PROFESSIONAL SUMMARY:

• Influencing Population Health Practices and Clinical Transformation with nationally recognized innovative use of technology to champion clinical practice for excellence in Confidential t care, regulatory compliance, clinical quality measures with utcome reporting, maximize provider reimbursement with incentive programs, Confidential t safety, and .

PROFESSIONAL EXPERIENCE:

Confidential

Population Health Strategic Consultant

Responsibilities:

• Providing strategy to ensure compliance with Health Plan (UHC Secure Horizons Medicare Advantage Full Risk and Humana Up - side Risk) delegated NCQA requirements for Complex Care Management (CCM), Disease Management (DM), Quality Improvement (QI) and Utilization Management (UM) Programs
• Perform market assessment and provide strategy recommendations to efficiently and effectively manage member care throughout all Transitions of Care, while achieving/surpassing established performance thresholds
• Clinical Advisor for:
• Referral Management System selection and implementation (Essette, Accupera, and HCP proprietary)
• SalesForce Customer Relation System for CCM, DM, and Population Health Coordinator
• CORHIO Colorado Regional Health Information Exchange member activity (ADT) notification
• Supporting/Coordinating efforts for health plan delegation with respect to CCM, DM, QI, and UM
• SNF HEDIS Analytic/Metrics Requirements, Utilization Metrics, Reporting, HP-CAHPS, Grievance Process and tracking, charters, policy and procedure development, job descriptions, etc.
• Developing Network Relations and socializing Service Level Agreements with health plan contracted providers, acute-care facilities, post-acute facilities, home health programs, and vendors
• University of Maryland Medical System
• Consultative Services at St. Joseph Medical Center and Union Hospital
• Performed Assessment of Transitions of Care with executives and frontline clinicians
• Presented Efficiency Recommendations for “Global Budget Revenue” to UMMS C-Level and Stakeholders

Confidential

System Director Clinical Quality Programs

Responsibilities:

• Lead Clinical Transformation through NCQA PCMH Recognition
• Influence and teach Physician Quality Reporting Service (PQRS) for Clinical Quality Measures (CQMs) Performance Reporting through GPRO with EHR Direct, Web Interface and Registry submission
• Provide recommendations for Risk and Confidential t Safety Events; mitigation and prevention
• Oversee Clinical Quality Crosswalk for CQM alignment with CMS, PQRS, PCMH, ACO and HEDIS
• Strategize system analytic tools for Population Health measurement and reporting dashboards
• Co-Lead EHR Incentive Program - Meaningful Use Guidance and Attestation
• Champion EPIC Optimization for CQM documentation, reporting and submission
• Champion EPIC internal Clinically Important Condition registries
• In corporate Evidence Based Practice Models into Best Practice Strategies
• Accountable for CG-CAHPS Press Ganey Performance with Confidential t Satisfaction Outcomes
• Lead Ambulatory Medication Safety Task Force initiatives
• Facilitate Policy and Procedure development through PolicyTech solution
• Author and execute Safety Grant for High Reliability Organization Philosophy Safety Huddles

Confidential

Principal Healthcare Clinical Transformation Consultant

Responsibilities:

• Denver Health Performance Management: Subject Matter Expert providing strategic direction for ARRA and HIT, CMS Core Measures and Clinical Quality Metrics, Outcomes, Compliance, and Reporting
• Denver Health Clinical Leadership for Workflow Enabled Performance Project, design and process recommendations for regulatory compliance with In Confidential t and Ambulatory Care eHR, and EDIS Projects
• Provide direction & direct oversight as necessary, to the ongoing development & maintenance of analytics & analytic requirements for Decision Support.
• An active thought partner with Customer C-level administrator’s, directors, managers, and physicians across the continuum of care and service lines
• Siemens representative for Denver Health research study in collaboration with Cornell University Center for Healthcare Informatics and Policy on the “Effect of an HIT transition on healthcare quality and provider productivity in the ambulatory setting”
• Utilize LEAN Methodology to coordinate the study & documentation of interventions that may become best practices; including problem formulation, articulation of logic models or concept maps, assisting in intervention design based on formative feedback, identifying appropriate outcomes measures and their collection, analysis and interpretation.

