Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Brittany McGahee

Lithonia,GA

Summary

Detail-oriented Health Plan Operations and Quality Improvement Professional with over 6 years in healthcare, specializing in Medicaid, Medicare, and various populations. Skilled in managing complex programs, documentation, and cross-functional collaboration to drive initiatives from planning to implementation. Lean Six Sigma Green Belt dedicated to enhancing healthcare performance and operational efficiency.

Overview

1
1
Certification
9
9
years of professional experience

Work History

Quality Improvement Specialist II

Centene Corporation - Meridian Health Plan (IL)
12.2022 - 09.2026
  • Led a multi-year Medicaid Transportation Performance Improvement Project (PIP) that achieved a 100% validation score and 'High Confidence' rating from HSAG; coordinated vendor oversight, reporting review, issue identification, and corrective follow-through.
  • Supported a Medicare Quality Improvement Project (QIP) that achieved a 94% validation score and independently completed a Health Risk Assessment (HRA)-focused PIP through final submission in August 2026.
  • Coordinated quality improvement initiatives across multiple departments while ensuring project deliverables remained compliant with regulatory expectations leading to several behavioral health measures improving into the 75th and 90th percentile for Youthcare, Medicare and Medicaid.
  • Led Chronic Conditions EPC workgroup, improving Controlling Blood Pressure (CBP) measure to 50th percentile for Medicaid and 75th percentile for Medicare.
  • Led quality reviews and operational assessments to identify process gaps, compliance risks, and improvement opportunities within Medicaid, Medicare, DSNP, Youthcare, and Ambetter lines of business.
  • Conducted root cause investigations using operational data, stakeholder interviews, and performance trends to identify underlying causes of quality issues.
  • Led vendor performance oversight for transportation operations, improving reporting accuracy by 10% and accountability through monthly enhanced quality monitoring.
  • Developed audit summaries, quality reports, dashboards, and presentations for senior leadership to inform decision-making and strategic planning.
  • Independently evaluated performance metrics and quality indicators to identify operational risks and recommend corrective actions.
  • Analyzed quality data to identify care gaps, trends, and opportunities for process optimization.
  • Led quality improvement initiatives supporting HEDIS, CAHPS, and NCQA performance across health plan operations.
  • Applied Lean process improvement principles to strengthen operational workflows and improve reporting accuracy.
  • Presented quality findings, recommendations, and project updates to executive leadership and cross-functional stakeholders.

Health Education Specialist

Centene Corporation - Peach State Health Plan (GA)
07.2020 - 12.2022
  • Supported enterprise quality initiatives through data validation and regulatory performance monitoring, enhancing accuracy of quality reporting.
  • Conducted needs assessments and quality reviews to pinpoint operational improvement opportunities, facilitating targeted interventions.
  • Conducted needs assessments and quality reviews to identify operational improvement opportunities.
  • Evaluated healthcare utilization trends and quality metrics, informing strategies for population health initiatives.
  • Supported enterprise quality initiatives through data validation, quality reporting, and regulatory performance monitoring.
  • Produced analytical reports supporting organizational quality initiatives and leadership decision-making.
  • Assisted with implementation and monitoring of quality improvement projects.

Health Education Specialist (Contract)

Healthcare Support Staffing
11.2019 - 07.2020
  • Delivered evidence-based education to empower members in managing chronic conditions.
  • Evaluated utilization patterns and quality outcomes to inform program enhancements.
  • Conducted outreach and monitored performance to ensure adherence to care plans.
  • Conducted outreach and performance monitoring.
  • Prepared reports supporting quality improvement initiatives.

Case Manager

Ace Care Management
04.2019 - 11.2019
  • Oversaw quality for individualized support plans to enhance client outcomes.
  • Monitored services and reviewed documentation to ensure compliance with standards.
  • Evaluated service delivery and implemented corrective actions where appropriate.
  • Evaluated service delivery and implemented corrective actions.
  • Managed quality oversight for individualized support plans.

Support Coordinator

Professional Case Management Services of America
04.2017 - 03.2018
  • Managed individualized support services for 50 adults with developmental disabilities, enhancing their quality of life and independence.
  • Coordinated multidisciplinary healthcare teams to ensure comprehensive care delivery and improve client outcomes.
  • Conducted community assessments and monitored service quality to align services with client needs and regulatory requirements.
  • Supported compliance with quality and regulatory standards.

Education

Master of Public Health - Public Health

Argosy University
Atlanta, Georgia
12-2016

Bachelor of Arts - Psychology

Spelman College
Atlanta, Georgia
05-2012

Skills

  • Quality Improvement Methodologies
  • Program & Project Management
  • Compliance auditing
  • Healthcare Quality Initiatives
  • Reporting & Data Validation
  • Audit compliance
  • Operational Tracking & Documentation
  • Vendor Management
  • Stakeholder Management
  • Population Health
  • Lean six sigma
  • Innovation and creativity

Certification

  • Lean Six Sigma Green Belt (LSSGB) - Six Sigma Global Institute (June 2026)

Timeline

Quality Improvement Specialist II

Centene Corporation - Meridian Health Plan (IL)
12.2022 - 09.2026

Health Education Specialist

Centene Corporation - Peach State Health Plan (GA)
07.2020 - 12.2022

Health Education Specialist (Contract)

Healthcare Support Staffing
11.2019 - 07.2020

Case Manager

Ace Care Management
04.2019 - 11.2019

Support Coordinator

Professional Case Management Services of America
04.2017 - 03.2018

Bachelor of Arts - Psychology

Spelman College

Master of Public Health - Public Health

Argosy University

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Brittany McGahee