Betsy Simpson

Mission-driven healthcare professional specializing in Quality Compliance and Improvement. Experienced leader-doer with the enthusiasm grow teams while also thriving in day-to-day deliverables. Supportive educator with a deep passion to improve the healthcare experience. Motivated thought-partner for efficient and effective design while preserving integrity. Expert in long-term strategizing with the ability to translate into short-term goal planning. Skillful at gathering, analyzing and defining business and functional requirements; assessing improvement opportunities; implementing interventions, creating and translating global metrics for optimal transparency; and designing/re-engineering processes, workflows and technology solutions for business systems and process. Operational Excellence professional with more than 25 years of experience in Program Strategy, Development and Effectiveness Analysis, Project Management, Process Development, Process Efficiency, People Management at the local, regional and national level for both start-up and established corporations.

Certified Professional of Healthcare Quality (CPHQ), 2022

Quality Improvement strategy: Centers for Medicare and medicaid

Technical Expertise Panel: 2014-2016

· National panel for developing policy to meet the ACA Quality Improvement Strategy

· Collaborate with NCQA, CMS and Booz Allen Hamilton

NATIONAL ALLIANCE OF STATE HEALTH co-OPS (NASHCO)

Quality and Accreditation Work group, Chair: 2013-2016

· Coordinate vendor collaboration activities

· Coordinate educational opportunities: CMS, QHP, NCQA

· Administer shared resource pool for policies and documentation

· Lead bi-weekly information sharing conference calls

NATIONAL COMMITTEE FOR QUALITY ASSURANCE

NASHCO representative for Health Plan Advisory Council: 2015

· Communicate between health plans and NCQA regarding standards for accreditation

· Create understanding and collaboration for accrediting bodies

• Quality Improvement Strategy: Centers for Medicare and Medicaid, Technical Expertise Panel, 2014, 2016
• National Alliance of State Health Co-ops (NASHCO), Quality and Accreditation Work group, Chair, 2013, 2016
• National Committee for Quality Assurance, NASHCO representative for Health Plan Advisory Council, 2015

• Healthcare Program Strategy
• Process Improvement and Logistics Management
• Data Analysis and Interpretation for Executive Leadership
• Relationship Management for Cross-departmental collaboration and design
• NCQA Health Plan Accreditation: Medicaid, Commercial, Marketplace, Medicare Advantage D-SNP
• NCQA Case Management Accreditation, Disease Management Accreditation
• HEDIS, CAHPS, Stars, QRS, QHP Surveys and Requirements
• People Management and Professional Development
• CMS Quality Improvement Activities (QIP), Performance Improvement Projects (PIPS)
• Health Plan Quality Improvement Development
• Credentialing Management
• Delegation Oversight
• Vendor Contracting and Management Team Management (Remote and local)
• Technical Writing (Policy/Procedures/SOPs/Manuals/System Specifications)
• Business Development
• Budget Maintenance and Control
• Data Flow & Process Mapping
• Intervention Development
• Program/Project Manager
• Database Design & Management
• Major Software/Systems Implementations
• Application Support, Quality Assurance and Training

Title: MHA, CPHQ