Confidential (Malvern, PA)

Clinical Product Marketing Specialist

Responsibilities:

• Strategic marketing evaluation for optimal industry advantage at customer events
• Execute world class customized Soarian and Invision Healthcare Information System demonstrations via customer site visits, Siemens Executive Briefing Center, conferences, and Web-cast.
• Partner with regional sales teams and affiliated vendors to effectively enhance customer relationships and sales opportunities
• ARRA, HITECH, and Compliance resource for HIS migration/implementation

Confidential (Brown Mills, NJ)

Programs and Health Coordinator

Responsibilities:

• Assure Best Confidential t Experience outcome measurement performance
• Assure compliance with The Joint Commission Surveys
• Coordinate all healthcare and support groups for internal and external clients
• Facilitate cultural diversity and sensitivity program
• Direct the interpreter program
• Coordinate the Speaker’s Bureau and manage community outreach activities
• Manage the Open Heart Surgery and Defibrillator Counselors
• Project Management for Health Connection Confidential t Wellness TV channel
• Project Manager on Wheels - Computer assisted

Confidential (Toms River, NJ)

Telemetry RN III - Per-diem status

Responsibilities:

• Provision of care for cardiac Confidential ts receiving telemetry monitoring
• Management of Natrecor, Heparin, and Dobutamine Therapy

Confidential (Toms River, NJ)

HIPAA Compliance Officer

Responsibilities:

• Designed and developed the Infusion Division in its entirety
• Contract negotiation with managed care companies
• Administrative and Management responsibilities
• HIPAA risk assessment with gap analysis, and compliance assurance
• Developed policy and procedures, documentation tools, competencies, and orientation program
• Project Manager: Selection and implementation of CPR+ software

Confidential (Toms River, NJ)

Documentation and Confidential t/Family Health Coordinator

Responsibilities:

• Continuing Medical development and presentation
• Coordination of all Confidential t/Family material and approved resources
• Performance Improvement Team Leader, facilitator, and committee member experience
• Responsible for The Joint Commission standards compliance regarding Confidential t
• CMC’s Project Manager and SBHCS consultant for Micromedex CareNotes and DrugNotes
• CMC’s Project Manager and SBHCS Liaison for InLight Interactive Internet
• Pioneered InLight kiosk conversion to Internet based Web Cam conferencing interactive Sign Language Interpreters for the Deaf
• Project Manager for CMC Health Line. Developed, authored, directed, edited, and acted/narrated for 2 documentaries, “Guided Imagery: A Journey to Tranquility,” 46 CMC department or service related commercials, testimonials, staff montages, and scheduled al programming for CMC Health Line closed circuit television
• Coordination of Annual Health Festival and Outstanding Educator’s and Facilitator’s Dinner.
• Site visit to Methodist Hospital, Omaha NE, for evaluation of Eclipsys Alpha Site for CareMinder documentation
• Documentation evaluation, revision, and compliance
• Limited English Proficiency Persons advocate and implemented CyraCom communication system

Confidential (Toms River, NJ)

Hi-Tech Coordinator

Responsibilities:

• Developed the Hi-Tech Program in its entirety
• Management of Hi-Tech Team - 2 shifts
• Developed Disease Management Program to reduce hospital admission and LOS
• Consulting for Hi-Tech referrals through the admission and ongoing management
• Coordinating in-services, developing and presenting seminars with contact hours
• Developing, revising, or consulting for: policies, procedures, care plans, and documentation tools
• Liaison for agency to Durable Medical Equipment Companies with Infusion Pharmacy
• Certifying RN’s for Intravenous Therapy, Venous Access Port Care, and PICC Care and Management
• Developed and coordinated entire program for Inotropic Home Therapy
• 24 hour on-call Hi-Tech administrative and staff coverage