Experience

Tandem Health

• United States
• Medical Practices
• 1 - 100 Employee

• Director of Risk Management and Quality Assurance

  • Aug 2023 - Present

  • Established multiple programs and plans responsible for increasing quality assurance and mitigating risks.• Maintains adherence to NCQA PCMH standards to ensure recognition/annual reporting.• Provides knowledge within the organization surrounding FQHC guidelines for Quality initiatives.• Lead role in gathering and confirming data for annual UDS submission.• Proactively evaluates areas of organizational risk based on internal assessments.• Provides guidance within the organization related to clinical and operational risk.• Analyzes statistical reports and advisories that identify risk management and patient safety.• Acts in a lead role in continuous compliance efforts related to HRSA requirements (Federal Torts Claims Act (FTCA), Operation Site Visits and Uniform Data System (UDS).• Maintains the organizational Emergency Operations Plan.•Responsible for overseeing and monitoring annual drills within the organization.• Maintains OSHA manuals within the organization.• Chairs the Safety Committee. Show less

• Director of Risk Management and Quality Improvement

  • Dec 2020 - Present

  • Established multiple programs and plans responsible for increasing quality assurance, mitigating risks,and recovering over $320K annually in quality dollars; programs include the Safety ComplianceCommittee, the Respiratory Protection Plan, an Emergency Operations Plan, a COVID-19 ContingencyPlan, and the establishment of Safety Liaisons• Received Patient Center Medical home (PCMH) recognition through NCQA for 3 locations within 6months• Created and implemented a Quality Improvement and Clinical Dashboard to provide real-time updateson QA processes• Spearhead the preparation and submission of detailed reports, including the Patient-Centered MedicalHome Report, the Uniform Data Systems report, the Federal Tort Claims Act application• Lead multiple committees and teams focused on implementing process improvements to enhanceworkflows and maximize quality dollars, including the Quality Compliance and Risk Management(QCRM) Committee and the Safety Compliance Team• Serve as a Subject Matter Expert on HEDIS, Medicare and Medicaid star ratings, MCAPI, MA-PCPi, andCPT codes Show less

• Quality & Compliance Audit Coordinator

  • Jan 2019 - Dec 2020

  • Conducted monthly chart and housekeeping site audits to increase star ratings with insurance providersand maximize revenue• Coordinated educational work days with company residents and led quarterly meetings for CQRM andinsurance providers

• Patient Financial Coordinator

  • Jul 2016 - Jan 2019

  • Directed a high-performing team of 5 Administrative Support Professionals by providing training onfinancial best practices

• Biller

  • Nov 2015 - Jul 2016

  • Facilitated staff trainings on sliding fee applications, money collection, and patient registrations toenhance daily workflows

• Patient Account Representative

  • May 2014 - Nov 2015

  • Created customized financial arrangements during patient check-in/out processes based on insurancepolicies and benefits



SUMTER MEDICAL SPECIALISTS, P.A.

• United States
• 1 - 100 Employee

• Medical Records Coordinator

  • Oct 2013 - Aug 2014

• Billing

  • Aug 2013 - Oct 2013