plan Philippines Inc., Unit 1410Prestige Tower Condominium Ortigas St., Pasig City
- 08/01/05, 01/15/17, Supervisor, Intellicare, 11thFloor Feliza Building Cor. V. A. Rufino Street, Makati City
- 09/01/02, 01/30/05, Hospital Liaison Officer, ValucareHealth Inc., 10thFloor PSE, Ortigas Avenue, Pasig City
- 08/01/97, 08/30/02, Underwriter Team Leader, Maxicare, 10th Floor Makati Medical Plaza Salcedo Village, Makati City
Timeline
Clinic Manager
Kaiser Medical Center - Robinsons Galleria
06.2023 - Current
GREENVILLE COLLEGE
MBA from Operations Management And Supervision
10.2022 - Current
Corporate Relations Officer
St. Camillus Medical Center
05.2021 - 02.2023
Manager - Business Operations
Marikina Doctors Hospital and Medical Center
09.2020 - 04.2021
Supervisor / Internal Quality Auditor - QMS ISO 9001
TriCityMedical Center Inc.
06.2019 - 09.2020
Supervisor - Medical Department
HPPI - Health Plan Philippines Inc.
05.2018 - 03.2019
Supervisor - Patient Relations Officer Department
Intellicare
08.2005 - 01.2017
Hospital Liaison Officer
ValucareHealth Inc.
09.2002 - 01.2005
Claims Analyst / Underwriter Team Leader
Maxicare
08.1997 - 08.2002
DE OCAMPO MEMORIAL COLLEGE
Bachelor of Science from Nursing
1988.May - 1992.Apr (3 years & 11 months)
ROOSEVELT MEMORIAL HIGH SCHOOL
High School Diploma
05.1984 - 03.1988
SAN JUAN ELEMENTARY SCHOOL
from Primary Education
06.1979 - 03.2023
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