Melliza Young
Dededo,GU
Summary
Detail-oriented general practitioner with strong background in the global scope of health and proven track record of efficiently completing tasks across diverse settings. Passionate about facilitating excellent patient care and equitable population health through evidence-based, culturally competent program assessment, design, monitoring, and evaluation. Ready to contribute to a dynamic team and make a positive impact.
Overview
20
20
years of professional experience
1
1
Certification
Work History
DSMES Consultant
TakeCare Insurance
Tamuning, GU
09.2023 - Current
- Enhance individuals' understanding through engaging one-to-one and group sessions on diabetes self-management education and support (DSMES).
- Analyze complex health information from multiple sources to identify patterns or trends.
- Evaluate existing systems and processes against industry best practices to enhance efficiency.
- Manage quality control activities of the DSMES program.
Director of Program Advocacy and Communications
Todu Guam Foundation
Tamuning, GU
05.2023 - Current
- Assess potential funding options to enhance the effectiveness of the CARES Program. Grants written/co-written and submitted as of date: a) CDC’s Expanding STI/Sexual Health Clinic Infrastructure (budget $500,000.00) – approved but unfunded, valid until September 2025; b) Robert Wood Johnson Foundation’s Disaster Recovery Fund – awarded $200,000.00; c) Guam Cancer Trust Fund FY 2024 for continuation and expansion of Healing for Women clinic, TGF’s cervical cancer screening and prevention program – awarded $1,015,038.00 for period of performance November 2023 to October 2024; d) Community Project Funding under the Office of Guam Congressional Delegate James Moylan – encumbered $1.5M to fund Phase 1 of Community Health and Wellness Center
- Implement enhancements to foundation's operational overlay following CARES Needs Assessment findings.
- Provide technical advice to determine requirements and qualifications for potential reimbursements from third-party payers.
- Devised growth strategy to expand organization's capacity and meet requirements for becoming a New Access Point community health center
- Oversaw all aspects of the start-up process for Eluciderm, Inc.'s Phase 2b open label clinical trial at Todu Guam Foundation clinic including coordinating pre-study site visit preparation, conducting contract reviews and budget negotiations while facilitating timely IRB submission to University of Guam.
- Supervised the development and analysis of a community health needs assessment survey, incorporating social determinants of health, by a public health master's candidate.
- Provided technical assistance in developing logic model for Guam Path to Zero Leprosy (GPZL) country report
Contractor/ DSMES Technical Advisor
National Association of Chronic Disease Directors
Decatur, GA
08.2019 - 07.2024
- Established a structured approach for promoting DSMES training and certification using the Navigating the course curriculum and Five A's in diabetes education among clinic-based employees and community outreach workers in the US-affiliated Pacific Island jurisdictions.
- Spearheaded technical support in creating culturally relevant and national standard-aligned DSMES resources and training for Pacific NCD Collaborative interdisciplinary teams.
- Contributed to the creation of the USAPI Diabetes Care and Management Guidelines (DCMG) by conducting thorough reviews of local, regional, national, and society guidelines.
- Fostered continued use and improvement of Chronic Disease Electronic Management System (CDEMS) and other health data sources for regional and interjurisdictional diabetes registry.
- Contributed to achieving PCDC and NCD Collaborative Initiative objectives by supporting various programmatic tasks including summarizing programs, reviewing briefing papers, evaluating program effectiveness, and responding to inquiries.
- Enhanced program activities and outreach by providing valuable insights on cultural relevancy and diplomacy.
- Played a critical role in supporting lead consultants with budget development, re-allocation of funds, and subcontract management.
Chief Executive Officer
Guam Community Health Centers
Dededo, GU
01.2023 - 03.2023
- Managed all aspects of the federally qualified health centers (FQHCs), including operations, finances, grants, personnel, and facilities, in alignment with the organization's mission and strategic plan.
