Experience

Neighborhood Health Plan of Rhode Island

• Insurance
• 300 - 400 Employee

• Senior Quality Improvement Specialist

  • Apr 2023 - Present

• Quality Improvement Specialist

  • May 2020 - Apr 2023

  Supporting the Rhode Island Accountable Entities Program (Medicaid ACO) working on Quality Improvement with all 7 Accountable Entities in Rhode Island. Working on Health Equity in the State of Rhode Island. Collaborating with the Rhode Island Department of Health on health initiatives including Lead Screening and STI testing.



Spence Partners Inc

• Greater Boston Area

• Healthcare Quality Specialist Consultant

  • Jun 2015 - Present

   Successfully reported on multiple years of Group Practice Reporting Option (GPRO)  Developed training materials for ACO GPRO collection and reporting  Developed strategies to keep participating physicians in compliance of ACO quality measures  Consulted with ACO administration to plan strategies for successful GPRO collection and reporting  Worked at the practice level to collect the appropriate information for the CMS GPRO Quality Measures using multiple Electronic Medical… Show more  Successfully reported on multiple years of Group Practice Reporting Option (GPRO)  Developed training materials for ACO GPRO collection and reporting  Developed strategies to keep participating physicians in compliance of ACO quality measures  Consulted with ACO administration to plan strategies for successful GPRO collection and reporting  Worked at the practice level to collect the appropriate information for the CMS GPRO Quality Measures using multiple Electronic Medical Records.  Traveled to ACO sites to ensure successful GPRO collection and reporting Jennifer Clair is a results-oriented and hands-on consultant with extensive expertise in the CMS (Centers for Medicare & Medicaid Services) quality measures and with a broad strategic and operational understanding of the Medicare Shared Savings Program (MSSP) and MACRA/MIPS Program. Quality Specialist with deep detailed knowledge of current and past CMS quality measure specifications and program rules. Since 2013, has conducted GPRO audits for more than 30 practices working with several EMR including Allscripts, Athena, eCW, Elation, eMD, Epic, Centricity, Cerner, Meditech, Practice Fusion, Quest Quanum, as well as audits for paper-based practices and SNFs. * Has managed the GPRO reporting process including QA checks, measure performance calculations, and measure optimization. * Developed GPRO training material and quick reference guides to conduct efficient and effective training sessions for Quality Improvement teams and PCP office staff. Has proven abilities to work collaboratively and facilitate a team environment and to communicate measure details across varying knowledge bases from physician to office staff to meet Quality improvement goals. Show less  Successfully reported on multiple years of Group Practice Reporting Option (GPRO)  Developed training materials for ACO GPRO collection and reporting  Developed strategies to keep participating physicians in compliance of ACO quality measures  Consulted with ACO administration to plan strategies for successful GPRO collection and reporting  Worked at the practice level to collect the appropriate information for the CMS GPRO Quality Measures using multiple Electronic Medical… Show more  Successfully reported on multiple years of Group Practice Reporting Option (GPRO)  Developed training materials for ACO GPRO collection and reporting  Developed strategies to keep participating physicians in compliance of ACO quality measures  Consulted with ACO administration to plan strategies for successful GPRO collection and reporting  Worked at the practice level to collect the appropriate information for the CMS GPRO Quality Measures using multiple Electronic Medical Records.  Traveled to ACO sites to ensure successful GPRO collection and reporting Jennifer Clair is a results-oriented and hands-on consultant with extensive expertise in the CMS (Centers for Medicare & Medicaid Services) quality measures and with a broad strategic and operational understanding of the Medicare Shared Savings Program (MSSP) and MACRA/MIPS Program. Quality Specialist with deep detailed knowledge of current and past CMS quality measure specifications and program rules. Since 2013, has conducted GPRO audits for more than 30 practices working with several EMR including Allscripts, Athena, eCW, Elation, eMD, Epic, Centricity, Cerner, Meditech, Practice Fusion, Quest Quanum, as well as audits for paper-based practices and SNFs. * Has managed the GPRO reporting process including QA checks, measure performance calculations, and measure optimization. * Developed GPRO training material and quick reference guides to conduct efficient and effective training sessions for Quality Improvement teams and PCP office staff. Has proven abilities to work collaboratively and facilitate a team environment and to communicate measure details across varying knowledge bases from physician to office staff to meet Quality improvement goals. Show less



Tufts Medicine Integrated Network

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Senior Practice Quality Associate

  • Jun 2015 - May 2020

  • Engages with patients through mailings, phone calls and other methods to ensure screening of preventive measures and to achieve optimum quality scores • Works closely with Local Care Organization (LCO) to help educate practices on new initiatives; such as Complex Care Management program • Works with HIS consultants to implement processes in Electronic Medical Records (EMR) that will support performance improvements, such as Accountable Care Organizations (ACO) quality measures •… Show more • Engages with patients through mailings, phone calls and other methods to ensure screening of preventive measures and to achieve optimum quality scores • Works closely with Local Care Organization (LCO) to help educate practices on new initiatives; such as Complex Care Management program • Works with HIS consultants to implement processes in Electronic Medical Records (EMR) that will support performance improvements, such as Accountable Care Organizations (ACO) quality measures • Successfully reported on several years of Group Practice Reporting Option (GPRO), which helped increase ACO performance score • Developed training materials for ACO GPRO collection and reporting • Developed strategies to keep participating physicians in compliance of ACO quality measures • Works efficiently in multiple electronic health records by retrieving pertinent information and documenting overdue measures • Develops strong relationships with LCO, primary care physicians and office staff to establish efficient office work flow • Organizes current member information by developing detailed documentation, which includes all outreach, appeals and other important data • Trains practice staff on new patient registry (athenaNet) • Works closely with HIS consultant in medical practices looking to successfully complete Patient Centered Medical Home certification • Serves as mentor to Practice Quality Associates • Works closely with Network Relations Managers on special projects and new PQA trainings • Serves as subject matter expert with regards to ACO GPRO reporting and Quality Measures • Serve on the MetroWest Quality committee • Serves as team leader in monthly team meetings (runs and leads these meetings) • Serves as a participating member on the Athena Data Management team • Serves as project manager for the NEQCA Point of Care Testing Survey • Analyzes Wellforce Medicaid ACO results to determine reasons for scoring and develop plans to improve Medicaid ACO Quality Scores.

