Allyson Winkles
Summary
Healthcare and business leader with 15+ years of experience in clinical quality management and regulatory compliance. Achieved significant improvements in patient outcomes and operational efficiency through successful accreditation initiatives and lean methodologies. Expertise in enhancing star and HEDIS measures, driving measurable results in healthcare settings.
Overview
1
1
Certification
2027
2027
years of professional experience
Work History
Clinical Quality Manager
Harbor Health
Remote
09.2025 - Current
- Directed comprehensive internal audits to ensure 100% compliance with CMS guidelines and HIPAA regulations.
- Managed clinical documentation integrity programs to ensure accurate reflection of patient acuity and illness severity, supporting quality patient care.
- Monitored clinical workflows to uphold high quality standards and legal compliance.
- Optimized DRG assignment accuracy by aligning clinical practice with billing for precise reimbursement.
- Oversaw quality management protocols during acquisition transition from Rippl Care to Harbor Health, facilitating smooth integration of standards across organizations.
- Ensured seamless integration of audit and documentation workflows across merging organizations.
- Standardized CDI processes to maintain operational continuity during organizational change, ensuring consistent quality metrics.
Founder & Chief Executive Officer
Anchor & Aid Respite Care LLC
Wesley Chapel, Florida
03.2026 - Current
- Founded respite care and skilled nursing organization committed to delivering compassionate in-home care for pediatric and adult clients.
- Directed all business operations, including strategic planning, budgeting, marketing, client acquisition, and regulatory compliance.
- Established referral relationships with physicians, hospitals, and community organizations, contributing to sustainable business growth.
- Developed organizational policies, procedures, and operational workflows to ensure safe and efficient service delivery.
- Coordinated client intake, care planning, and scheduling to enhance client and family experiences through effective ongoing communication.
- Implemented quality assurance measures to elevate care standards and ensure compliance with industry best practices.
- Ensured compliance with Florida regulations, documentation requirements, and industry best practices for respite care and skilled nursing services.
Registered Nurse Consultant (PRN)
CSI Caregivers for Home Health
Wesley Chapel, Florida
05.2026 - Current
- Performed comprehensive clinical assessments and evaluated care plans to ensure quality outcomes.
- Delivered skilled nursing consultation to enhance care for Medicare-certified home health patients.
- Ensured compliance with Medicare regulations and clinical documentation standards.
- Worked with interdisciplinary teams to improve patient safety and ensure continuity of care.
Quality Improvement Nurse
Humana
Remote
05.2022 - 09.2025
- Achieved successful three-year AAACH accreditation as subject matter expert in UM, CM, and credentialing.
- Managed clinical necessity reviews and level-of-care determinations using MCG and InterQual tools, ensuring adherence to best practices.
- Audited medical necessity pathways to ensure 100% compliance with CMS regulations and Medicaid mandates.
- Analyzed documentation trends and implemented initiatives to close care gaps, positively impacting corporate STAR measures.
- Guided provider groups in quality improvement protocols using Lean methodologies, resulting in enhanced operational workflows.
- Collaborated with leadership teams to streamline utilization metrics and achieve performance benchmarks.
Quality Compliance Nurse (Contract)
Humana
Remote
01.2022 - 05.2022
- Executed medical record reviews to enhance coordination of care studies.
- Maintained HEDIS databases to ensure accurate reporting.
- Provided patient care by assessing needs and administering medications.
- Collaborated with healthcare team to develop patient care plans.
- Educated patients on health management and preventive care strategies.
Emergency Department Registered Nurse
Advent Health Wesley Chapel Hospital
Wesley Chapel, Florida
04.2020 - 02.2022
- Acuity Care: Provided comprehensive emergency care for diverse age groups (neonates to geriatrics) in high-pressure environment.
- Assessment & Evaluation: Conducted thorough patient assessments, ensuring delivery of safe, compassionate, evidence-based care.
- Provided compassionate patient care in fast-paced hospital environment.
- Administered medications and treatments as prescribed by physicians.
- Collaborated with multidisciplinary teams to develop patient care plans.
