Theresa Buford

Experience

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  Kaiser Permanente

  Oct 1995 - Dec 2006

  Support Services Supervisor

  Epic EHR pilot implementation: 2006Managing Emergency Room and Urgent Care registration and unit coordinator operations while maintaining high quality level of patient care expected by Kaiser Permanente. Initiated first ever Epic electronic ED Log via extracted reports to Excel. Researching, compiling, analyzing, and preparing visuals. Leading and coaching compliance initiatives toward the achievement of organizational goals; retention, continuity of care according to Emergency Medical Treatment and Labor Act (EMTALA), Joint Commission, The California Department of State Hospitals (DHS) requirements. 32 direct reports, HUC and Registration Clerks providing 24 hour coverage for inpatient and ambulatory patients. Creating leadership and staff development while increasing co-pay collection by 40% in the ED. Performing staff matrix while developing recruiting, screening and hiring processes with new job descriptions. Hiring, training, attendance and behavior discipline and dismissal. Managing and resolving human resource, labor relations, risk management employee and department safety issues. Developing and monitoring support staff budgets and resource allocations. Identifying and implementing strategies to reduce costs and improve quality of care/service. *Got married and carried away to Spokane, WA. Show less

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  Providence Health & Services

  Jun 2007 - Dec 2009

  Sr. Administrative Assistant

  Executive Administrative Assistant Supporting VP Regional Quality and Risk Management, Division Director of Reimbursement, Sr. Director Clinical Value Analysis. General office duties including office budget, maintaining, scheduling purchasing travel, office supplies, professional subscription renewals, manuals, teaching materials, ordering hospital supply chain supplies.

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  Pepsi Beverages Company

  Mar 2010 - Jul 2012

  Logistics Administrator

  This warehouse was adjacent to the production plant: Managing the receiving and delivery of finished products for a $4.1 million inventory. Ensuring optimal inventory levels of full goods are maintained in order to fulfill daily sales needs. Maintaining the inventory system to aid in production scheduling. *This position was accepted due to the 2008 market crash that lead to state funding removing funds to healthcare.

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  University of Oklahoma

  Jul 2012 - Mar 2014

  Quality/Population Health Analyst

  Lead Patient Services Representative (PSR) implementing CPCi, Value Based P4P, PCMH, NCQA, Meaningful Use initiatives in 5k plus Family Medicine Residency practice. Supervising 13 direct supports: PSR’s in Call Center, Referrals, foreign language translators, Sooner Care Field Representative, Registration for four (4) clinic mods and Radiology. Developing and implementing standardized processes and policies around the delivery of train-ing methods leading operations staff improve clinic efficiencies and patient outcomes, registration and ap-pointment availability. Monitored and analyzed, call center staff performance, patient flow data/office visits. Same day schedule availability and documentation. Hiring, training, attendance and behavior discipline and dismissal.Quality/Population Health Quality Analyst for electronic Health IT Meaningful Use & NCQA Home Alignment improvement (QM/PI) initiatives. P4P/CMS 5 Star trending analysis, researching, compiling, analyzing, and preparing reports utilizing GE Centricity and AllScripts EMR. Providing technical expertise and guidance on the most effective use of electronic medical record (EMR) informatics and information technology (IT) systems. Providing visuals and guidance to the leadership team on interpretation and application of quality data/reports, analysis of workflow, ICD, CPT, and billing related processes that impact results, Building end user tools to integrate changes. *Tornado hit 10 miles from my home and decided to return home to Sacramento. Show less

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  Health Net

  Apr 2014 - Mar 2015

  Administrative Specialist

  Kelly Services Contract Assignment: Provided administrative support to executive leaders. Handled details of a highly confidential and critical nature.

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  Dignity Health

  Mar 2015 - Aug 2016

  Care Coordination Assistant

  While working side by side with the RN Case Manager assessing, planning, facilitating and advocating post inpatient options and services for continuum of care post discharge. Obtaining insurance authorization (medicaid managed care, medicare, private), scheduling transport (imaging, dialysis, chemo) booking home health services (HH), physical therapy, wound vac, oxygen, cpap, walker, wheelchair, etc. Midas referral entry for SNF, HH and Pharmacy referrals appropriate for level of care patient/family requests while assuring all orders documentation compliance according to CMS DME standards and requirements. Show less

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  Providence Health & Services

  Sept 2016 - Jun 2018

  Integrated Systems Analyst

  Provided administrative support to executive leaders. Handled details of a highly confidential and critical nature.

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  Scrapped In Dog Adventures

  Jul 2018 - Jun 2022

  K9 Hiker

  Dog sitting, hiking, walking, training

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  Sutter Health

  Mar 2019 - Sept 2019

  Quality Management Systems Analyst

  Robert Half Inc (Contract)Supporting SHVA Midas security access and data management.

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  Adventist Health

  Sept 2019 - Dec 2019

  Legal Contract Management Specialist

  Robert Half Inc (Contract) Analysis of all Corporate and Hospital legal contracts - Conga Contract Implementation

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  Goodwill Industries International

  Dec 2019 - Jun 2020

  Complex Case Manager

  complex case management for the homeless population. Upon intake, case was planned based on need with the goal to housing first. Medication management, Job and resume assessment, skills review, counseling, crisis management while making changes family-owned step at a time. referrals, collaborating with County programs accordingly (AoD, Adult Access, Planning appointments, Medical rides and well as CoveredCalifornia Health Case workers)

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  CIOX HEALTH CARING FOUNDATION INC

  Nov 2020 - Jun 2021

  Medical Records Management Analyst

  Receive, Date and Respond to Legal and Subpoena requests processing within tight time constraints according to instructions, Company procedures, rules, regulations and HIPAA guidelinesValidate requests and authorizations for release of medical information compliance Perform quality checks on a regular basis on all work to reassure accuracy of the release, confidentiality, and proper invoicingProvide excellent customer service by being attentive, respectful and professional at all times; insures understanding of customer request and follows-through as promised; being proactive in identifying and addressing member concerns, or problemsDemonstrate helpful and effective telephone etiquette and customer service skills by providing appropriate information to callersMaintain working knowledge of the current state laws regarding fee structure, and HIPAA regulations as well as facility policies and procedures in regards to release of information Adheres to the Company’s Code of Conduct and business standardsOngoing awareness of hazardous situations and be able to provide a leadership role in emergencies as needed Show less

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  Delta Dental Ins.

  Jun 2021 - Dec 2021

  Credentialing Analyst

  Wollborg Michelson (contract), Credentialing Analyst – DDC State Government ProgramsAnalyze and research incoming provider revalidation enrollment applicationsRevalidate or deactivate provider Medi-Cal Dental Enrollment participationEnsure all regulatory, DDPA and DHH compliance and guideline expectations are met and in complianceVerify applicants are not excluded from participation in Medicaid programs

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  Dignity Health

  Feb 2022 - May 2022

  Credentialing Coordinator

  Robert Half International

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  Dignity Health Medical Foundation

  Jun 2022 - now

  Credentialing Systems Specialist