Experience

Union Health Center
• United States
• Hospitals and Health Care
• 1 - 100 Employee
• Director Of Performance Improvement

  • Jul 2016 - Present

VillageCare HomeCare CHHA
• Manager Performance Development

  • Jun 2014 - Jun 2016


VNSNY CHOICE Health Plans

• Quality Improvement Specialist

  • Oct 2012 - Jun 2014

  Project Manager Centers for Medicare & Medicaid Services Quality Improvement Projects Responsible for implementation, training, analysis and oversight Health Plan wide for the multiyear Chronic Care Improvement Program (CCIP) and Quality Improvement Project (QIP). • Implementation of the Plan Do Study Act Cycle, Annual Submission via Health Plan Management System (HPMS) and status submissions to Senior Management. Principal Investigator Quality of Care Concerns (Medicare and HIV SNP) Intensive clinical record review pertaining to serious reportable events (SRAE) and healthcare associated conditions identified through utilization review, claims and grievance and appeals. • Collaboration with the Chief Medical Officer, Compliance Director and Credentialing Committee regarding provider corrective action plan/root cause analysis submission and any disciplinary action related to fraud and abuse. Responsible for all trending and data evaluation for submission to Health Plan Leadership including Medicare Part C Data Validation (SRAE). Regulatory Auditor (Medicare and HIV SNP) Primary Care Provider documentation auditor for compliance to Health Plan, CMS standards (defined by NCQA) and HIVQUAL (defined by NYS Quality Advisory Committee). • Additional key tasks include study composition, submission to senior leadership, action plan implementation and status checks. Developer Case Manager Score Card (Medicare) Established criteria and process to evaluate Case Manager integrated care coordination through evaluation of compliance with care planning timeframes, member contact standards and Special Needs Plan (SNP) Structure and Process Elements with a focus on transitional care management. Show less



Express Scripts

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Nurse Quality Specialist

  • Jan 2009 - Sep 2012

  Healthcare Quality Improvement: Regulatory & Compliance Auditing, Clinical Procedure Development, Leader Cross Divisional Infection Control Program, The Joint Commission & URAC Compliance. Research & Implementation of Evidence Based Practice. Informatics-Electronic Health Record & Nursing Scheduler- Development, Training & Testing Healthcare Quality Improvement: Regulatory & Compliance Auditing, Clinical Procedure Development, Leader Cross Divisional Infection Control Program, The Joint Commission & URAC Compliance. Research & Implementation of Evidence Based Practice. Informatics-Electronic Health Record & Nursing Scheduler- Development, Training & Testing



Accredo Health Group a Medco Company

• Manager-Outcomes and Clinical Integrity

  • Jan 2007 - Jan 2009

  Implementation of the Organization's Quality Improvement Initiatives: Development and institution of Accredo’s “best practices” adding standardization and value to the organization Corporate Performance Improvement Team Lead Oversight of regulatory compliance Implementation of the Organization's Quality Improvement Initiatives: Development and institution of Accredo’s “best practices” adding standardization and value to the organization Corporate Performance Improvement Team Lead Oversight of regulatory compliance



Accredo Health Group- a Medco Company

• Branch Manager

  • Jan 2005 - Jan 2007

  Manage all reimbursement, pharmacy nursing & warehouse activities of Accredo-Medco’s leading Immune Globulin location. Manage all reimbursement, pharmacy nursing & warehouse activities of Accredo-Medco’s leading Immune Globulin location.



Gentiva Health Services

• United States
• Hospitals and Health Care

• Clinical Operations Specialist

  • Jan 2000 - Jan 2005

  Provide operations, clinical, and regulatory supervision for all northeast Specialty Pharmaceutical sites including Accredo Health Group’s National Distribution Center Ad Hoc Director, National Distribution Center Provide operations, clinical, and regulatory supervision for all northeast Specialty Pharmaceutical sites including Accredo Health Group’s National Distribution Center Ad Hoc Director, National Distribution Center


TransWorld Health Care Inc.
• United States
• Hospitals and Health Care
• Regional Director of Quality Improvement & Nursing Services

  • 1995 - 2000

Roche Professional Service Centers
• New York Metro Area Clinical Manager & Quality Improvement Team Lead

  • 1993 - 1995

Abel Health Management Services
• Field Clinical Team Leader & Intravenous Therapy Nurse Clinician

  • 1990 - 1993

Stamford Hospital
• United Kingdom
• Medical Practices
• 1 - 100 Employee
• Registered Nurse & Evening Charge Nurse-Labor and Delivery

  • 1987 - 1990

Beth Israel Medical Center
• United States
• Medical Practices
• Registered Nurse-Antepartum, Postpartum, Labor & Delivery, Term Nursery, NICU, Pediatrics

  • 1986 - 1987

White Plains Hospital
• United States
• Hospitals and Health Care
• 700 & Above Employee
• Registered Nurse & Night Charge Nurse-Medical Surgical Unit

  • 1985 - 1986