Knowledgeable Quality Improvement Specialist passionate about maximizing patient care standards in Managed Care environments. Mentally sharp professional with 20+ years of behavioral healthcare experience.
Overview
22
22
years of professional experience
Work History
Quality Improvement Specialist
Eastpointe Human Services
Lumberton, NC
04.2018 - Current
Conducted audits of a variety of Managed Care processes, including Claims, Care Coordination, Call Centers, and Provider Network, ensuring adherence to quality standards and regulations.
Collaborated with cross-functional teams to identify opportunities for continuous improvement.
Data Analyst
Eastpointe Human Services
Lumberton, NC
12.2014 - 03.2018
Enhanced business efficiency by identifying trends and patterns in complex datasets.
Streamlined data processing for faster results by implementing advanced analytics tools.
Improved decision-making processes with accurate data analysis and visualization techniques.
Collaborated with cross-functional teams to ensure data integrity and accuracy, resulting in better-informed decisions.
Claims Quality Analyst
Eastpointe Human Services
Lumberton, NC
01.2013 - 11.2014
Developed and implemented claims auditing process.
IPRS Funding Specialist
Eastpointe Human Services
Lumberton, NC
07.2012 - 12.2012
Processing and Review of invoices for State and County Funding.
Tracking expenditures of State and County Funded services against approved budgets.
Reimbursement Officer I
Southeastern Regional Mental Health, DD/SAS
Lumberton, NC
08.2007 - 06.2012
Supervised, directed and evaluated staff members of Reimbursement Department
Improved overall department efficiency by streamlining processes and implementing new policies.
Enhanced communication between provider network by organizing regular meetings and fostering open dialogue.
Administrative Assistant
University Of North Carolina At Pembroke
Pembroke, NC
01.2007 - 06.2007
Enhanced office efficiency by streamlining administrative processes and implementing organizational systems.
Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents.
Ensured accurate record-keeping with diligent data entry and database management for Sponsored Research and Programs Department.
Patient Relations Rep IV - V
Southeastern Regional Mental Health, DD/SAS
Lumberton, NC
07.2002 - 01.2007
Processing remittance advice.
Researching and correcting denied claims.
Data entry and submission of IPRS member target population/eligibility data.
Quality Specialist-Plant Focused Improvement Team Leader at Goodyear Tire and Rubber CompanyQuality Specialist-Plant Focused Improvement Team Leader at Goodyear Tire and Rubber Company