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Click here or scroll down to respond to this candidateCandidate's Name
New Braunfels, TX Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEExperienced in a multitude of nursing positions in the past 34 years 12+ years in Hedis/Stars in Quality ImprovementAuthorized to work in the US for any employerWork ExperienceCase Management Analyst, Hedis, Stars compliance Cigna Care AlliesAugust 2008 to June 2021Care Allies Healthspring - 8 /2008 thru 6/02/21(Cigna HealthSpring/Texas HealthSpring Merger)Responsible for Hedis/Stars Quality Measures - EMR Documentation Abstraction Created a program tool in 2008 for cigna to simplify obtaining measures for Quality Improvement which is still being utilized by Cigna Healthcare today. Advanced Cardiovascular Specialist Beaumont Texas (Christus Transfer). Responsible for pacemaker clinic for 4-Physician office Pre and post operative care to include wound care and instructions Pacemaker follow-up monthly computerized phone checks Floor nurse to include pre physical chart preparation Perform treadmill Stress test. Dr. Tighe Huber and Dr. Frank Kotzur Family Practice (Christus) Head office nurse interim office manager of 30+ staff All office nursing patient care duties including minor surgeries Preparing charts with RX's, etc for Dr. viewing and signing. Scheduling out patient procedures. Coordinator of all nurses schedules Coordinator all OSHA compliance for the officeDr. Scott Compton Orthopedic SurgeonResponsible for obtaining All Texas licensure/ Medicare/ Medicaid and private insurance obtained prior to Dr. coming to Texas.Head nurse/ office manager of staffAll office nursing duties including patient care surgery schedule Medicare and Insurance pre and post op verification Extensive workers compensation experience.Doctors HospitalFront office pre- admission. All insurance pre-admission utilization review for monthly staff meetings. Receiving pre-admission ordersScheduling out patient testScheduling out patient surgeriesUtilization review for extended stayMedical Surgical patient care duties out of school 1st 6 months then Primary Charge Nurse on 3-11 shift. Duties to include patient care I.V. therapy. Medication administration.Record report for A.M. shiftManager of all the staff on whatever shift I was charge nurse on. Case Management Analyst, Hedis, Stars compliance Cigna care Allies - Houston, TXAugust 2008I help Drs obtain Stars scores and Hedis Compliance. Data entry. Ive done start up in 11 offices. My 1st year of work in 2008 with Texas HealthSpring I composed measure tools which put my 5 Physicians in the top 8 in compliance in the the country. My tools have been used now across the country for years now and they are still used in some offices... most are now integrated into EMR systems. Ive used multiple EMR systems over the past 13 years.EducationAssociate in NursingLVN Lamar State College - Port Arthur, TX1987Skills Self Starter, EMR trained EClinicals, Ascender, Tableau, Arcadia, PowerPoint, EMD, Word, Amazing Charts, Quest 360, Inovalon (10+ years) Data Entry (10+ years) HEDIS (10+ years) Microsoft Office (5 years) Medical Records (10+ years) Excel Microsoft Word Medical Terminology (10+ years) Microsoft Outlook Documentation (10+ years) Management (8 years) problem solving (10+ years) ICD-9 (10+ years) Insurance Verification (8 years) CPT Coding (10+ years) Acute Care (10+ years) Managed Care (10+ years) Office Experience (10+ years) Customer Service (5 years) Microsoft Powerpoint Phone Etiquette (10+ years) English (10+ years) Office Manager Experience (8 years) Supervising Experience (8 years) Microsoft Excel Time Management (10+ years) Data Collection (10+ years) Business Analysis Medical Coding (10+ years) Quality Assurance (10+ years) ICD-10 Leadership Experience (10+ years) EMR Systems (10+ years) HIPAA (10+ years) Medical Office Experience (10+ years) Utilization Review (2 years) Analytics Patient Care (10+ years) Catheterization (3 years) Triage (5 years) Medical Scheduling (10+ years) Anatomy Knowledge (10+ years) Hospital Experience (6 years) Medical Billing (2 years) Nursing (10+ years) Experience Administering Injections (10+ years) Employee Orientation (3 years) Business Requirements (10+ years) Problem-solving (10+ years) Team Work (10+ years) Reliability Physiology Knowledge Typing (10+ years) Autism experience (10+ years) Contracts (1 year) Documentation review (10+ years) Process improvement (10+ years) Medical management (10+ years) Medication administration (10+ years) Case Management (Less than 1 year) Flexibility (10+ years) quality improvement hedis Stars extraction (10+ years) Computer literacy (10+ years) Research Utilization management (1 year) Vital Signs (10+ years) Filing Utilization review Nursing home experience Interviewing Primary care LeadershipAwardsCigna champion x3 2019An employee that goes above an beyond to fulfill the job title or to help those in need Cigna ChampionsJanuary 2019awards given by management for going above and beyond Certifications and LicensesLPNJanuary 1987 to February 2023AssessmentsPatient-focused care ProficientJuly 2021Responding to patient concerns with sensitivityFull results: ProficientData entry: Attention to detail ProficientJuly 2021Maintaining data integrity by detecting errorsFull results: ProficientElectronic health records: Best practices Familiar July 2021Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: FamiliarIndeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.Additional InformationCertified ICD9/CPT coding certified at Lamar University in 2000. OSHA compliance nurse for 5 yearsUp to date on Stars, Hedis, OSHA, all yearly training |
