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Skills

  • Budgets
  • Data accuracy auditing
  • Coding participant data
  • Business operations
  • Category equipment
  • First Aid/CPR
  • Regulatory compliance
  • MS Office
  • Effective communication with medical offices
  • Key performance indicator (KPI) tracking

Work Experiences

  • Achieved a 22% improvement in timeliness.
  • Aligned HEDIS review findings with facility process improvements.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Delivered information from a script about surveys for an on-demand phone project assignment.
  • Analyzed chart abstraction data from 16+ medical centers, uncovering trends and improving HEDIS scoring accuracy by 55%.
  • Oversaw the delivery of process project by framework team, which resulted in program.
  • Abstracted data for 4 difficult-to-retrieve records.
  • Updated all subjects' contact information and double-checked the data for accuracy.
  • Data from participant interviews was coded.
  • Achieved a retrieval rate of 15%.

Summaries

  • Consistently improved timeliness.
  • Achieved 49% improvements in review accuracy.
  • Within Miscellaneous, senior HEDIS Field Reviewer and outstanding performer in stakeholder engagement and workflow optimization.
  • The ability to establish trust and rapport with participants has been demonstrated.
  • Collaborative HEDIS Field Reviewer.
  • Achieved 37% improvements in HEDIS measure adherence.
  • Accomplished at implementing HEDIS abstraction best practices, enhancing the team’s performance and improving audit results by 72%.
  • Motivated individual who has spent more than 18 years working for a Brightline organization and has been trained to be a top-level Interviewer.
  • Completed complex HEDIS projects on time.
  • Achieved consistent 78% accuracy in HEDIS reviews.

Accomplishments

  • Resolved product issue through consumer testing.
  • Analyzed and abstracted medical records across 12 provider locations, improving overall HEDIS measure compliance by 41%.
  • Piloted a provider-relations program in Phoenix, boosting HEDIS documentation retrieval rate by 45% from historically lower-performing health offices.
  • Collaborated with 5 teams to enhance documentation compliance, increasing the accuracy of reported quality measures by 40% for the 2021 audit.
  • Contributed to a multi-state HEDIS project, successfully retrieving 3 patient records, resulting in a 43% score improvement in quality measures.
  • Awarded for leading an initiative that improved chronic condition documentation accuracy, directly increasing compliance with HEDIS by 70%.
  • Collaborated with team of 16 in the development of standard.
  • Reduced overall chart review workload by 47% by streamlining data entry processes using Salesforce, leading to faster HEDIS submission cycles.
  • Partnered with healthcare providers to retrieve critical documentation, achieving a retrieval rate of 26% for HEDIS reporting from rural practices.
  • Facilitated a review of 17 patient records within a the past year, leading to a 64% increase in the completeness of information for HEDIS reporting.

Affiliations

  • Jaycees
  • Institute for Healthcare Improvement (IHI)
  • National Association of Social Workers
  • State Association of Health Underwriters Ohio
  • International Council of Nurses
  • Council for Affordable Quality Healthcare (CAQH)
  • CERTIFIED Professional in Healthcare Quality (CPHQ) Program
  • American Nursing Informatics Association (ANIA)
  • Professional Association of Health Care Office Management (PAHCOM)
  • Population Health Alliance (PHA)

Certifications

  • HEDIS certifier by NCQA
  • First Aid/CPR Certified
  • Certified Information Systems Auditor (CISA) for Healthcare by ISACA
  • CompTIA Security+
  • ICD-10 Proficiency Certification by AAPC
  • ServSafe
  • Certified Healthcare Chart Auditor (CHCA) by American Institute of Healthcare Compliance (AIHC)
  • Healthcare Auditor (HC) Certification by Beacon Labs
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Risk Adjustment Coder (CRC) by AAPC

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