• Practice Quality Coordinator

  • Jul 2012 - Jun 2015

  • Engaged with patients through mailings, phone calls and other methods to ensure screening of preventive measures and to achieve optimum quality scores • Worked closely with Local Care Organization (LCO) to help educate practices on new initiatives; such as Complex Care Management program • Worked with HIS consultant to implement processes in Electronic Medical Records (EMR) that will support performance improvements, such as Accountable Care Organizations (ACO) quality measures •… Show more • Engaged with patients through mailings, phone calls and other methods to ensure screening of preventive measures and to achieve optimum quality scores • Worked closely with Local Care Organization (LCO) to help educate practices on new initiatives; such as Complex Care Management program • Worked with HIS consultant to implement processes in Electronic Medical Records (EMR) that will support performance improvements, such as Accountable Care Organizations (ACO) quality measures • Successfully reported on three years of Group Practice Reporting Option (GPRO), which helped increase ACO performance score • Developed training materials for ACO GPRO collection and reporting • Developed strategies to keep participating physicians in compliance of ACO quality measures • Worked efficiently in multiple electronic health records by retrieving pertinent information and documenting overdue measures • Developed strong relationships with LCO, primary care physicians and office staff to establish efficient office work flow • Organized current member information by developing detailed documentation, which includes all outreach, appeals and other important data • Trained practice staff on new patient registry (athenaNet) • Worked closely with consultant in medical practices looking to successfully complete Patient Centered Medical Home certification



Brigham and Women's Hospital

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

• Administrative Assistant in Cardiac Surgery

  • Jul 2010 - Jun 2012

  Administrative support to Director of Cardiac Transplant Program and Cardiac Circulatory Assist Program, Assistant Professor of Surgery Harvard Medical School; Clinical and Administrative Scheduling (consultations, surgeries, post operative visits, meetings, conference calls); New England Organ Bank Reporting

• Practice Secretary in Cardiovascular Clinic

  • Sep 2007 - Jul 2010

  Watkins Cardiovascular Clinic Front Desk Operations (100-180 patients per day); Administrative Services, Supply Orders, New Patient Registration; Scheduling (clinic appointments, testing, waitlist management); Managed Care Referrals and Authorizations



Weston Racquet Club

• Greater Boston Area

• Member Services Specialist

  • Aug 2006 - Sep 2007

  Front Desk Operations; Administrative Services, Statistics (using Excel), Direct Mailing; Customer Service, Court Reservations/Matchmaking Services (50-100 reservations per day), Special Events Front Desk Operations; Administrative Services, Statistics (using Excel), Direct Mailing; Customer Service, Court Reservations/Matchmaking Services (50-100 reservations per day), Special Events



City of Goldsboro

• Government Administration
• 1 - 100 Employee

• Recreation Center Leader I - Herman Park Center

  • Dec 2004 - Aug 2006

  Center Office Operations, Center Reservations, Facility Management, Budgeting; Preschool Programming, Youth Programming, Teen Programming, Adult Wellness Programming, 4-H, Special Olympics, Senior Games, Special Events, Hershey Track and Field Coordinator; Promotional Material Design, Website Organizer, Municipal Vehicle Accident Review Committee - Vice Chair Center Office Operations, Center Reservations, Facility Management, Budgeting; Preschool Programming, Youth Programming, Teen Programming, Adult Wellness Programming, 4-H, Special Olympics, Senior Games, Special Events, Hershey Track and Field Coordinator; Promotional Material Design, Website Organizer, Municipal Vehicle Accident Review Committee - Vice Chair



N/A

• Musicians
• 1 - 100 Employee

• Recreation Program Assistant - Youth, Teens, and Athletics

  • May 2004 - Dec 2004

  Department Office Duties; Program Brochure Design, Promotional Material Design, Related Field Research; Summer Day Camp, Preschool Programming, Garner Youth Council, Schools Out Programs, Youth and Teen Field Trips, Garner Outdoors Youth, Special Events Department Office Duties; Program Brochure Design, Promotional Material Design, Related Field Research; Summer Day Camp, Preschool Programming, Garner Youth Council, Schools Out Programs, Youth and Teen Field Trips, Garner Outdoors Youth, Special Events



Elon University

• United States
• Higher Education
• 700 & Above Employee

• Student Activites Intern

  • Jan 2003 - May 2003

  developed Freshmen student experiences program; planned, developed, and coordinated student activities on campus; advised Student Union Board developed Freshmen student experiences program; planned, developed, and coordinated student activities on campus; advised Student Union Board