Summary
Overview
Work History
Education
Skills
Timeline
Generic

CANDIS THOMPSON

Fort Worth,TX

Summary

Self motivated professional well-versed in collecting and analyzing data to evaluate interventions and programs. Skilled in creating and maintaining accurate patient records and medical documentation. Creates positive, collaborative working environment with colleagues and other healthcare providers to support delivery of optimal patient care

Overview

9
9
years of professional experience

Work History

Nurse Case Management Lead Analyst

Cigna Healthsprings
08.2020 - 03.2023
  • Assist the STARs team with member outreach and record retrieval as needed
  • Work closely with STARs team regarding quality measures and strategies for closing gaps
  • Participated in internal audits regarding quality management system.
  • Investigated system issues and implemented resolutions to reduce downtime.

Quality HEDIS Abstractor/Reviewer

CHRISTUS Health
12.2019 - 06.2022
  • Assisted in the development of new HEDIS/STARS interventions and corrective action plans for measures that fall below goals
  • Supported quality improvement program studies requesting records from providers, maintaining databases, and researching to identify members' provider encounter history
  • Worked collaboratively with Data Analyst to develop stronger and more real-time EMR integration efforts
  • Provided clinical expertise to Medical groups and key high volume providers, which will include but not limited to,
  • HEDIS/STAR measures education, gap listing engagement, workflow process improvements, improved documentation practices
  • Applied Knowledge of CPT codes, ICD-10 Diagnosis codes and HEDIS Technical Specification Requirements related to the HEDIS measures for data extraction when applicable
  • Conducted quality improvement and customer satisfaction surveys to evaluate patient care.
  • Retrieved medical data for physicians and patients.

Case Management Analyst

Cigna Healthsprings
03.2019 - 11.2019
  • Provided advocacy, information and referral services to members, member’s families, and providers to address their medical and psycho-social needs
  • Completed and implement a comprehensive individualized service plan on each member
  • Conducted health risk assessments and supplemental condition specific assessments
  • Participated in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as a member of the healthcare team
  • Maintained a daily caseload as assigned for telephonic outreach
  • Acted as a liaison and facilitates the coordination of benefits and resources.

LVN Quality HEDIS Coordinator

United Healthcare
08.2016 - 12.2018
  • Analyzed data, evaluate for possible data integrity and data deficits and document findings and trends with
  • HEDIS/STAR rates within in a clinic setting
  • Responsible for educating clinic staff on quality measures and strategies for closing gaps
  • Obtained quality detail report for providers and flags patient’s charts with the missing measures
  • Worked closely with local leadership to execute quality strategies
  • Supported and assists PCPs/clinics with quality data collection
  • Gained skillful knowledge with multiple EMR systems

LVN Case Manager

ResCare Inc
06.2015 - 08.2016
  • Managed care for IDD clients in an ICF/HCS group home setting

Internal Medicine Clinic Nurse

LCMC
05.2014 - 05.2015
  • Adhered to healthcare facility protocols and all regulations.
  • Counseled patients on newly diagnosed health conditions and maintenance of existing conditions.
  • Followed clinical guidelines while treating internal medicine patients.
  • Attended appointments with 12-15 different patients per day.

Education

Practical Nursing Certificate -

Delta College
2013

Skills

  • Regulatory Reporting Requirements
  • Write Reports
  • Trend Data Analysis
  • Work Organizing and Prioritizing
  • Timely Project Completion
  • Electronic Medical Record Software
  • Data Research and Analysis
  • Management Team Support
  • Quality Assurance
  • Quality Improvement Plans
  • Quality Reporting
  • Data Abstraction
  • Medical Records Review
  • Charting and Clinical Documentation

Timeline

Nurse Case Management Lead Analyst

Cigna Healthsprings
08.2020 - 03.2023

Quality HEDIS Abstractor/Reviewer

CHRISTUS Health
12.2019 - 06.2022

Case Management Analyst

Cigna Healthsprings
03.2019 - 11.2019

LVN Quality HEDIS Coordinator

United Healthcare
08.2016 - 12.2018

LVN Case Manager

ResCare Inc
06.2015 - 08.2016

Internal Medicine Clinic Nurse

LCMC
05.2014 - 05.2015

Practical Nursing Certificate -

Delta College

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CANDIS THOMPSON