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Click here or scroll down to respond to this candidateCandidate's Name
PHONE NUMBER AVAILABLE (h.) EMAIL AVAILABLE PHONE NUMBER AVAILABLE (c.)Key Areas of ExpertiseQuality & Risk Management ImplementationSales & Sales ManagementStreet Address + Years of Supervisory & ManagementRecruitment, Interviewing & HiringCustomer Service & Reimbursement OperationsEmployee Training & SupervisionAccounts ReceivableOffice Management & AdministrationEfficiency & Productivity ImprovementPC Proficient with Microsoft OfficeExcellent Communication, Organizational & Management SkillsProfessional ExperienceChildrens Health Home of Upstate New York, Rochester, NYManager of Quality Programs 2018-presentResponsible for developing and leading quality.Develop and implement a Quality Management Program addressing areas including but not limited to; chart audit process, gaps in care, utilization management, documentation compliance, NYS Health Home Performance Metrics, Medicaid Managed Care Plan expectations, and morePromotes quality in clinical practice by collaborating in the development of policy and proceduresOversee Medicaid Managed Care Plans outcome expectations and alignment of care management activities with HEDIS, QARR, and other measures as defined by the Managed Care Plan in preparation for value-based payment modelsCollaborate with Medicaid Managed Care PlansWork with network providers to drive care management improvement while educating on measures, performance, and the care management modelLead the Clinical Quality WorkgroupDevelop key performance indicators to identify gaps and successes with network providersParticipate on case reviews as neededIdentify training needs and secure subject matter experts to provide trainings to network providersProvide direction and oversight to business associates performing quality tasksAnalyze data and report information to identify the need for change, minimize risk, and ensure effectiveness of quality improvementDesign a reporting structure to inform CEO of network provider performanceAssists in development and implementation of any performance improvement plans required by governing bodies or managed care plansWork closely with state agency partners to ensure all stakeholder expectations are addressed as it relates to quality of care management servicesNiagara Falls Memorial Medical Center Niagara Falls, NYDirector of Quality Management 2018-2018Responsible for developing and leading quality.Quality improvement and performance improvement leadership.Risk management.Manages utilization review team.Participates and when required chairs committees around quality metrics and performance improvement.Assists quality initiatives with primary care practices.Saratoga Hospital Primary Medical Group Saratoga, NYProject Manager Primary Transformation Healthcare Reform 2017-2018Leads the primary care teams in transformation for Patient Centered Medical Home, CPC Plus and other medical/healthcare incentives.Coordinates will essential clinical and administrative staff to implement new process and policies developed to meet required standards.Writes policies and procedures aligning the primary care offices with the necessary requirements.Meets regularly with medical leadership to inform of progress, barriers etc. regarding progress towards meeting the requirements to receive accreditation.Established eight patient advisory councils.Worked with each primary care office in establishing a quality improvement committee.Responsible for additional programs such as APC (Advanced Primary Care), EPC (Enhanced Primary Care), DSRIP, and Patient Centered Medical Home.Capital District Physicians Health Plan, Albany, NY 2015-2016Performance Management CoordinatorAssisted offices improve quality, patient satisfaction, and healthcare cost reduction to align with established goals.Collaborated with other internal departments i.e. Quality, Contracting, Provider Relations, Medicare Chronic Conditions etc., to provide provider offices necessary education / information.Served as mediator between CDPHP and Enhanced Primary Care (EPC) accounts to aid in a fast response or assist in their need.Identified areas of opportunity for each EPC account, provided reports supporting information to present to account while helping to establish strategic plan to move toward goals while identifying barriers and addressing them.Helped to re-develop Sales Force team reporting template to provide ease of use for coordinator while continuing to capture necessary information required at a management level.Community Care Physicians, Clifton Park, NY 2013-2015Practice Administrator (2014-2015)Clifton Park Family Medicine and Clifton Park Pediatrics.Managed, maintained all daily functions of both offices.Establish solid workflows to allow for a smooth office operation.Increased staffing and identified right person for the right job to promote employee satisfaction and job performance.Empowered staff by assigning high level job functions; increased communication amongst staff and providers.Practice Manager (2013-2014)Scheduled all office activities including staff and provider schedules. Managed day-to-day operations of all reception, medical records and nursing staff.Initiated Medical Home, Meaningful Use, HEDIS and other government and insurance incentives to acquire better patient care / control of chronic diseases.Promoted excellent customer service.Improved workflows / processes to promote timeliness and improve overall patient care.Candidate's Name Page 2Hudson Headwaters Health Network, Queensbury, NY 2007-2013Performance Improvement Manager (2010-2013)Implemented day-to-day Network Quality.Investigated all events, incidents, complaints and compliments.Reported quarterly to Network Quality Committee, Board of Directors trends / performance improvement in these areas.Promoted incentive based programs, assisted Network in achieving monetary incentive goals.Chairs Network Clinical Quality Committee and four sub-work groups.Established, implemented Patient Advocacy Council in accordance with Hudson Headwaters and PCMH guidelines, requirements, and vision.Health Center Administrator (2009-2010)Complete oversight of the healthcare facility; entire front office staff supervision, staffing, day to day operations, health center budgets preparation for front office and assistance with nursing.Assumed assistance with nursing supervision when applicable.Worked closely with lead physician to obtain optimal customer service and health care to patients and their families.Health Center Manager (2007-2009)Responsible for entire front office staff supervision, staffing, day to day operations, health center budgets preparation for front office. Scheduled, prepared agendas, performed team meetings, staff and front office meetings. Worked side by side on health center issues with the lead physician and nurse manager.O2 Solutions, Saratoga Springs, NY 2006-2007Reimbursement DirectorOversight of 3 billing staff members and 3 customer service staff. Performed hiring, counseling and termination of staff as required. Worked closely with CEO, Investors, and CFO. Provided company financial projections from billing and accounts receivables.EducationSage College, Albany, NYMasters - Healthcare AdministrationSUNY Empire, Albany, NYB.S. - Business AdministrationA.S. - Business StudiesECRI InstituteQuality & Risk Management CME CoursesMemberships / AffiliationsChairperson CHHUNY Clinical Quality WorkgroupCWI (Community Workshop and Independence) Queensbury, NY- Former Informed Consent AdvocateHudson Headwaters Health Network, Queensbury, NY Former Network Quality Committee ChairpersonBoy Scouts of America Troop #22 Corinth, NY - Former Boy Scout TreasurerCWI (Community Workshop and Independence) Queensbury, NY Former Board of Directors |