Emergency Department Registered Nurse
HCA Brandon Regional Hospital
Brandon, FL
07.2019 - 07.2020
- Critical Care: Delivered patient care in fast-paced environment, exercising decisive judgment and working autonomously.
- Clinical Implementation: Developed and assessed nursing action plans, ensuring safe and competent care delivery.
- Provided direct patient care in various departments to ensure comfort and safety.
- Administered medications and monitored patient responses for effective treatment outcomes.
- Collaborated with multidisciplinary teams to develop and implement care plans.
Cloud Product Manager / Marketing Manager
Bisk Education
Tampa, FL
01.2013 - 12.2017
- Led $5 million technology initiative, managing requirements, vendor relationships, implementation strategy, testing, and deployment.
- Collaborated with software engineering, IT infrastructure, sales leadership, marketing, and executive leadership to deliver scalable cloud-based solutions that met evolving business needs.
- Executed successful implementation and launch of enterprise CTI integration into Salesforce, transforming sales and customer engagement operations.
- Managed front-end and back-end telephony systems, ensuring seamless support for enterprise contact center operations.
- Utilized data analytics and continuous process improvement methodologies to enhance operational performance and customer experience.
Director of Business Development (Contract)
Sourcetoad
Tampa, Florida
2017 - 2017
- Developed strategic partnerships to enhance business growth and market reach.
- Led negotiation processes with potential clients to secure agreements.
- Conducted market research to identify new business opportunities and trends.
- Collaborated with cross-functional teams to align business objectives and initiatives.
Founder & Chief Executive Officer
AllyCat Desserts LLC
Tampa, FL
2010 - 2014
Director of Marketing & Operations
Ice Cold Air
Tampa, FL
2011 - 2013
Account Executive & Office Manager
Winkles Law Group
Tampa, FL
2003 - 2010
- Focus on personal injury claims, medical malpractice, and disability.
Education
Bachelor of Science - Nursing
Rasmussen College
Tampa, FL06-2019
Master of Business Administration -
The University of Tampa
Tampa, FL12-2011
Bachelor of Arts - Communications
University of South Florida
Tampa05-2009
Skills
- CMS, NCQA, and HIPAA compliance
- AAAHC accreditation
- HEDIS and STAR measures
- MIPS
- Regulatory compliance
- Quality assurance
- Clinical documentation integrity
- DRG and ICD accuracy
- Utilization management
- Case management
- Lean Six Sigma certified
- Process improvement
- Audit management
- Data-driven quality improvement
- Performance metrics
- Strategic planning
- Project management
- Telehealth services
- Population health strategy
- Product strategy
Certification
- Registered Nurse (RN), Active multi-state compact license (FL Board of Nursing, Lic. #9516648)
- Basic Life Support (BLS), American Heart Association
- Lean Leader Certification, Humana, 2023LL000076
Timeline
Registered Nurse Consultant (PRN)
CSI Caregivers for Home Health
05.2026 - Current
Founder & Chief Executive Officer
Anchor & Aid Respite Care LLC
03.2026 - Current
Clinical Quality Manager
Harbor Health
09.2025 - Current
Quality Improvement Nurse
Humana
05.2022 - 09.2025
Quality Compliance Nurse (Contract)
Humana
01.2022 - 05.2022
Emergency Department Registered Nurse
Advent Health Wesley Chapel Hospital
04.2020 - 02.2022
Emergency Department Registered Nurse
HCA Brandon Regional Hospital
07.2019 - 07.2020
Cloud Product Manager / Marketing Manager
Bisk Education
01.2013 - 12.2017
Director of Business Development (Contract)
Sourcetoad
2017 - 2017
Founder & Chief Executive Officer
AllyCat Desserts LLC
2010 - 2014
Director of Marketing & Operations
Ice Cold Air
2011 - 2013
Account Executive & Office Manager
Winkles Law Group
2003 - 2010
Bachelor of Science - Nursing
Rasmussen College
Master of Business Administration -
The University of Tampa
Bachelor of Arts - Communications
University of South Florida