- Oversaw the formation of working groups for various upcoming events, including CLIA waiver renewal, NCQA's PCMH recognition renewal, HRSA operational site visit, and EHR implementation.
- Redesigned FQHC's care coordination process to incorporate a team-based appointment system.
- Implemented best practices in revenue cycle management to ensure program income growth through clinical documentation integrity and incident-to billing.
- Facilitated dialogue with Guam Medicaid state plan to support telehealth services coverage between Northern and Southern CHCs, remove prior authorization for preventive services like well-child visits and annual physicals, and establish medical standards for expediting eligibility applications.
- Enforced policies to include licensed, non-licensed, and student volunteers at CHCs. Additionally, initiated donation of supplies and equipment for patient consumption and care.
- Successfully brought back subcommittee functions, such as Credentialing and Privileging, and Quality Improvement Committee (QIC), which had ceased before the COVID outbreak.
Outpatient Specialty Services Department Manager
Guam Regional Medical City
Dededo, GU
02.2019 - 01.2023
- Provided day-to-day leadership in the largest outpatient multi-specialty services on Guam and Micronesia region for a complex range of specialties such as Cardiology (general, interventional, diagnostic and electrophysiology), General Surgery, Infectious Disease, Orthopedics, Podiatry, Pulmonary, Neurology, Neurosurgery, Neuro-interventional Radiology, Sports Medicine and Wound Care and Hyperbaric Treatment; with previous oversight of Hematology-Oncology Department and Infusion Services until August 2022, when both departments converged into the new division of Cancer Center.
- Effectively utilized Tableau data analytics along with PDSA, DMAIC, and Lean methodologies to lead the department in compliance and quality improvement initiatives.
- Managed department budget and multiple projects and programs concurrently.
- Lead a diverse team of 80 employees, ensuring they possess the skills necessary to provide competent and culturally appropriate care.
- Drove the establishment of departmental policies in accordance with strategic initiatives, federal/state regulations, and rigorous care standards.
- Served as Allscripts (EHR) subject matter expert in the outpatient department.
- Served as co-chair for Institutional Review Board (IRB), handling all responsibilities in absence of chairperson, overseeing research protocol reviews and ensuring compliance with policies.
Patient Education Manager
Guam Regional Medical City
Dededo, GU
05.2015 - 06.2020
- Advocated for health literacy in hospital through patient & family education program, emphasizing primary, secondary, and tertiary prevention of non-communicable diseases (NCDs) using patient-centered and culturally sensitive methods in individual and group settings.
- Conducted one-on-one and group training sessions
- Served as a key point of contact between the hospital and the National Network of Libraries of Medicine, Pacific Southwest Region (NNLM PSR)
- Skilled in the navigation of Allscripts (EHR) for effective case reviewing and documentation
Medical Management Supervisor
TakeCare Insurance
Tamuning, GU
11.2014 - 05.2015
- Enhanced the hand-off process for off-island referrals by implementing interdepartmental forms, leading to a more efficient collaboration between Customer Service and Medical Management departments.
- Created medical necessity guideline for internal use of cases not available in MCG (formerly Milliman CareGuidelines).
- Outlined strategy to enhance company's case management program by implementing prioritization system.
- Delivered informative didactic sessions on a regular basis to the medical management staff, focusing on topics such as medical coding and medical necessity review.
Health Management Manager
StayWell Insurance
Hagatna, GU
01.2013 - 10.2014
- Developed StayWell's 'EnjoyLife' Health Management Program to cater to 15k+ healthcare plan subscribers in Guam and CNMI, implementing beneficial features such as on-site health fairs/vaccination clinics, comprehensive risk assessments, personalized lifestyle/disease management programs, informative nutrition/wellness sessions, and dynamic fitness regimens focused on patient education.
- Assisted staff and external stakeholders in developing, implementing, and evaluating cross-sectoral delivery of primary care services, corporate health, and disease management programs. This included technical support for business groups, the Department of Public Health and Social Services, and private non-profit community organizations.
