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Skills

  • Annual HEDIS® methodology review
  • Handling sensitive patient information
  • Clinical data accuracy monitoring
  • ICD-9 forms
  • Patient and family advocacy
  • Strong clinical judgment
  • Chronic disease management support
  • HEDIS® measure abstraction
  • Collecting vitals
  • Women's health exams

Work Experiences

  • Achieved 72% improvement in 2022's performance metrics.
  • Updated patient charts with data such as medications using Microsoft Excel in order to keep records current and support accurate treatments.
  • Provided patient education and answered questions about their health, prognosis, and treatment options.
  • Medication and IV administration, catheter insertion, and airway management were among the interventions I implemented.
  • Provided critical-ill patients with a skilled, timely, and level-headed emergency response.
  • Achieved a 28% reduction in chart abstraction errors.
  • Advocated for patients in my care and implemented prescribed treatment strategies using firsthand knowledge and clinical expertise.
  • Took part in educational activities such as the implementation of evidence-based practice projects, nursing competency development, and nursing simulation activities.
  • Administered medications orally, intravenously, and intramuscularly, and tracked responses to address new concerns.
  • Abstracted and reported data on HEDIS® performance measures.

Summaries

  • Accurately monitor and report clinical data.
  • Proven leader with a track record of successfully uniting and guiding nursing teams toward patient care goals, increased satisfaction, and the continuous implementation of widespread healthcare system initiatives.
  • Achieved measurable improvements in hypertension HEDIS measures.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Achieved 36% accuracy.
  • Flexible and adaptable to changing patient needs and conditions.
  • Ready for a new opportunity to put my outstanding nursing skills to work in a method setting.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the procedure business.
  • Achieved improved HEDIS outcomes.

Accomplishments

  • Helped deploy interventions specifically tailored to improve HEDIS® performance in depression screening, achieving a 56% measure improvement in 2022.
  • Maintained detailed documentation of HEDIS® abstraction processes, which increased transparency and led to zero discrepancies during the NCQA audit in 2019.
  • Executed a multi-departmental training on HEDIS® data capture processes, resulting in a 53% increase in data submission accuracy.
  • Analyzed historical HEDIS® performance and successfully introduced initiatives that increased score retention by 63%, achieving target goals for 2016.
  • Supported medical records retrieval for HEDIS® audits, ensuring that 8 records met NCQA standards, which led to zero deficiencies in the audit.
  • Created a HEDIS® abstraction guide that improved the training of new hires, reducing onboarding time by 6 weeks, bolstering team productivity.
  • Documented and resolved system which led to metric.
  • Managed data abstraction for 18 HEDIS® measures, successfully reducing data entry errors by 26%, improving overall reporting accuracy.
  • Recommended and implemented a new HEDIS® measure tracking protocol, which enhanced reporting efficiency and achieved compliance well before 2017 deadlines.
  • Introduced automated tools for HEDIS® abstraction, reducing time spent on manual data retrieval and enhancing measure accuracy by 26%.

Affiliations

  • National Association of Social Workers
  • Utilization Review Accreditation Commission (URAC) Membership
  • Toastmasters
  • International Association of Administrative Professionals
  • Society for Healthcare Epidemiology of America (SHEA)
  • Lions Club
  • National Association for Healthcare Quality (NAHQ)
  • Project Management Institute
  • American Medical Informatics Association
  • American Medical Informatics Association (AMIA)

Certifications

  • Lean Six Sigma Green Belt for Healthcare
  • Microsoft Certified Systems Engineer (MCSE)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified HEDIS® Compliance Professional (CHCP)
  • AHIMA Certified Healthcare Documentation Specialist (CHDS)
  • Certified Public Accountant
  • Certified Professional for HEDIS® Compliance Metrics
  • ICD-10 Medical Coding Specialist (ICD-10-CM)
  • Project Management Professional (PMP) in Healthcare
  • Cisco Certified Network Associate (CCNA)

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