Tosha Blackmon

Compassionate and detail-oriented Licensed Vocational Nurse (LVN/LPN) with over 20+ years of healthcare experience providing exceptional patient-centered care across diverse healthcare settings, including long-term care, hospice, remote, telephonic, and acute environments. Skilled in clinical assessment, medication administration, wound care, care/case management, and patient education. Demonstrating strong communication and leadership in interdisciplinary teams while maintaining professionalism under pressure.

Adept at fostering trust, ensuring compliance with regulatory standards, and delivering high-quality outcomes that enhance patient safety and satisfaction. Passionate about holistic care, advocacy, quality care management, patient advocacy, and promoting dignity for every patient served.

Willing to relocate: Anywhere. Authorized to work in the US for any employer.

Quality Improvement Specialist at IMCS/Centene (2026-01 – 2026-04)

Develop and implement strategies to enhance HEDIS compliance and quality metrics

• Develop and implement strategies in collaboration with clinical and quality teams to enhance compliance with behavioral health and medical HEDIS metrics
• Monitor the effectiveness of existing and new HEDIS initiatives, ensuring appropriate knowledge sharing, staff validation for HEDIS measures according to NCQA and organizational standards
• Support quality improvement programs and studies by requesting records from providers, maintaining databases, and researching health plan encounter data on an ongoing basis
• Assist with tracking data for clinical and non-clinical quality performance improvement activities
• Perform continuing medical record evaluation and follow-up education as required

Senior Clinical Quality Analyst at Russell Tobin/UnitedHealth Group (2026-01 – 2026-04)

Data collection, abstraction, and quality improvement activities for health plan HEDIS metrics

• Responsible for ongoing data collection, abstraction, data entry, and Performance improvement activities at the Health plan and reports to Supervisor of HEDIS
• Maintain current knowledge of HEDIS and state-mandated quality metrics specifications, and proficiency with the vendor's reporting software to provide analytic support with data quality review, care gap analysis and reports
• Support quality improvement programs and studies by requesting records from providers, maintaining databases, and researching health plan encounter data on an ongoing basis
• Assist with tracking data for clinical and non-clinical quality performance improvement activities
• Participate in and represent the health plan at community and other organizational meetings focusing on quality improvement, member education, care gap completion, risk reduction
• Perform continuing medical record evaluation and follow-up education as required

LVN Travel Home Health Nurse at Core Medical - Faith Home Health and Hospice (2025-11 – 2026-01)

13-week travel contract providing home health and hospice nursing care

• Blood sugar checks and insulin administration to patients
• Chronic Care Management, Disease Process patient education
• Accurate electronic medical record charting and documentation of physician orders
• Patient confidentiality and privacy
• Field nursing for Topeka Kansas area
• Provide patient care for all residents in home/assisted living settings
• Quality Assurance for documentation of field nurses
• Wound Care, Wound Vac, PT/INR monitoring, Foley Cath/Suprapubic Cath care, and other skills needed

LVN Health Coach/Care Manager at Pride Health/Wellmed (2025-09 – 2025-10)

Clinical health coaching and care management in primary care setting

• Perform initial patient interviews to assess health coaching needs
• Conduct Chronic Care Model visits, reviewing support systems and setting patient-centered goals
• Provide coaching on lifestyle changes, chronic disease management, and risk reduction strategies
• Educate patients about exercises, weight loss programs, and dietary plans for a healthier lifestyle
• Use motivational interviewing to assist patients in completing self-management goals/action plans
• Maintain accurate electronic medical record documentation, including tracking outcomes
• Stay current on CHF, IHD, COPD/asthma, diabetes, and related medications

LVN Travel Charge Nurse at Triage (2025-07 – 2025-09)