- Maintained adherence to evidence-based clinical practice guidelines, such as those provided by the US Preventive Services Task Force (USPSTF), while delivering corporate wellness program and disease management interventions.
- Conducted analysis of health plan data to enhance and update plan benefits, incorporating information from utilization and claims data.
Medical Extern
American Nephrology Associates
Orlando, FL
08.2014 - 09.2014
- Acquired knowledge of effective Nephrology referral management techniques through close observation of Dr. Jafar Mahmood's procedures and exams at Florida Hospital in Downtown, Orlando
- Observed hospital management of various wound types including colostomy, decubitus ulcers, diabetic foot ulcers, and chronic non-healing wounds.
Medical Extern
Advanced Medical Practice
Chicago, IL
07.2014 - 08.2014
- Conducted daily patient assessments while administering care and collaborating with Dr. Lev-Weissberg for optimal treatment plans
- At Advocate Lutheran General Hospital's Heart Station, observed various procedures like stress testing (exercise and pharmacological), along with pacemaker and implantable cardio defibrillator interrogation.
Medical Extern
TS Wright MD Occupational Medicine and Family Practice
Chicago, IL
06.2014 - 08.2014
- Handled direct and indirect management of Dr. Theodore Wright Jr.'s clinic patients while gaining valuable insights into hospital and assisted living facility patient care.
- Independently performed history-taking, physical examination, phlebotomy, IM administration of medications and vaccinations, developing x-ray films, facilitating diathermy, and conducting pre-employment and work physicals. I also assisted Dr. Wright in various office procedures such as arthrocentesis (elbow, knee, metatarsal), application of casts and splints, excision of mass, repair of wound laceration, excision of thrombosed external hemorrhoid, corn and callus removal, removal of foreign body (eyes and ears), politzerization, and Pap smear.
Utilization Management Coordinator
StayWell Insurance
Hagatna, GU
07.2008 - 12.2012
- Conducted concurrent utilization reviews and case management for members admitted to Guam Memorial Hospital and those enrolled in the company's Worker's Compensation product, ensuring adherence to evidence-based clinical practice guidelines. Significantly reduced average hospital stay to only 3 days.
- Conducted utilization reviews for healthcare services provided on Guam and CNMI.
- Utilized expertise in MCG, other nationally recognized society guidelines, and government agency standards to determine medical necessity reviews and evaluate the efficiency and effectiveness of company's medical management programs in comparison to local and national health insurance programs.
- Provided presentations and facilitated discussions with the Appeals Committee regarding grievances raised by members and providers in response to adverse determinations from medical necessity reviews.
- Assisted Actuary Department in interpreting underwriting information and impact of legislation for health plan design and insurance premium pricing.
- Performed data collection, analysis, and synthesis for multiple departmental activities to develop the company's bed days and medical loss ratio report.
Medical Case Coordinator
StayWell Insurance
Quezon City, Philippines
02.2006 - 06.2008
- Guided and coordinated the implementation of the company's case management and quality management programs in the Philippines
- Managed the pre-certification process, hospital claims review, and policy compliance for insurance members referred to network providers in the Philippines.
- Collaborated with Guam-based Medical Director to address issues related to long-staying cases and potential denials through regular didactic sessions.
- Demonstrated advanced operational expertise in using MCG, other nationally recognized society guidelines, and government agency standards for medical necessity reviews and evaluating the efficiency and effectiveness of company’s medical management programs in relation to US national and local Philippine health insurance programs.
Provider Relations Officer/ Asst Med Coordinator
DB Davis & Associates dba StayWell Manila
Quezon CIty, Philippines
01.2005 - 02.2006
- Grew provider/specialist network by 10% to accommodate rising referral needs from Guam and CNMI.
- Conducted analysis, benchmarking, and proposed a revised fee schedule for the surgical specialty provider network in the Philippines.
- Created informational materials to streamline the pre-certification process, enhancing patient understanding of referral procedures and insurance coverage in the Philippines.
