Summary
Overview
Work History
Education
Skills
Timeline
Generic

Calisha Crowder

GA

Summary

Experienced HEDIS Specialist with background in quality improvement initiatives and healthcare audits. Strengths include thorough knowledge of NCQA standards, adeptness at data collection and analysis, and strong communication skills for effective patient education. Previous work has shown significant impact on improving healthcare quality measures and achieving organizational goals.

Overview

17
17
years of professional experience

Work History

Analyst Outreach Coordinator

Aetna, CVS Health
03.2023 - Current
  • Develops comprehensive reports and presentations to communicate key findings and recommendations to stakeholders, ensuring actionable insights for healthcare management
  • Engages with members via phone to educate on the significance of healthcare screenings and coordinates appointments, enhancing patient-provider interactions and care continuity
  • Analyzes survey data to discern member engagement patterns, contributing to informed decision-making and strategic planning for health services improvement
  • Conducted outbound calls to providers in order to obtain additional information needed for accurate reporting of HEDIS measure results.
  • Provided education and training to staff related to HEDIS measures and standards.
  • Developed detailed reports regarding HEDIS performance, including areas of improvement.
  • Interpreted complex coding rules when abstracting medical records into specific fields required by the NCQA standards.
  • Maintained up-to-date knowledge of all applicable regulations, guidelines, and accreditation requirements pertaining to HEDIS measures.
  • Fosters collaborative partnerships with healthcare providers, promoting adherence to HEDIS measures and compliance with quality assurance standards
  • Initiate projects, plan, and manage deliverables, while communicating project progress to key stakeholders.
  • Analyzed data from multiple sources such as EMRs, claims systems, and other external databases to ensure accuracy of reported metrics.
  • Reviewed medical records to identify and gather necessary data for HEDIS measures.

Educator

Gwinnett County Public School System
Snellville, GA
07.2019 - 06.2023
  • Developed and implemented customized lesson plans to address diverse student needs, enhancing individual learning outcomes
  • Fostered a positive educational atmosphere by cultivating strong relationships with students, ensuring a conducive environment for learning
  • Pioneered the integration of multimedia tools into the curriculum, enriching the educational experience and accommodating various learning styles
  • Collaborated with peers to exchange effective teaching strategies and actively involved parents in their children's academic progress through consistent communication.

Educator

Savannah Chatham County Public Schools
Savannah, GA
07.2014 - 06.2019
  • Designed and facilitated professional development sessions to enhance staff competencies in instructional strategies and resource utilization
  • Tailored instructional approaches by incorporating a range of educational programs and online tools, ensuring accessible and differentiated support for student learning
  • Fostered an inclusive classroom atmosphere that promoted academic and social growth, and utilized assessment data to refine teaching methods for improved student outcomes.

Shift Supervisor

AMF Bowling
Savannah, GA
09.2007 - 11.2011
  • Delivered comprehensive training to new employees, emphasizing adherence to safety and sanitation standards
  • Managed financial responsibilities, including accurate cash counting, register balancing, and preparation of bank deposits
  • Provided customer assistance with product selections and promoted offerings to enhance sales through effective communication of promotions and pricing.

Outreach Coordinator

Savannah State University
Savannah, GA
07.2009 - 01.2011
  • Managed the organization of community events, enhancing public awareness of services offered, and maintained comprehensive records of outreach activities, including event outcomes
  • Developed and executed promotional campaigns to boost engagement with target demographics, ensuring increased interest in organizational services
  • Delivered exceptional customer service, both in-person and via telephone, while providing vital support to team members in outreach-related tasks, including strategy assessment.
  • Assisted with the coordination of inpatient and outpatient medical services.
  • Educated patients on available medical resources and helped them access community assistance programs.
  • Reviewed relevant literature related to healthcare trends in order to stay informed about current best practices.

Education

Master of Science - Public Health

Southern New Hampshire University
12.2018

Master of Arts - Education

Armstrong Atlantic State University
12.2013

Bachelor of Science - Biology

Savannah State University
05.2005

Skills

  • Patient Care Coordination
  • Healthcare management
  • HIPAA knowledge
  • Clinical Documentation
  • Quality improvement initiatives
  • Workflow efficiency
  • Adaptability and Flexibility
  • Organizational Skills
  • Project Planning
  • Meeting facilitation
  • Records Management
  • Technology Implementation
  • Proficiency in Microsoft Office
  • Proficiency in Google Suite

Timeline

Analyst Outreach Coordinator

Aetna, CVS Health
03.2023 - Current

Educator

Gwinnett County Public School System
07.2019 - 06.2023

Educator

Savannah Chatham County Public Schools
07.2014 - 06.2019

Outreach Coordinator

Savannah State University
07.2009 - 01.2011

Shift Supervisor

AMF Bowling
09.2007 - 11.2011

Master of Science - Public Health

Southern New Hampshire University

Master of Arts - Education

Armstrong Atlantic State University

Bachelor of Science - Biology

Savannah State University
Calisha Crowder