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Skills

  • ICD-9 forms
  • Fluent in Spanish
  • Team supervision
  • Well visit procedures
  • Medication administration
  • Women's health exams
  • EMR / EHR
  • Acute care expertise
  • Family planning services education
  • Conflict resolution skills

Work Experiences

  • Achieved 54% accuracy in reporting.
  • Achieved a 31% improvement in accuracy.
  • Addressed patient care issues such as discharge delays, procedures that were postponed, and discharge equipment that was unavailable.
  • Addressed unclosed care gaps.
  • Collaborated with physicians and care coordinators.
  • Oversaw 18 nurses and nursing activities in a 11-bed hospital, providing comprehensive nursing guidance and ensuring high levels of patient satisfaction and care.
  • Prepared blood, tissue, and other laboratory specimens for testing in the lab.
  • Was in charge of patient care from admission to discharge, including patient assessments, care planning, health education, and discharge support, in order to provide comprehensive care to over 10 patients on a daily basis.
  • Provided patient education and answered questions about their health, prognosis, and treatment options.
  • Gave patients, families, and caregivers information on diagnosis and prognosis, treatment options, disease process and management, and lifestyle choices.

Summaries

  • Achieved a 62% increase in abstraction speed.
  • Achieved 32% increases in NCQA compliance.
  • Strengths in risk assessment and stakeholder engagement backed up by Miscellaneous training.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Achieved compliance benchmarks ahead of schedule.
  • Successfully led unit-based groups to improve care delivery and patient satisfaction.
  • With expert healthcare knowledge, clear verbal and written communication skills, and sound clinical judgment, this person is team-oriented and dependable.
  • Boosted compliance by 17%.
  • Ready for a new opportunity to put my outstanding nursing skills to work in a procedure setting.
  • Registered Nurse, Massachusetts Board-Certified, with 8 years of experience providing high-quality care to patients in procedure and metric care units.

Accomplishments

  • Mentored junior clinical staff on the nuances of HEDIS compliance, resulting in 18% improvement in review accuracy and time-efficiency.
  • Reviewed over 10 patient medical records, ensuring complete and accurate abstraction for HEDIS submission, improving audit pass rates by 81%.
  • Facilitated weekly cross-departmental meetings to align our strategies with HEDIS measure requirements, generating a 82% improvement in clinical compliance.
  • Led a cross-functional team in optimizing chart abstraction workflows, improving documentation speed by 60% and reducing error rates by 16%.
  • Part of a team that achieved NCQA accreditation for Vantage by ensuring continuous adherence to HEDIS guidelines and measures.
  • Conducted ICD-10 training sessions for staff to better align coding practices with HEDIS requirements, reducing claim errors by 38%.
  • Streamlined communication between clinical and administrative teams during HEDIS review cycles, reducing data discrepancy occurrences by 67%.
  • Audited clinical care documentation to ensure compliance with HEDIS standards, achieving a 79% improvement in outcome measure reporting accuracy.
  • Collaborated with team of 2 in the development of metric.
  • Resolved product issue through consumer testing.

Affiliations

  • Association for Computing Machinery
  • National Healthcare Quality Summit Attendee, 2022
  • Toastmasters
  • Affiliated with the Quality Assurance Nursing Association (QANA)
  • Certified HEDIS Compliance Professional (CHCP) 2017
  • Member of the Council on Nursing Informatics & Technology
  • National Committee for Quality Assurance (NCQA) Certification 2024
  • Member of Sigma Theta Tau International Honor Society of Nursing
  • Freemason
  • American Association of Managed Care Nurses (AAMCN)

Certifications

  • Certified in Healthcare Risk Management (CPHRM)
  • Certified Professional in Health Information Technology (CPHIT)
  • Certified Professional in Healthcare Quality (CPHQ)
  • First Aid/CPR Certified
  • Certified in Clinical Quality Healthcare Informatics (CCQHI)
  • Certified Case Manager (CCM)
  • Certified Nurse Health Coordinator Harbor & Co.
  • Population Health Management Certification Beacon Labs
  • CHCQM (Certified in Health Care Quality Management) Meridian
  • ServSafe

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