KIM BADEN

Experience

• 

  MSN Homecare

  Feb 2007 - Apr 2009

  RN Case Manager/Alternate Administrator

  Supervising and coordinating care between healthcare professionals and patients we serve.Developing and implementing Care Plans for clients while working closely with Physicians ensuring current orders are reflected.Receiving intake referrals, completing initial assessments and completing appropriate required paperwork in a timely manner to Medicaid. Provide education to staff and evaluate staff skill levelMaintain positive ongoing relations with physicians, referral sources, community resources, clients and staff.Actively pursue creative new and innovative marketing opportunities on a consistent basis.Serve on Peer review boards Show less

• 

  Molina Healthcare

  Dec 2009 - May 2011

  Quality Improvement Nurse

  Manage Performance Improvement measurement (PIGs), ensuring goals are met, obtaining aggregate data, compiling reports and submit to HHSC semi-annually. Participate in HEDIS activities IRR and MRR, including training activities. Familiarity and functional use of NCQA guidelines for Quality Management activities to improve Health Plan scores. Obtain aggregate data on designated HEDIS interventions and preventive health measures to improve rates. Timely process of Appeals including coordinate investigation, track and trend results and ensure compliance with NCQA standards. Investigation of all PQOC complaints and issues, track and trend results, report to MAC quarterly. Conduct Facility based Audits, identify deficiencies, analyze results, prepare report and submit to MAC for trending. Continually update clinical practice guidelines and monitor physician compliance with CPG's Show less

• 

  Riverhill Golf and Country Club

  Apr 2011 - Jul 2012

  Event Sales Manager and Front of the house manager.

  Market organize and execute all events, special occasions, weddings, to ensure the maximum financial outcomes. Maintain current client accounts and market to new clients to promote sales and membership Track and trend monthly sales, comparative analysis from prior year data, identify opportunities for improvement. Create and modify existing marketing plans.

• 

  Peterson Community Care Clinic

  Jul 2012 - Mar 2013

  RN Case Manager/QI

  Case manager and QI Nurse at new primary care clinic that is being developed and will be opening in September 2012. Case management activities and QI support for newly developed clinic. Will achieve Patient Centered Medical Home after first year of opening.

• 

  The View at Pagosa Springs

  Feb 2013 - Jul 2013

  General Manager

  General Manager new restaurant startup with 2 Dining options of Casual and Fine Dining that seats total 250 people. Responsible for all foh operations, sales management, reporting of all f&b sales, beverage management and marketing operations.

• 

  Anthem, Inc.

  Sept 2013 - May 2023

  In the Quality Management Department for Amerigroup Community Care. Manage HEDIS project, HEDIS SME, RCI PIPs, ER Performance Improvement Projects from State, Ambulatory Medical Record Reviews and other Quality Improvement projects at Health Plan dedicated to improving the health and lives of our members.

  • Interim Quality Director

    Jul 2022 - May 2023

  • Clinicql Quality Program Manager

    Jun 2021 - May 2023

  • HEDIS Manager

    Sept 2013 - Jun 2021
• 

  Elevance Health

  May 2023 - now

  Advanced Execution Lead

  GBD Analytics Advanced Execution Lead. Excited to begin my new role and take my Quality experience to continue to improve the health of humanity!