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
