Experience

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  Lexington pulmonary

  Mar 2003 - Jan 2009

  Practice manager

  • Work closely with Physicians to manage daily business operation to include; policy/compliance, quality assurance/improvement, performance management, office administration duties • Reviews Human Resources management throughout the company to ensure compliance with established federal, state and corporate policies and procedures.• Ensure billing encounters and co-pays are accurate and reconciles each day. Assures all encounters and monies are submitted to Finance. Analyze transactions for appropriateness of charges and payment.• Create monthly financial reports and budget office funds, work accounts payable and receivable• Data collection for clinical trials, ensure protocol management and compliance• Implement training of new information and changes according to state. Perform internal auditing and process improvement• Monitors adherence to HIPAA policies and procedures related to management of protected health information.• Assist with Interviewing and selecting candidates for open positions, provide orientation, and ongoing management of employee performance. Responsible for training staff in relation to revised and/or newly implemented policies and procedures. Manage daily function of my team. Pokaż mniej

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  University of south carolina

  Jan 2009 - Jan 2013

  Program manager

  • Serve as leader and point of contact of the South Carolina Cancer Disparities Community Network; Coordinate work assessments with efforts of those of the national network of 23 Community Networks Program Centers established by the National Institutes of Health and National Cancer Institute to identify and address national research needs supporting cancer prevention and control program implementation guidelines and their dissemination to address cancer disparities• Manage and coordinate large multi-component projects, budget and procurement process. Create and monitor monthly reporting of expenditures to ensure proper use of grant’s fund allocation, timelines and deliverables. Develop and disseminate project plan, identify and report risk, compile documentation for reporting. Complete and define the process flow.• Manages, directs and supervises the staff and activities of the agency. Coordinate performance management, recruit, and train, interview for potential candidates and coach staff and faculty, ensure department compliance and manage legal issue. • Lead, mange, direct the planning, development, evaluation, decision making and implementation of project activates and reporting of ongoing program activities. Seek funding opportunities to support program and department.• Monitor, guide and evaluate project activities to address research needs, identifying new and expanding existing collaborative partners who share the vision of reducing cancer disparities in South Carolina Supervise the performance of the supplemental research projects • Coordinate and facilitate bimonthly and monthly meetings with core leaders and staff to effectively communicate and address issues related to the progress of the project. Pokaż mniej

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  Sc department of health and human services

  Jan 2013 - Jan 2017

  Program manager

  Coordination of state and federal rules as they apply to Medicaid service delivery. Ensure coordination of state plan approved services with current program policies and procedures. Assists team with a complete overview of Medicaid published manuals and provide recommendations for improving the flow of information and presentation. Assists in the redesign and on-going monitoring of manuals and publications for all medical services programs. Researches, writes and publishes complete, accurate and easily usable policies and procedures according to Department standards regarding order, clarity, conciseness, style and terminology. Stays abreast of health care trends, legislative acts and alternative delivery systems. Assists staff with oversight of all medical services including Managed Care and the Dual Eligible program. Assists with the development of Requests for Proposal and recommend changes to program coordination and management. Assists in the coordination and flow of information to CMS regarding State Plan Amendments. Assists in the review of related correspondence and ensures the timeliness of request in order to meet required deadlines. Pokaż mniej

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  Unitedhealthcare

  Jan 2017 - Jan 2021

  Optum - Monitor and support quality improvement initiatives with particular emphasis on CAHPS/HOS and SDOH, and will proactively identify performance improvement opportunities through analysis.Lead and Manage the Quality Patient Navigator Program and outreach activities to promote and improve positive member experience. Create strategic partnerships with internal and external stakeholders to ensure a comprehensive quality program. Identify and manage community outreach programs to support initiatives and best practices that could directly impact member satisfaction rates.Create and maintain monthly dashboard/report for each business supported providing a current status of key program compliance indicators for CAHPS/HOS and SDOH.Identified, developed, and implemented several more best practices member and provider interventions to improve HEDIS and Stars metrics. Pokaż mniej

  • National Quality Program Manager, OptumCare at UnitedHealth Group

    Jan 2019 - Jan 2021

  • Practice Performance Manager STARS/HEDIS

    Jan 2017 - Jan 2021
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  Arkansas blue cross blue shield

  Jan 2021 - Jan 2022

  Member experience management
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  Molina healthcare

  Jan 2022 - Jan 2024

  Director of quality improvement & risk adj
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  Humana

  Jan 2024 - now

  Director of quality improvement