Renee Foster-McFarland MSN, RN, CPHQ
Director of Clinical Quality at TCA Health Inc.- NFP- Claim this Profile
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Bio
Credentials
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Certified Professional in Healthcare Quality
National Association for Healthcare Quality (NAHQ)Jul, 2020- Sep, 2024 -
Active Registered Nurse License
State of IllinoisMay, 2018- Sep, 2024
Experience
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TCA Health Inc.- NFP
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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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Director of Clinical Quality
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Sep 2018 - Present
Direct daily operations and administrative services for multi-site ambulatory health centers operated under HRSA 330 grant requirements. Develop, implement and maintain all quality improvement initiatives. Manage policies and procedures, EMR workflow, clinical service improvements, and oversight of Continuous Quality Improvement (CQI) projects focused on a culture of quality throughout the organization. Care Coordination – Developed and delivered new programs to enhance care coordination and management services for patients with chronic diseases. Patient-Centered Care – Succeeded in leading transition to a “patient-centered” model of care delivery requiring updating of new job descriptions and roles for staff to provide support for new program focused on service excellence. Risk Management Program – Spearheaded an evidence-based Risk Management Program to reduce risk and improve patient safety based on industry standards. National Accreditation – Team leader and facilitator for national accreditation for NCQA PCMH Recognition Program. Reporting System – Developed an improved reporting system to track and monitor progress for key quality indicators to enhance accuracy and completeness for process and clinical outcomes. Performance Improvement – Effectively manage performance improvement metrics for HEDIS, HRSA and Pay for Performance quality metrics.
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Regional Director of Quality Assurance and Performance Improvement
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May 2017 - Sep 2018
Directed strategy planning and execution of quality improvement for patient safety, infection prevention, risk management, regulatory and performance improvements projects for post-acute care facilities. Evidence-Based Systems – Designed and introduced evidence-based systems and clinical processes that directly improved patient/resident care across the care continuum in collaboration with each line of business. Nursing Onboarding Program – Significantly reduced Director of Nursing (DON) turnover by 70% with introduction of new DON onboarding program. Hospital Readmission Reduction – Introduced program to train staff on quality improvement initiatives to enhance knowledge and understanding in key quality metrics for sub-performing facilities that significantly reduced falls, readmissions, and patient safety. Also reduced readmissions by 5% with facilitation of INTERACT (Interventions to Reduce Acute Care Transfers). Performance Improvements – Functioned as clinical vendor liaison to facilitate standardization of supply chain products and services focused on quality and reduced costs. Investigations– Led local teams and risk managers in incident investigation of events, adverse outcomes, and use of root cause analysis, creation of action plans, and required reporting for regulatory and/or accreditation agencies.
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Blue Cross Blue Shield of Illinois
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Insurance
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Quality Management Specialist III
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Jan 2015 - Apr 2017
Directed daily operations for multiple clinical quality functions for Performance Improvement, Primary Care Medical Home Initiative, Clinical Data Integrity, and Ambulatory Medical Record Reviews, and development of Primary Care Medical Home policy and procedures for the Government Programs Division. HEDIS Project – Led planning and oversight of staff of 40 HEDIS nurses and administrative teams for annual HEDIS project requiring medical record audit for clinical quality compliance. PCMH Standards – Developed and introduced organization-wide policy for patient-centered medical home (PCHM) standards to be able to assess provider compliance. Program Co-Chair – Key member of quarterly Quality Improvement Committee for Government Program Division for oversight of federal and state quality improvement projects. Managed data abstraction for federal and state regulatory standards and delivered reports and recommendation to leadership teams. Clinical Performance – Monitored clinical performance and services and educated staff to ensure clinical performance standards were met to improve population health management.
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Executive Clinical Administrator
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Aug 2014 - Jan 2015
Collaborated with the Executive Leadership Team on the development of clinical quality improvement strategies. Responsible for planning and executing complex cross-functional initiatives using advanced performance improvement skills and methods while working with agency nursing staff to ensure organizational goals are met. Facilitates decision-making regarding appropriateness of performance improvement methods, implications of data, compliance with regulator standards, process change or practice change. Responsible for the production of quality reports and quality information, oversees analysis and presentation of relevant quality data to Executive Leadership Team. Manages quality improvement projects and activities to ensure compliance with contractual agreements in the provision of care. Directs continuous improvement programs throughout the organization and leads in the development of a culture of continuous improvement and excellence. Engages with leaders and clinicians throughout the organization in a hands-on fashion to build quality, efficiency, effectiveness and a sense of shared accountability. Takes a clinical leadership role in evaluating care delivery and developing the infrastructure for improvement.
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Director Of Quality Health
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Jul 2012 - Jan 2014
Directed the comprehensive performance and quality improvement program for the third largest community health network in Illinois. AMYSC provides primary health care services to residents of seven counties through HRSA-supported health centers. The Director of Quality is responsible for developing, implementing, and leading the comprehensive performance and quality improvement program for clinical services and quality management. Applies solid health care administration skills and innovation in planning, designing, integrating, implementing, modifying clinical and administrative activities to improve patient care services. Monitors compliance with Joint Commission accreditation standards and consistently seeks to exceed requirements.
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North Shore Health Centers
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United States
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Veterinary Services
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1 - 100 Employee
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Director of Quality Improvement
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Jan 2010 - Jun 2012
Initiates, develops, leads, and directs all performance improvement programs to ensure high quality patient care. Successfully developed and implemented project plan for NCQA certified Primary Care Medical Home recognition. Directed clinical practice teams in developing workflows, policies and procedures, and guidelines for EHR implementation. Directed implementation of use of Indiana Health Information Exchange to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care.
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Unicare
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Cyprus
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Retail Office Equipment
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Lead Nurse Case Manager
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Jan 2005 - Nov 2009
Managed and directed cost-effective services for PPO/HMO medically-complex patient populations with emphasis on high-dollar utilization management. Directed appropriate use of disease management programs. Collaborated with internal and external customers to promote care coordination and effective utilization of covered benefits. Supervised case management departments utilization management program guaranteeing internal criteria was met for acute, trauma, and high-risk patients. Managed and directed cost-effective services for PPO/HMO medically-complex patient populations with emphasis on high-dollar utilization management. Directed appropriate use of disease management programs. Collaborated with internal and external customers to promote care coordination and effective utilization of covered benefits. Supervised case management departments utilization management program guaranteeing internal criteria was met for acute, trauma, and high-risk patients.
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New Visions Home Health Care
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United States
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Hospitals and Health Care
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Administrator
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Jul 1999 - Jan 2005
Directed daily agency operations for licensed Medicare home health agency. Responsible for planning, organizing, and developing all home health agency functions including, operations administration, clinical oversight, supervision and leadership. Supervised licensed healthcare professionals in the provision of skilled home health care services. Directed patient care services to ensure compliance with federal and state regulatory guidelines for the provision of skilled nursing and rehabilitation services. Budget and profit/loss (P/L) statement management experience. Proven success in revenue growth and in the development and execution of marketing plan.
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Education
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2012 - 2014
Governors State University
Masters Degree, Nursing Administration -
2012 - 2014
Governors State University
Master of Science (M.S.), Nursing Administration
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