Education
Master of Science - Global Health
Northwestern University
Evanston, IL06-2019
M.D. - Doctor of Medicine
University of Santo Tomas
Manila, Philippines03-2002
Bachelor of Science - Biochemistry
University of Santo Tomas
Manila, Philippines03-1998
Skills
- Evidence-based health program design, implementation and evaluation
- Person-centered care
- Population health management
- Quality assurance/ quality improvement
- Analysis and problem solving
- Partnership and collaboration
- Cultural competence
Languages
Tagalog
First Language
English
Proficient (C2)
C2
Accomplishments
- National Association of Chronic Disease Directors, Community Impact Award 2023
- Guam Pharmacists Association, Executive Board Medal Award 2023
- Association of Diabetes Care and Education Specialists (ADCES) Foundation, Diabetes Technology Conference Scholarship, December 2021
- Academy of Communication in Healthcare, Health Equity Scholar, 2018
- National Network of Libraries of Medicine Pacific Southwest Region, Professional development Award, 2018
Certification
- Certified Diabetes Care and Education Specialist (CDCES, formerly CDE or Certified Diabetes Educator) certificate # 21800296, for renewal by December 31, 2028
- Philippine Physician License # 0101307, for renewal by July 22, 2027
- Certification in Health Care Quality and Management (CHCQM), for renewal by December 31, 2025
- Board Certified through the American College of Medical Practice Executives (CMPE), for renewal by December 31, 2024
- CITI Good Clinical Practice for Clinical Trials with Investigational Drugs and Medical Devices (US FDA focus), for renewal by September 24, 2024
- American Heart Association BLS Provider, for renewal by August 2024
- Educational Commission for Foreign Medical Graduates (ECFMG), July 2011; no expiration.
References
References available upon request.
Timeline
DSMES Consultant
TakeCare Insurance
09.2023 - Current
Director of Program Advocacy and Communications
Todu Guam Foundation
05.2023 - Current
Chief Executive Officer
Guam Community Health Centers
01.2023 - 03.2023
Contractor/ DSMES Technical Advisor
National Association of Chronic Disease Directors
08.2019 - 07.2024
Outpatient Specialty Services Department Manager
Guam Regional Medical City
02.2019 - 01.2023
Patient Education Manager
Guam Regional Medical City
05.2015 - 06.2020
Medical Management Supervisor
TakeCare Insurance
11.2014 - 05.2015
Medical Extern
American Nephrology Associates
08.2014 - 09.2014
Medical Extern
Advanced Medical Practice
07.2014 - 08.2014
Medical Extern
TS Wright MD Occupational Medicine and Family Practice
06.2014 - 08.2014
Health Management Manager
StayWell Insurance
01.2013 - 10.2014
Utilization Management Coordinator
StayWell Insurance
07.2008 - 12.2012
Medical Case Coordinator
StayWell Insurance
02.2006 - 06.2008
Provider Relations Officer/ Asst Med Coordinator
DB Davis & Associates dba StayWell Manila
01.2005 - 02.2006
Master of Science - Global Health
Northwestern University
M.D. - Doctor of Medicine
University of Santo Tomas
Bachelor of Science - Biochemistry
University of Santo Tomas
- Certified Diabetes Care and Education Specialist (CDCES, formerly CDE or Certified Diabetes Educator) certificate # 21800296, for renewal by December 31, 2028
- Philippine Physician License # 0101307, for renewal by July 22, 2027
- Certification in Health Care Quality and Management (CHCQM), for renewal by December 31, 2025
- Board Certified through the American College of Medical Practice Executives (CMPE), for renewal by December 31, 2024
- CITI Good Clinical Practice for Clinical Trials with Investigational Drugs and Medical Devices (US FDA focus), for renewal by September 24, 2024
- American Heart Association BLS Provider, for renewal by August 2024
- Educational Commission for Foreign Medical Graduates (ECFMG), July 2011; no expiration.
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