Sheryl Christianson

Patient and provider focused and outcomes-driven Healthcare Quality Management Consultant with over 15 years' experience in healthcare administration and substantial success in directing quality improvement projects and initiatives in health care environments.

Experience includes leadership of large departments, the development of Quality Management projects and the management of healthcare providers. Uses sound knowledge of the challenges in healthcare and reproductive health to drive improvements, promotes data-driven decision-making and develops and inspires senior cross-functional teams to success. Applies an analytical approach to solve problems and cultivates trusted partnerships with industry role players and agencies.

HEDIS OPERATIONS SENIOR MANAGER - LOUISIANA HEALTH CARE CONNECTIONS/CENTENE CORP. - BATON ROUGE, LA

(2019-10)

Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing and improvement operations. Collaborate with internal and external stakeholders to ensure HEDIS and CAPHS initiatives are fully integrated throughout the organization, maximizing opportunities to improve outcomes for members. Leading steering committees related to physical and mental health outcome measures, leading companywide HEDIS steering committees.

Formulate and ensure compliance with HEDIS technical specifications for Medicaid and Medicare lines of business. Provide comprehensive analysis HEDIS measures, barriers and opportunities and present results of improvement efforts to senior management, Manage all clinical quality metrics and HEDIS process/results. Oversee all HEDIS projects to include assignment of nurses, adherence to plan timelines and quality; ensure compliance for all quality audits and maintain all data and process controls.

Supervised a multidisciplinary team of staff (quality improvement abstractors, Quality Practice Advisors, member outreach specialists) and including the EPSDT coordinator and addressed Vaccine for Children (VFC) reports for the Louisiana Department of H

• Lead team to improve quality (HEDIS) outcomes via collection methods, reporting and outreach
• Created and lead training for HEDIS measures (technical specifications)
• Coordinated member and provider outreach to help close gaps in care
• Submitted data via state, national and corporate submission files
• Created member and provider mailings and POM calls to address care needs
• Worked on state Performance Improvement Plans; collected metrics and completed reports
• Interdepartmental coordination for HEDIS and quality improvement measures; staff and provider training
• Coordinated and lead the HEDIS team to 4 star health plan rating for MY2024

HEALTHCARE QUALITY MANAGEMENT CONSULTANT - MERCY CARE PLAN/AETNA - PHOENIX, AZ

(2016-04 - 2019-09)

Process and evaluate complex data and information sets for accreditation/regulatory requirements. Analyze HEDIS data, conduct quantitative and qualitative data analysis, and assist with annual AHCCCS (state Medicaid) hybrid outcome and measurement audits. Author quality management documents, contribute to the development of QM projects, and educate providers about performance measures.

Update provider outreach manuals each year (EPSDT), manage relationships with contracted healthcare providers, and coordinate with Claims, Credentialing, and other departments to ensure that quality and outcome measures are met. Work, with healthcare providers to review Vaccine for Children standards, monitoring ASIIS inputs and recommend corrective action as required. Contribute actively at Quality of Concern Committee and Quality Committee meetings, make recommendations, and deliver presentations about the Medicaid line of business.

Participate in the state stakeholder Access to Care Work Group and the Arizona Chapter of the American Diabetes Coalition Health Equity Work Group to address population health goals.

• Led quality improvement initiatives and oversaw the implementation of Quality Management plans
• Reviewed Medicaid/Medicare measures and assisted Mercy Care Plan and providers to close gaps in care
• Conducted a root cause analysis to determine why a specific HEDIS measure was below the minimum and played a key role in the development of targeted interventions and performance improvement plans
• Created targeted member and provider mailings for vaccine interventions to improve HEDIS and CMS core measures, to enhance population health and to close gaps in care primarily for the Medicaid EPSDT age group

SENIOR PROGRAM MANAGER - CATHOLIC CHARITIES COMMUNITY SERVICES - PHOENIX, AZ

(2013-02 - 2016-03)

Coordinated the functions of large departments, which included the Domestic Violence Shelter and the Counseling, Victim Advocacy and Transitional Housing Departments and managed 15 full time and 15 part-time staff. Maintained documentation associated with contractual agreements, finances, budgets, and information systems integration, as well as grievance/complaint resolution, staff evaluations and performance metrics. Prepared proposals and budgets for existing and new services, applied for multiple government grants and compiled program evaluation reports.

Recruited and trained staff and prepared for survey readiness for the Counsel on Accreditation (COA) by reviewing standards, by reviewing and updating policies and procedures and by meeting with Surveyors.

• Secured additional Federal Funding through the VOCA Grant for Transitional Housing, Counseling Services, Victim Advocacy and Shelter Services
• Completed a new community partnership grant with three other community partners to bring parenting classes to the Domestic Violence Shelter to help improve social determinants of health/child welfare outcomes

SENIOR PROGRAM STAFF - ARIZONA MENTORS - PHOENIX, AZ

(2012-11 - 2013-02)

Managed staff at multiple group homes for seriously mentally ill adults and provided in-home training for staff.

• Compiled comprehensive budgets and financial reports for the Office of the Court Monitor
• Prepared detailed compliance reports for the Department of Health Services
• Developed individual treatment plans for the members to enable staff to conduct monthly reviews of member treatment/placement

CLINICAL COORDINATOR - PEOPLE OF COLOR NETWORK - PHOENIX, AZ

(2009-07 - 2012-10)

Supervised eight Case Managers and Clinical Liaisons and a Rehabilitation Specialist providing services for the seriously mentally ill adults on AHCCCS and stood in for the Clinical Director in their absence. Collaborated with Medicare and other health plans for health care coverage and medication benefits and coordinated hospital discharges from mental health and medical facilities. Participated in utilization reviews, discharge staffing, risk management reviews and mortality reviews, as well as grievance and appeal calls, crisis management and interventions.

• Took over supervision of the Arizona State Hospital and Supervisory Care Home outpatient teams in Aug 2010
• Successfully managed the transition of numerous recipients from residential to independent living
• Assisted with the transition of services for members no longer eligible for Title 19 services to ensure continued community-based health services/care in Jul 2010
• People of Color Network assumed care of the direct service Clinic in Jul 2009 from Magellan Health Services, which still held the Regional Behavioral Health Authority (RBHA) contract for Maricopa County

CLINICAL COORDINATOR - MAGELLAN HEALTH SERVICES - SAINT LOUIS, MO

(2008-09 - 2009-07)

CLINICAL COORDINATOR - VALUE OPTIONS - PHOENIX, AZ

(2001-07 - 2008-08)

Master of Administration - Health Science - NORTHERN ARIZONA UNIVERSITY

Bachelor of Arts - Political Science - CALVIN COLLEGE