Kelsey Shaw, MSN, RN, AMB-BC
Operations Advisor at Evernorth- Claim this Profile
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Bio
Credentials
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Ambulatory Care Nursing (AMB-BC)
American Nurses Credentialing Center -
Basic Life Support for Healthcare Providers (BLS)
American Heart Association -
Patient-Centered Medical Home Content Certification Expert (PCMH CCE)
National Committee for Quality Assurance -
Registered Nurse License
New Jersey
Experience
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Evernorth Health Services
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United States
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Hospitals and Health Care
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700 & Above Employee
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Operations Advisor
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Sep 2021 - Present
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Cigna Healthcare
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Hospitals and Health Care
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700 & Above Employee
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Operational Readiness Training Lead Analyst
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Oct 2019 - Sep 2021
• Design and facilitate instructional curriculum for new and existing employees on a variety of topics, including utilization management, behavioral health, compliance, and health literacy via live virtual platform • Provide feedback reports to leadership regarding learner progress • Perform roster management and reconciliation of assessment scores • Facilitate courses pertaining to use of a multitude of medical necessity guidelines, including National and Local Coverage Determinations •Design and update Operational Readiness Training SharePoint Show less
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Hackensack Meridian Health
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United States
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Hospitals and Health Care
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700 & Above Employee
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Patient-Centered Transformation Lead
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Apr 2014 - Oct 2019
• Subject matter expert at network level who led team to achieve NCQA PCMH/PCSP recognition for 100% of practices submitted, which included 38 internal medicine practices, 14 obstetrics and gynecology practices, 4 surgical practices, 1 endocrinology practice, and 1 pediatric practice, which accounts for 61% of the NCQA PCSP practices in the state• Interacted with senior leadership to head re-launch of lab, image, and referral tracking workflows to increase patient outcomes and meet quality metrics and MIPS requirements in 38 internal medicine, 20 obstetrics and gynecology, and 1 pediatric practice• Utilized and manipulated BI data to lead and achieve NCQA DRP recognition for 100% of 40 providers submitted, which accounts for 75% of providers with NCQA DRP recognition in NJ• Utilized and manipulated BI data to lead and achieve NCQA HSRP recognition for 100% of 17 providers submitted, which accounts for 100% of providers with NCQA HSRP recognition in NJ• Led provider education campaign and interactive voice recording campaign for 38 ambulatory practices that resulted in a 119% increase in Medicare Wellness visits over a two period• Participated in team with senior leadership to devise plan for ambulatory quality goals across the organization’s clinically integrated network• Supervisor for team of 7 practice facilitators who provide workflow support to 52 practices• Managed team in design of pre-visit planning report used by 52 practices to proactively identify patient needs prior to visit arrival• Analyzed Press Ganey survey data to design and implement quality improvement projects to increase patient satisfaction scores• Provided post-hospitalization follow-up education and transition of care coordination to patients from across 11 primary care practices Show less
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Community Outreach RN Educator
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Nov 2009 - Apr 2014
• Researched, composed and delivered health education programs for children and adults on a multitude of health-related topics • Facilitated classes for adults living with chronic diseases
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Women's Health & Counseling Center
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Somerville, NJ
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Registered Nurse
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Feb 2009 - May 2010
• Wrote article published in women’s health section of local newspaper • Attended conferences and provided staff in-services • Provided nursing care to patients • Wrote article published in women’s health section of local newspaper • Attended conferences and provided staff in-services • Provided nursing care to patients
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Monmouth Medical Center
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Hospitals and Health Care
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700 & Above Employee
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Registered Nurse
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Sep 2006 - Feb 2009
• Educated parents regarding patient condition and provided routine nursing care • Educated parents regarding patient condition and provided routine nursing care
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Women's Health & Counseling Center
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Somerville, NJ
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Outreach Nurse
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Sep 2005 - Aug 2006
• Assisted in educating and case managing approximately 15 at risk high school students • Developed and organized community resource health fair for students • Assisted in educating and case managing approximately 15 at risk high school students • Developed and organized community resource health fair for students
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Children’s Hospital of New Jersey at Newark Beth Israel Medical Center
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Registered Nurse
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Jul 2004 - Aug 2005
• Admitted high risk infants to the unit. Provided routine nursing care and assessments • Admitted high risk infants to the unit. Provided routine nursing care and assessments
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Education
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Thomas Edison State University
Master of Science in Nursing, Nursing Informatics -
Quinnipiac University
Bachelor of Science in Nursing, Registered Nursing/Registered Nurse