13-week travel contract as charge nurse overseeing patient care

• Oversee 50+ patient care load from 6pm-6am
• Provide patient care for all residents in facility
• Active charting and observation of residents according to doctors' orders
• Administer medication, insulin, oxygen administration, IV Therapy, breathing treatments
• Perform change over at the end of the month
• Admission of new resident (doctor orders, new MAR's, medication, TAR)
• ID new medication, order new medication through pharmacy
• Change Oxygen tubing/tanks, Foley catheters (in and out)
• Point ClickCare EMR System used

Quality Improvement Specialist at IMCS/Centene (2024-11 – 2025-06)

Quality improvement strategies and HEDIS compliance initiatives

• Develop and implement strategies in collaboration with clinical and quality teams to enhance compliance with behavioral health and medical HEDIS metrics
• Monitor the effectiveness of existing and new HEDIS initiatives, ensuring appropriate knowledge sharing, staff validation for HEDIS measures according to NCQA and organizational standards
• Support quality improvement programs and studies by requesting records from providers, maintaining databases, and researching health plan encounter data on an ongoing basis
• Assist with tracking data for clinical and non-clinical quality performance improvement activities
• Perform continuing medical record evaluation and follow-up education as required

HEDIS Abstractor at Randstad/UnitedHealth Group (2024-11 – 2025-06)

HEDIS data collection, abstraction, and quality metrics analysis

• Responsible for ongoing data collection, abstraction, data entry, and Performance improvement activities at the Health plan and reports to Supervisor of HEDIS
• Maintain current knowledge of HEDIS and state-mandated quality metrics specifications, and proficiency with the vendor's reporting software to provide analytic support with data quality review, care gap analysis and reports
• Support quality improvement programs and studies by requesting records from providers, maintaining databases, and researching health plan encounter data on an ongoing basis
• Assist with tracking data for clinical and non-clinical quality performance improvement activities
• Participate in and represent the health plan at community and other organizational meetings focusing on quality improvement, member education, care gap completion, risk reduction
• Perform continuing medical record evaluation and follow-up education as required

Transition Of Care/Health Care Coach/Care Manager at Insight Global/CVS/Aetna (2024-03 – 2024-11)

Phone-based transitional care coordination and health coaching

• Responsible for phone-based interaction with patients after discharge from Hospital of Skilled Nurse Facility
• Coordinated follow up care with Primary Care Physician, Specialist, Delegated Vendors (Meals on Wheels, Community Outreach, Local Official Facilities, etc)
• Assists with monitoring and continually assess the success of discharging diagnoses
• Assisted with post discharge needs such as prescriptions, transportation, Durable Medical Equipment (DME), appointments, food services, home placements
• Performed accurate and timely documentation in the electronic medical record
• Performed clinical tasks within scope of practice for LVN
• Visiting referrals while in the facility to explain the TCM program and determine if there are any anticipated needs post discharge
• Daily logging of referrals and discharges
• Post discharge calls to patients within Medicare and Case Management guidelines

HEDIS Abstractor at Randstad Healthcare/United Healthcare (2024-02 – 2024-06)

HEDIS data collection and quality metrics analysis

• Responsible for ongoing data collection, abstraction, data entry, and Performance improvement activities at the Health plan and reports to Supervisor of HEDIS
• Maintain current knowledge of HEDIS and state-mandated quality metrics specifications, and proficiency with the vendor's reporting software to provide analytic support with data quality review, care gap analysis and reports
• Support quality improvement programs and studies by requesting records from providers, maintaining databases, and researching health plan encounter data on an ongoing basis
• Assist with tracking data for clinical and non-clinical quality performance improvement activities
• Participate in and represent the health plan at community and other organizational meetings focusing on quality improvement, member education, care gap completion, risk reduction
• Perform continuing medical record evaluation and follow-up education as required

Transitional Care Coordinator at Segue Healthcare (2023-09 – 2024-02)

Transitional care coordination for post-discharge patients

• Responsible for phone-based interaction with patients after discharge

Licensed Vocational Nurse (LVN/LPN) in Nursing