To obtain a position in a company that will allow me to utilize my skills and experience to provide the highest level of service. I am a self-motivated, dependable, and a team player.
insurance, management, service, prior authorization, outpatient, hospital, urgent care, organization, hedis, case management, medicaid, quality, health care, acute care, medical management, maintenance, medical
management, office, medical, hospital, patient, quality management, process improvement, safety, case management, quality, patient safety
Provide clinical care for the outpatient and inpatient care facilities, including the utilization of the Meditech system, and the use of the CHCS, and other health-related information.
Provided direct supervision to the health care department, Hospital, home health, and other medical service providers. Supervised and trained staff, case managers, and social workers.
Provided clinical support for the implementation of a new Medicaid program for the joint Commission on accreditation of healthcare organizations (JCAHO), the National hospice Board of pharmacy, and the joint Commission.
Oversaw the implementation of the clinical and operational aspects of the home health care system, including the utilization of Medicare, Medicaid, and private service providers.
Managed the coordination of the Medicare and Medicaid reimbursement process for the acute care home and the clinical service department.
Provided clinical training for the HEDIS program for the coordination of the Medicare advantage program. Conducted quality review of the hospital prior authorization process.
In conjunction with the Director of nursing, I was responsible for the management of the department, including staffing, scheduling, and staffing.
Works with the hospital leadership to ensure patient safety and quality of care. Maintain and improve the overall management of the department.
Achieved a deficiency free DOH survey. Management of medical and surgical procedures. Developed and implemented a new employee orientation program.
Implemented and evaluated the management of the quality improvement team (QI) and the development of a comprehensive health plan.
Management of the quality improvement team (QI) and the development of a strategic plan for the practice. Developed and implemented a new process for the department.
O member of the Executive management team to identify and resolve issues. Develop and implement corrective action plans. Maintain and improve employee performance.
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