- Messages
- 1
- Best answers
- 0
email: mario.santiago2@upr.edu
Profile: Registered Nurse with expertise in acute and chronic care, clinical quality assurance, utilization and risk management, care transitions, service coordination, and staff supervision, seeking advancement.
Education:
2020 – 2023 University of Puerto Rico, Medical Sciences Campus
Master of Science in Nursing
2011 – 2016 University of Puerto Rico, Mayagüez Campus
Bachelor of Science in Nursing
Professional Experience:
Apr. 2026 – Present Optum, (800)-561-0861, Remote – Full-time
Clinical Reviewer
Review medical records to ensure accurate coding, proper documentation, and compliance with billing regulations.
Sept. 2024 – Feb. 2026 Infosys BPM Limited, (770)-799-1958, Aguadilla – Full-time
Utilization Management Supervisor
Supervised the daily operations of a 32‑person team.
Jun. 2023 – Aug. 2024 MCS, (787) 758-2500, San Juan – Full-time
Special Need Plan Program Supervisor
Supervised policies and processes that support ongoing improvement of clinical programs for special needs populations.
Aug. 2022 – Aug. 2024 Mennonite General Hospital, (787)-852-0505, Humacao – Per-diem
House Supervisor
Organize, direct and control staffing schedules, daily assignments, acuity reports, and safe and efficient use of staff resources.
Dec. 2019 – Aug. 2020 Metro Pavía Clinic, (787) 296-9778, Aguadilla – Per-diem
ER Staff RN
Evaluated episodic and acute responses to broad classifications of physical/psychosocial conditions that demanded emergency care.
Jan. 2019 – June 2023 Triple-S Salud, (787) 749-4949, San Juan – Full-time
Utilization Management Supervisor (2021 – 2023)
Responsible for overseeing contracted delegated entities that perform hospital related utilization management services in the US and PR.
Transition of Care / Utilization Review Nurse (2019 – 2020)
Acted as a clinical liaison with providers to develop and implement a comprehensive service plan for insurers during acute hospitalization.
Oct. 2016 – Dec. 2018 Bella Vista Hospital, (787) 834-6000, Mayagüez – Full-time
2-years, 3-months ICU Charge Nurse (2018)
Delegated nursing assignments, directed patient admissions/discharges and served as the unit forefront.
Professional Certifications:
InterQual® Certified Instructor (Triple-S Salud)
Certified Professional Coder (CPC) [American Academy of Professional Coders – AAPC]
Research
2022 Principal investigator: Knowledge and acceptability of PrEP among Puerto Rican transgender women and men who have sex with men
Research assistant: Hurricane Maria Mortality Project
Served as an expert consultant in the extraction and interpretation of clinical information from hospital records island wide.
Jun. 2020 Triple-S’s epidemiology project
Logistics aid
Partook a leading role in the COVID-19 diagnostic testing of more than a thousand employees of Triple-S Management.
Helped with logistics and served as a lab runner.
Specialization Highlights:
Cancer & HIV/AIDS Research Community health programs
Care Management Nursing Management
Clinical Experience Utilization Management
Clinical quality assurance Risk Management
MCG (Milliman Care Guidelines) Process Improvement
Education:
2020 – 2023 University of Puerto Rico, Medical Sciences Campus
Master of Science in Nursing
2011 – 2016 University of Puerto Rico, Mayagüez Campus
Bachelor of Science in Nursing
Professional Experience:
Apr. 2026 – Present Optum, (800)-561-0861, Remote – Full-time
Clinical Reviewer
Review medical records to ensure accurate coding, proper documentation, and compliance with billing regulations.
Sept. 2024 – Feb. 2026 Infosys BPM Limited, (770)-799-1958, Aguadilla – Full-time
Utilization Management Supervisor
Supervised the daily operations of a 32‑person team.
Jun. 2023 – Aug. 2024 MCS, (787) 758-2500, San Juan – Full-time
Special Need Plan Program Supervisor
Supervised policies and processes that support ongoing improvement of clinical programs for special needs populations.
Aug. 2022 – Aug. 2024 Mennonite General Hospital, (787)-852-0505, Humacao – Per-diem
House Supervisor
Organize, direct and control staffing schedules, daily assignments, acuity reports, and safe and efficient use of staff resources.
Dec. 2019 – Aug. 2020 Metro Pavía Clinic, (787) 296-9778, Aguadilla – Per-diem
ER Staff RN
Evaluated episodic and acute responses to broad classifications of physical/psychosocial conditions that demanded emergency care.
Jan. 2019 – June 2023 Triple-S Salud, (787) 749-4949, San Juan – Full-time
Utilization Management Supervisor (2021 – 2023)
Responsible for overseeing contracted delegated entities that perform hospital related utilization management services in the US and PR.
Transition of Care / Utilization Review Nurse (2019 – 2020)
Acted as a clinical liaison with providers to develop and implement a comprehensive service plan for insurers during acute hospitalization.
Oct. 2016 – Dec. 2018 Bella Vista Hospital, (787) 834-6000, Mayagüez – Full-time
2-years, 3-months ICU Charge Nurse (2018)
Delegated nursing assignments, directed patient admissions/discharges and served as the unit forefront.
Professional Certifications:
InterQual® Certified Instructor (Triple-S Salud)
Certified Professional Coder (CPC) [American Academy of Professional Coders – AAPC]
Research
2022 Principal investigator: Knowledge and acceptability of PrEP among Puerto Rican transgender women and men who have sex with men
Research assistant: Hurricane Maria Mortality Project
Served as an expert consultant in the extraction and interpretation of clinical information from hospital records island wide.
Jun. 2020 Triple-S’s epidemiology project
Logistics aid
Partook a leading role in the COVID-19 diagnostic testing of more than a thousand employees of Triple-S Management.
Helped with logistics and served as a lab runner.
Specialization Highlights:
Cancer & HIV/AIDS Research Community health programs
Care Management Nursing Management
Clinical Experience Utilization Management
Clinical quality assurance Risk Management
MCG (Milliman Care Guidelines) Process Improvement