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Medical Records Quality Assurance Resume...
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Title Medical Records Quality Assurance
Target Location US-GA-Atlanta
Email Available with paid plan
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Candidate's Name , MS, MBAEMAIL AVAILABLE (cell) PHONE NUMBER AVAILABLEEDUCATIONGrand Canyon UniversityAugust Street Address  -Doctorate in Healthcare Administration/Organization Leadership (Qualitative Studies)Southern New Hampshire UniversityMay 2019Master of Business AdministrationThe University of GeorgiaMay 2012Master of Science: Housing and Consumer EconomicsGraduate Gerontology CertificateWesleyan CollegeMay 2006Bachelor of Arts Degree in Marketing and Advertising CommunicationsWORK HISTORYEagle Health Analytics, LLC/CDC (ISO/DHQP/NCEZID/CDC), Atlanta, GAApril 2022-CurrentPublic Health Analyst/Program Coordinator/Project Analyst (VARES)-Contractor Operate in a fast-paced environment, to oversee/manage multiple complex projects simultaneously, and to meet deadlines.Daily review of available VAERS reports to meet abstraction criteria and assign across abstraction teams (i.e., manage up to 5 VAERS projects concurrently).Accessing internal customer service management system to manage daily medical abstraction assignments (up to 10 cases daily per abstractor): data translation, data entry, and quality assurance.Serve as the POC for maintaining relationships with VAERS staff (technical monitor, clinical nurses/nurse practioners, medical officers, health scientist and epidemiologists) and contractors and ensuring day-to-day tasks, duties, and functionality of platform/program.Serve as VAERS Subject Matter Expert to effectively frame, review, and advise project activities.Assist with the identification and development of appropriate technical training and training material to all stakeholders, anticipating any issues with performance, and deliverables.Conduct weekly quality assurance checks and manage daily back up of CRM systems, such as REDCap or DCIPHER, and master spreadsheets.Work with the VAERS team to ensure processes (medical records retrieval, open and closing of cases) are followed per study protocol and established SOPs.Updating VAERS Standard Operations Procedure for medical abstractors and project coordinators as new protocols emerge; includes abstraction guides, processes, and templates for communications with health care providers.Obtain medical records for an assigned group of VAERS (Vaccine Adverse Event Reporting System) IDs.Access medical records spreadsheets to assure faxes are sent to facilities and document the status of medical records requests.Facilitate orientation for all medical record members (20+), weekly meetings, and all communications regarding medical records retrieval process and accessibility to systems and VAERS Team meeting.Assures all deplorers and contractors (20+) are on-boarded/off-boarded to the team and has access to VAERS VPN, Teams, and REDCapWork directly with CDC internal data management team on abstraction form updates and data imports.Conduct weekly quality assurance checks (i.e., cleared backlog of 3000+ unassigned cases, weekly assignment of 200+ cases to medical records team, weekly record management of 200+ uploaded medical records, daily management of 50+ GDIT cases sent to contact) within both the VAERS and CDC Internal customer relationship management (CRM) systems, such as REDCap.Exercise initiative and independent judgement.Tanaq Support Services, LLC/CDC (DDID/NCRID), Atlanta, GAOctober 2021-March 2022Public Health Analyst/Operations Coordinator (Vaccine Task Force)-Contractor Oversaw and participated in the design, implementation, deployment, and maintenance of reporting and analytic solutions to ensure effective information delivery, empowering stakeholders to make informed, data-driven business decisions. Worked to support leadership in the Vaccine Task Force (VTF) under the CDC COVID-19 Activation and liaised within the team, vendors staff, and VTF Associate Directors to expand the Clearance teams capabilities and toolset to ensure content updates, tasks, reports, or other requests reach the appropriate members of the team promptly. Worked closely with various VTF Operations Lead staff and other VTF staff to ensure documents, such as SOPs, Workflow prepared responses (PRs), and IVR content were updated as needed. Attended weekly response meetings and helped review call recordings, emails, and identify quality concerns and opportunities for improvement in processes or areas related to the business units (e.g., training, content,etc.). Managed and updated various policy, health, and medical documents ready for clearance in spreadsheets, while providing support for clearance triage, tracking, and follow-up to ensure content updates, tasks, reports, or other requests reach the appropriate members of the team promptly. Maintained teams staffing roster, task assignments, and roll-on/roll-off dates. Ran metrics reports and reviewed qualitative data to identify trends in inquiries, and shared them with team members and leadership, as well as other stakeholders as necessary (i.e., cleared 200+ documents). Monitored staff or response mailbox and screened emails (300+) for critical emails that require attention from team leadership or other team leads (reporting requests, need for urgent content updates, or other requests from leadership). Communicated daily with team leaders on updates and status of documents that require attention and action. Produce ad-hoc reports and analyses on an as-needed basis. Mentored, guided, and provided training and development to clearance team members (including onboarding processes).CB STRAT/CDC (DHAP/NCHHSTP), Atlanta, GADecember 2020-October 2021Public Health Analyst-ContractorEstablished program standards, policies, strategies, goals, and evaluation plans in conjunction with senior staff.Collected and interpret data and information from a variety of sources and prepares recommendations accordingly.Researched various sources and references, respond to inquiries, and write issue papers, a variety of reports, policies, proposals, and other substantive documentation.Served as a liaison, committee member, or similar point of contact with internal and external representatives.Analyzed data and managed projects.Presented and disseminate data and presentations.Ability to quickly learn and integrate new tools and technologies to meet customer needs.Participated on community of practice calls, document methods being used across health department agencies and catalogue.Provided communications to users and help coordinate and host webinars Quarterly Health Department calls/meetings.Supported technical writing work, including Health Department and NMH&E write ups, HD/CBO Contact and Distribution Lists, SOPs, and incoming ServiceNow ticket inquires.Assisted staff and response mailbox monitoring to ensure urgent requests are handled appropriately.Optum Health (United Healthcare), Smyrna, GAMay 2020-December 2020Utilization Management SpecialistActed as a liaison between managed care organizations and facility's professional clinical staff to assist with reviewing and updating UM policies and procedures.Utilization of internal criteria to review admitted patients for appropriate status placement based on client health guidelines.Provided data input and feedback to strategic support to improve member care, operational efficiency, and regulatory compliance.Kept accurate health analytic records of all contact with external organizations and persons who have legitimate interest and legal access to information on the care of patients.Monitored and Reviewed criteria for authorizations, triaging faxes, eligibility, and admissions for members of LA Care and Optum Health medical plans.Worked closely with training facilitators and department management in review of cases for medical necessity and benefit coverage.Conducted health data searches and web-based queries to resolve missing data, health inquiries.Conducted moderately complex to complex analyses concerning efficiency and effectiveness of substantive health informatics program operations.Gathered, analyzed, and presented data for current and future project analysis, utilizing member health data trends and results tracking to assist decision makers with policy and program changes.Identified opportunities for continuous improvement to databases, data gathering and analytical approaches.Optum Health (United Healthcare), Smyrna, GAJuly 2012-June 2020Clinical Administrator Coordinator/Health Care AdvisorManaged over 200 patient cases monthly for benefit verification and other insurance coverage, using federal, state and the strict verification parameters.Worked closely with clinical staff including nurses (>20), clinical managers as a liaison to coordinate disease management utilization management and provide timely and actionable healthcare information.Collaborated on new client implementations including system interfaces, client set-up, liaison with Legal, and operational setup.Distributed weekly and monthly reports to staff of customers individual healthcare plan contracts.Modified client improvement opportunities to enable the most efficient workflows for the clients account receivable.Identified trends and recommend actions to ensure maximum productivity and efficiency.The National Council on AgingJune 2011  August 2011Economic Security InternCompleted routine studies regarding researching, planning, and implementing pro-active, and aging programs that improved the overall economic security for older adults in the Washington D.C. area.Implemented marketing documents that supports the importance of elders within the workforce within the Workforce Development Department projects.Managed the development topics of forum while serving as an official council representative at economic workforce development events, meetings, meeting minutes, and briefings.Prepared agenda, handouts, and presentations to ensure all client needs are being met as it relates to financial performance, current trends, future needs of the business, operational excellence, and metrics.Worked collaboratively with Operations/ Marketing/WFM/Analyst to ensure proper information is presented.Athens Council on Aging (Internship)July 2010  December 2010Medicare Research SpecialistRefocused Medicare cases for over 100 clients to meet the economic security needs.Educated clients on proper methods to adhere to while applying for drug and health benefits during one-on-one consultations Accumulated research material and necessary data which were required for specific tasks and functions of the organization.Counseled clients on prescription drug costs and other medical information to ensure an overall knowledgeable experience.Millward Brown, Alpharetta, GAAugust 2006-March 2007Research Support SpecialistAnalyzed client marketing campaigns and offered valuable insight on enhancing marketing creativity with aesthetic applications.Compiled and studied statistical data with the aid of unique market research methodologies to interpret key findings.Consulted management and account executives on innovative approaches to offer expert solutions for company clientele.Skills (Business/Technical/Projects)Research DevelopmentProject Management/Microsoft Project PlanHealth AnalyticsReporting Data Management (Health Information Technology)Clinical Management and Documentation (Electronic Medical Recording)Training and DevelopmentRedCap/VAERSSharepointClient Relationship ManagementChange ManagementEnterprise O365 products suite

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